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This is Henry,
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a cute boy,
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and when Henry was three,
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his mom found him having
some febrile seizures.
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Febrile seizures are seizures that occur
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when you also have a fever,
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and the doctor said,
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"Don't worry too much.
Kids usually outgrow these."
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When he was four,
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he had a convulsive seizure,
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the kind that you lose consciousness
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and shake,
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generalized tonic-clonic seizure,
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and while the diagnosis of epilepsy
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was in the mail,
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Henry's mom went to get him
out of bed one morning,
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and as she went in his room,
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she found his cold, lifeless body.
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Henry died of SUDEP,
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Sudden Unexpected Death in Epilepsy.
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I'm curious how many of you
have heard of SUDEP?
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This is a very well-educated audience,
and I see only a few hands.
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SUDEP is when an otherwise
healthy person with epilepsy
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dies and they can't attribute it
to anything they can find in an autopsy.
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There is a SUDEP
every seven to nine minutes.
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That's on average two per TED Talk.
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Now, a normal brain
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has electrical activity.
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You can see some of the electrical waves
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coming out of this picture
of a brain here.
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And these should look
like typical electrical activity
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that an EEG could read on the surface.
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When you have a seizure,
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it's a bit of unusual electrical activity,
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and it can be focal.
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It can take place in just
a small part of your brain.
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When that happens,
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you might have a strange sensation.
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One could be happening,
several could be happening
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here in the audience right now
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and the person next to you
might not even know.
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However, if you have a seizure
where that little brush fire
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spreads like a forest fire over the brain,
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then it generalizes,
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and that generalized seizure
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takes your consciousness away
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and causes you to convulse.
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There are more SUDEPs
in the United States every year
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than Sudden Infant Death Syndrome.
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Now, how many of you have heard
of Sudden Infant Death Syndrome.
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Right? Pretty much every hand goes up.
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So what's going on here?
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Why is this so much more common
and yet people haven't heard of it?
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And what can you do to prevent it?
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Well, there are two things
scientifically shown
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that prevent or reduce the risk of SUDEP.
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The first is follow
your doctor's instructions,
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take your medications.
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Two thirds of people who have epilepsy
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get it under control
with their medications.
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the second thing that reduces
the risk of SUDEP is companionship.
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It's having somebody there
at the time that you have a seizure.
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Now, SUDEP, even though
most of you have never heard of it,
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is actually the number two cause
of years of potential life lost
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of all neurological disorders.
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The vertical axis is the number of deaths
times the remaining lifespan,
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so higher is much worse impact.
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SUDEP, however, unlike these others
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is something that people right here
could do something to push that down.
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Now, what is Ros Picard, an AI researcher,
doing here telling you about SUDEP? Right?
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I'm not a neurologist.
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When I was working at the Media Lab
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on measurement of emotion,
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trying to make our machines
more intelligent about our emotions,
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we started doing a lot of work
measuring stress.
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We built lots of censors
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that measured it
in lots of different ways.
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But one of them in particular
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grew out of some of this very old work
with measuring sweaty palms
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with an electrical signal.
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This is a signal of skin conductance
that's known to go up
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when you get nervous,
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but it turns out it also goes up with
a lot of other interesting conditions.
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But measuring it with wires on your hand
is really inconvenient.
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So we invented a bunch of other ways
of doing this at the MIT Media Lab,
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And with these wearables,
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we started to collect the first ever
clinical quality data 24/7.
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Here's a picture of what that looked like
the first time that an MIT student
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collected skin conductance
on the wrist 24/7.
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Let's zoom in a little bit here.
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What you see is 24 hours
from left to right,
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and here is two days of data,
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and first what's surprised us
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is the sleep was
the biggest peak of the day.
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Now, that sound broken. Right?
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You're calm when you're asleep,
so what's going on here?
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Well, it turns out that
our physiology during sleep
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is very different than
our physiology during wake,
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and while there's still a bit of a mystery
why these peaks are usually
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the biggest of the day during sleep,
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we now believe they're related
to memory consolidation
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and memory formation during sleep.
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We also saw things that were
exactly what we expected.
