First smart watch cleared by FDA for use in neurology

Beautiful wearable device brings revolutionary help for people living with epilepsy.

Embrace is a smart watch for Epilepsy Management which uses advanced machine learning to identify convulsive seizures and send alerts to caregivers. It also provides sleep, rest, and physical activity analysis. Empatica

PR Newswire February 05, 2018

Cambridge, Mass. — Empatica Inc has received clearance from the FDA for Embrace, its award-winning smart watch. Embrace uses AI (advanced machine learning) to monitor for the most dangerous kinds of seizures, known as “grand mal” or “generalized tonic-clonic” seizures, and send an alert to summon caregivers’ help.

In a multi-site clinical study, 135 patients diagnosed with epilepsy were admitted to top level IV epilepsy monitoring units for continuous monitoring with video-EEG, while simultaneously wearing an Empatica device. From these patients, 6,530 hours of data were recorded over 272 days, including 40 generalized tonic-clonic seizures. Embrace’s algorithm was shown to detect 100% of the seizures. The trial used the gold standard of comparing to seizures clinically labelled by at least 2 out of 3 independent epileptologists, who examined the video-EEG data without seeing any data used by Embrace.

Embrace stands apart from any seizure detection system in that it measures multiple indicators of a seizure. Its unique property is its use of Electrodermal Activity (EDA), a signal used by stress researchers to quantify physiological changes related to sympathetic nervous system activity, also known as the “fight or flight” response. Embrace had already been approved in Europe as a medical device for seizure monitoring and alert since April 2017.

According to recent estimates by CDC,1 1.2% of the US population suffers from Epilepsy, amounting to around 3.4 million patients, including 470,000 children. Around 35% of these patients do not respond to medication to control their seizures, while another third is only partially responsive to medication.2

Generalized tonic-clonic seizures result in a loss of consciousness and can leave the person in a state of confusion for some time afterwards. Traditionally, clinical trials have had to rely upon patients to self-report in a diary when a seizure happens, a process known to be inaccurate. Over 40% of the most dangerous generalized tonic-clonic seizures are not reported,3 but Embrace’s high sensitivity makes seizure reporting easier and more accurate. The bracelet also sends an alert immediately to a caregiver, to bring help at the time of need.

The field has been waiting for decades for a biomarker alternative to wearing an EEG, that can be automated, used outside of the hospital, and isn’t bulky or cumbersome to wear.

Orrin Devinsky, one of the world’s foremost experts in Epilepsy, Director of the Comprehensive Epilepsy Center at NYU, has seen the shortcomings of traditional systems during his 35+ career. “The FDA approval of the Embrace device to detect major convulsive seizures represents a major milestone in the care of epilepsy patients. Tragically, more than 3000 Americans die each year from Sudden Unexpected Death in Epilepsy (SUDEP) and the Embrace offers the potential to alarm family members and caretakers that a tonic-clonic seizure is occurring. The scientific evidence strongly supports that prompt attention during or shortly after these convulsive seizures can be life-saving in many cases.”

Seizure monitoring research started at the MIT Media Lab with Rosalind Picard, where she is Director of the Affective Computing Group and Chief Scientist at Empatica, and later at Boston’s Children Hospital. “It’s been quite the journey — we have worked for years building wearable stress and emotion sensors, and then accidentally discovered we could pick up changes in the skin elicited by brain activity related to the most dangerous kinds of seizures. It has been very meaningful to see this technology move from the lab into the most accurate, beautiful and easy to use sensor on the market.”

Empatica initially launched Embrace through a crowdfunding campaign in 2015, focusing heavily on high quality design. According to Matteo Lai, Co-Founder and CEO of Empatica, “Medical devices face a huge problem: they’re usually too bulky and uncomfortable, and people simply don’t want to wear them. Empatica took a different path. We wanted to design the world’s first medical device that could win a design award, while being used as a lifesaving product. Patients actually love Embrace and are proud to wear it. We think this has been one of the keys of its success and an interesting lesson for healthcare. Cutting edge technology and good design need to go together.”

About Empatica
Empatica Inc is a MIT Media Lab spin-off, with offices in Cambridge, MA and Milan, Italy. It has 45 employees and designs everything in-house (Hardware, Software, Data Science). It also manufactures a research device, the E4, that has been sold to thousands of institutional partners, including the world’s top hospitals, research institutions and pharmaceutical companies. It has been used in studies for stress, sleep, migraines, depression, and many other conditions.
Embrace is the only FDA-cleared seizure monitoring smart watch that also continuously captures physiological data of interest for general wellbeing, monitoring sleep, stress, and physical activity. Press contact

Source PR Newswire

  1. Epilepsy Prevalence in the United States, National Center for Chronic Disease Prevention and Health Promotion – Division of Population Health in Centers for Disease Control and Prevention
  2. Current issues in the management of epilepsy: the impact of frequent seizures on cost of illness, quality of life, and mortality, Baker GA, Nashef L, van Hout BA. Epilepsia. 1997;38 Suppl 1:S1-8.
  3. The Real Truth Behind Seizure Count, Jorge G Burneo MD MSPH. Epilepsy Curr. 2008 Jul; 8(4): 92–93. doi: 10.1111/j.1535-7511.2008.00251.x
  Further reading

Convulsive seizure detection using a wrist-worn electrodermal activity and accelerometry biosensor, Poh MZ, Loddenkemper T, Reinsberger C, Swenson NC, Goyal S, Sabtala MC, Madsen JR. and Picard RW (2012) Epilepsia, 53: e93–e97. doi:10.1111/j.1528-1167.2012.03444.x

A Wearable Sensor for Unobtrusive, Long-Term Assessment of Electrodermal Activity, Ming-Zher Poh, Nicholas C Swenson, Rosalind W Picard. IEEE Transactions on Biomedical Engineering Volume: 57, Issue: 5, May 2010. DOI: 10.1109/TBME.2009.2038487

Continuous monitoring of electrodermal activity during epileptic seizures using a wearable sensor, Poh MZ, Loddenkemper T, Swenson NC, Goyal S, Madsen JR, Picard RW. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:4415-8. doi: 10.1109/IEMBS.2010.5625988.

iCalm: Measuring electrodermal activity in almost any setting, Elliott Hedman, Oliver Wilder-Smith, Matthew S Goodwin, Ming-Zher Poh, Rich Fletcher, Rosalind Picard. Conf Proc IEEE Affective Computing and Intelligent Interaction and Workshops, ACII 2009. DOI: 10.1109/ACII.2009.5349490

Electrodermal Activity Sensor for Classification of Calm/Distress Condition, Zangróniz R, Martínez-Rodrigo A, Pastor JM, López MT, Fernández-Caballero A. Sensors (Basel). 2017 Oct 12;17(10). pii: E2324. doi: 10.3390/s17102324.

Also see
Embrace is Now an FDA-approved Medical Device! Empatica
A week of a student’s electrodermal activity Joi Ito, MIT Media Lab
This Seizure-Detecting Smartwatch Could Save Your Life IEEE Spectrum

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