Why the study?
Implantable sub-scalp EEG systems show promise for long-term seizure monitoring in epilepsy, but how automated seizure detection performance varies by montage configuration is unknown.
Does automated seizure detection performance differ between full and reduced montages in patients with epilepsy?
Population
436 patients (466 admissions) with at least one annotated seizure and one interictal clip
Comparison
Full vs reduced montages simulating published sub-scalp devices
Design
Single-center retrospective cross-sectional simulation study
Key result
Automated seizure detection using simulated reduced-channel montages showed only modest performance decreases (absolute F1 change -0.09 to 0.014) compared to full montages.
Authors
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May support sub-scalp device feasibility for long-term monitoring; leaves open prospective validation before clinical use.
Cross-Sectional (n=436)
No
Does automated seizure detection performance differ between full and reduced montages in patients with epilepsy?
Effect estimate: absolute F1 change -0.09 to 0.014
Automated seizure detection algorithms perform with comparable accuracy on reduced-channel montages simulating sub-scalp devices, supporting their feasibility for ultra-long-term monitoring.
Kojima et al. (2026) conducted a cross-sectional in Epilepsy (n=436). Reduced montages simulating published sub-scalp devices vs. Full montage (standard 10-20 EEG channels) was evaluated on Event-based F1 scores evaluated for three published seizure detectors (absolute F1 change -0.09 to 0.014). Automated seizure detection using simulated reduced-channel montages showed only modest performance decreases (absolute F1 change -0.09 to 0.014) compared to full montages.