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When an MIT student
is working hard in the lab
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or on homework,
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there is not only emotional stress,
but there's cognitive load,
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and it turns out that cognitive load,
cognitive effort, mental engagement,
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excitement about learning something,
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those things also make the signal go up.
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Unfortunately, to the embarrassment
of the MIT professors,
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the low point every day
is classroom activity.
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Now, I am just showing you
one person's data here,
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but this unfortunately is true in general.
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This sweatband has inside it
a home-built skin conductance sensor,
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and one day, one of our undergrads
knocked on my door
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right at the end of the December semester,
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and he said, "Professor Picard,
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can I please borrow
one of your wrist band sensors?
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My little brother has autism,
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he can't talk,
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and I want to see
what's stressing him out."
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And I said, "Sure, in fact,
don't just take one, take two,"
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because they broke easily back then.
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So he took them home,
he put them on his little brother.
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Now, I was back in MIT
looking at the data on my laptop,
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and the first day, I thought,
hmm, that's on,
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he put them on both wrists
instead of waiting for one to break.
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OK, fine, don't follow my instructions.
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I'm glad he didn't.
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Second day, chill,
looked like classroom activity.
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A few more days ahead.
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The next day, one missed signal was flat
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and the other had
the biggest peak I've ever seen,
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and I thought, what's going on?
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We've stressed people out at MIT
every way imaginable.
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I've never seen a peak this big.
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And it was only on one side.
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How can you be stressed on one side
of your body and not the other?
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So I thought one or both
sensors must be broken.
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Now, I'm an electro engineer by training,
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so I started a whole bunch of stuff
to try to debug this,
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and long story short,
I could not reproduce this.
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So I resorted to old-fashioned debugging.
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I called the student at home on vacation.
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"Hi, how's your little brother?
How's your Christmas?
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Hey, do you have any idea
what happened to him?"
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And I gave this particular date and time,
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and the data.
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And he said, "I don't know,
I'll check the diary."
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Diary? MIT student keeps a diary?
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So I waited and he came back.
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He had the exact date and time,
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and he says, "That was right before
he had a grand mal seizure."
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Now, at the time, I didn't know
anything about epilepsy,
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and did a bunch of researcher,
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realized that another student's dad
is chief of neurosurgery
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at Children's Hospital Boston,
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screwed up my courage
and called Dr. Joe Madsen.
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"Hi, Dr. Madsen,
my name's Rosalind Picard.
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Is it possible somebody could have
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a huge sympathetic
nervous system surge" --
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that's what drives the skin conductance --
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"20 minutes before a seizure?"
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And he says, "Probably not."
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He says, "It's interesting.
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We've had people whose hair
stands on end on one arm
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20 minutes before a seizure."
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And I'm like, "On one arm?"
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I didn't want to tell him that initially
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because I thought this was too ridiculous.
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He explained how
this could happen in the brain,
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and he got interested.
I showed him the data.
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We made a whole bunch more devices,
got them safety certified,
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90 families were being enrolled in a study
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all with children who were going
to be monitored 24/7
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with gold standard EEG on their scalp
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for reading the brain activity,
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video to watch the behavior,
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electrocardiogram ECG,
and now EDA, electrodermal activity,
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to see if there was
something in this periphery
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that we could easily pick up
related to a seizure.
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We found in 100 percent
of the first batch of grand mal seizures
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these whopper of responses
in the skin conductance.
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The blue in the middle, the boy's sleep,
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is usually the biggest peak of the day.
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These three seizures you see here
are popping out of the forest
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like redwood trees.
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Furthermore, when you couple
these skin conductance at the top
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with the movement from the wrist
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and you get lots of data
and train machine learning and AI on it,
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you can build an automated AI
that detects these patterns
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much better than just
a shake detector can do.
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So we realized that we needed
to get this out,
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and with the PhD work
of ??
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and later great
improvements by Empatica,
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this has made progress and the seizure
detection is much more accurate.
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But we also learned some other things
about SUDEP during this.
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One thing we learned
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is that SUDEP is,
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while it's rare after
a generalized tonic-clonic seizure,
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that's when it's most likely
to happen after that type,
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and when it happens,
it doesn't happen during the seizure,
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and it doesn't usually happen
immediately afterwards,
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but immediately afterwards when the person
just seems very still and quite,
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they may go into another phase
where the breathing stops,
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and then after the breathing stops,
later the heart stops.
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So there's some time
to get somebody there.
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We also learned that there is a region
deep in the brain called the amygdala,
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which we had been studying
in our emotion research a lot.
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We have two amygdalas,
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and if you stimulate the right one,
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you get a big right
skin conductance response.
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Now, you have to sign up right now
for a craniotomy to get this done,
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not exactly something
you're going to volunteer to do,
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but it causes a big right skin
conductance response.
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Stimulate the left one, big left
skin conductance response on the palm.
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And furthermore,
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when somebody stimulates your amygdala
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while you're sitting there
and you might just be working,
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you don't show any signs of distress,
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but you stop breathing,
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and you don't start again
until somebody stimulates you.
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"Hey, Ros, are you there?"
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And you open your mouth to talk.
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As you take that breath to speak,
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you start breathing again.
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So we had started with work on stress,
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which had enabled us
to build lots of sensors
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that were gathering
high quality enough data
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that we could leave the lab
and start to get this in the wild,
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accidentally found a whopper
of a response with the seizure,
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neurological activation that can cause
a much bigger response
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than traditional stressors,
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lots of partnership with hospitals
and an epilepsy monitoring unit,
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especially Children's Hospital Boston
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and the Brigham,
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and machine learning and AI on top of this
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to take and collect lots more data
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in service of trying
to understand these events
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and if we could prevent SUDEP.
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This is now commercialized by Empatica,
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a startup that I had
the privilege to cofound,
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and the team there has done an amazing job
improving the technology
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to make a very beautiful sensor
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that not only tells time and does steps
and sleep and all that good stuff,
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but this is running real time
AI and machine learning
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to detect generalized
tonic-clonic seizures
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and send an alert for help
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if I were to have a seizure
and lose consciousness.
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This just got FDA-approved
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as the first smartwatch
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to get approved in neurology.
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(Applause)
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Now the next slide is what made
my skin conductance go up.
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One morning, I'm checking my email
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and I see a story from a mom
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who said she was in the shower
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and her phone was
on the counter by the shower,
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and it said her daughter
might need her help.
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So she interrupts her shower and goes
running to her daughter's bedroom,
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and she finds her daughter
face down in bed blue and not breathing.
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She flips her over, human stimulation,
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and her daughter takes a breath,
and another breath,
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and her daughter turns pink and is fine.
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I think I turned white reading this email.
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My first response is,
"Oh no, it's not perfect.
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The Bluetooth could break.
The battery could die.
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All these things could go wrong.
Don't rely on this."
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And she said, "It's OK.
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I know no technology is perfect.
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None of us can always
be there all the time.
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But this, this device plus AI
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enabled me to get there in time
to save my daughter's life.
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Now, I've been mentioning children,
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but SUDEP peaks actually among people
in their 20s, 30s, and 40s,
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and the next line I'm going to put up
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is probably going to make
some people uncomfortable,
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but it's less uncomfortable
than we'll all be
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if this list is extended
to somebody you know.
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Could this happen to somebody you know?
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And the reason I bring up
this uncomfortable question
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is because one in 26 of you
will have epilepsy at some point,
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and from what I've been learning,
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people with epilepsy often don't tell
their friends and their neighbors
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that they have it.
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So if you're willing to let them
use an AI or whatever
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to summon you in a moment
of possible need,
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if you would let them know that,
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you could make a difference in their life.
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Why do all this hard work to build AIs?
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A couple of reasons here:
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one is Natasha, the girl who lived,
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and her family wanted me
to tell you her name.
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Another is family
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and the wonderful people out there
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who want to be there to support people
who have conditions
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that they've felt uncomfortable
in the past mentioning to others.
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And the other reason is all of you,
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because we have the opportunity
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to shape the future of AI.
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We can actually change it,
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because we are the ones building it.
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So let's build AI
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that makes everybody's lives better.
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Thank you.
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(Applause)