Dataset Information

Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings.

ABSTRACT: OBJECTIVE:We aimed at studying the hemodynamic response (HR) to Interictal Epileptic Discharges (IEDs) using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG) and functional Near InfraRed Spectroscopy (fNIRS) recordings. METHODS:The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collodion to achieve prolonged acquisition with high quality signal. fNIRS data analysis was handled with no a priori constraint on HR time course, averaging fNIRS signals to similar IEDs. Cluster-permutation analysis was performed on 3D reconstructed fNIRS data to identify significant spatio-temporal HR clusters. Standard (GLM with fixed HRF) and cluster-permutation EEG-fMRI analyses were performed for comparison purposes. RESULTS:fNIRS detected HR to IEDs for 8/9 patients. It mainly consisted oxy-hemoglobin increases (seven patients), followed by oxy-hemoglobin decreases (six patients). HR was lateralized in six patients and lasted from 8.5 to 30 s. Standard EEG-fMRI analysis detected an HR in 4/9 patients (4/9 without enough IEDs, 1/9 unreliable result). The cluster-permutation EEG-fMRI analysis restricted to the region investigated by fNIRS showed additional strong and non-canonical BOLD responses starting earlier than the IEDs and lasting up to 30 s. CONCLUSIONS:(i) EEG-fNIRS is suitable to detect the HR to IEDs and can outperform EEG-fMRI because of prolonged recordings and greater chance to detect IEDs; (ii) cluster-permutation analysis unveils additional HR features underestimated when imposing a canonical HR function (iii) the HR is often bilateral and lasts up to 30 s.

SUBMITTER: Pellegrino G

PROVIDER: S-EPMC4801878 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings.

Pellegrino Giovanni G Machado Alexis A von Ellenrieder Nicolas N Watanabe Satsuki S Hall Jeffery A JA Lina Jean-Marc JM Kobayashi Eliane E Grova Christophe C

Frontiers in neuroscience 20160322

<h4>Objective</h4>We aimed at studying the hemodynamic response (HR) to Interictal Epileptic Discharges (IEDs) using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG) and functional Near InfraRed Spectroscopy (fNIRS) recordings.<h4>Methods</h4>The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collo ...[more]

PMID: 27047325

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Project description:ObjectiveTo evaluate the diagnostic performance of artificial intelligence (AI)-based algorithms for identifying the presence of interictal epileptiform discharges (IEDs) in routine (20-min) electroencephalography (EEG) recordings.MethodsWe evaluated two approaches: a fully automated one and a hybrid approach, where three human raters applied an operational IED definition to assess the automated detections grouped into clusters by the algorithms. We used three previously developed AI algorithms: Encevis, SpikeNet, and Persyst. The diagnostic gold standard (epilepsy or not) was derived from video-EEG recordings of patients' habitual clinical episodes. We compared the algorithms with the gold standard at the recording level (epileptic or not). The independent validation data set (not used for training) consisted of 20-min EEG recordings containing sharp transients (epileptiform or not) from 60 patients: 30 with epilepsy (with a total of 340 IEDs) and 30 with nonepileptic paroxysmal events. We compared sensitivity, specificity, overall accuracy, and the review time-burden of the fully automated and hybrid approaches, with the conventional visual assessment of the whole recordings, based solely on unrestricted expert opinion.ResultsFor all three AI algorithms, the specificity of the fully automated approach was too low for clinical implementation (16.67%; 63.33%; 3.33%), despite the high sensitivity (96.67%; 66.67%; 100.00%). Using the hybrid approach significantly increased the specificity (93.33%; 96.67%; 96.67%) with good sensitivity (93.33%; 56.67%; 76.67%). The overall accuracy of the hybrid methods (93.33%; 76.67%; 86.67%) was similar to the conventional visual assessment of the whole recordings (83.33%; 95% confidence interval [CI]: 71.48-91.70%; p > .5), yet the time-burden of review was significantly lower (p < .001).SignificanceThe hybrid approach, where human raters apply the operational IED criteria to automated detections of AI-based algorithms, has high specificity, good sensitivity, and overall accuracy similar to conventional EEG reading, with a significantly lower time-burden. The hybrid approach is accurate and suitable for clinical implementation.

Project description:ObjectiveThis study was undertaken to evaluate the influence that subject-specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy.MethodsOne hundred fifty subjects with intracranial electrodes performed multiple sessions of a free recall memory task; this standardized task controlled for subject attention levels. We utilized a dominance analysis to rank the importance of subject-specific factors based on their relative influence on IED rates. Linear mixed-effects models were employed to comprehensively examine factors with highly ranked importance.ResultsAntiseizure medication (ASM) status, time of testing, and seizure onset zone (SOZ) location were the highest-ranking factors in terms of their impact on IED rates. The average IED rate of electrodes in SOZs was 34% higher than the average IED rate of electrodes outside of SOZs (non-SOZ; p < .001). However, non-SOZ electrodes had similar IED rates regardless of the subject's SOZ location (p = .99). Subjects on older generation (p < .001) and combined generation (p < .001) ASM regimens had significantly lower IED rates relative to the group taking no ASMs; newer generation ASM regimens demonstrated a nonsignificant association with IED rates (p = .13). Of the ASMs included in this study, the following ASMs were associated with significant reductions in IED rates: levetiracetam (p < .001), carbamazepine (p < .001), lacosamide (p = .03), zonisamide (p = .01), lamotrigine (p = .03), phenytoin (p = .03), and topiramate (p = .01). We observed a nonsignificant association between time of testing and IED rates (morning-afternoon p = .15, morning-evening p = .85, afternoon-evening p = .26).SignificanceThe current study ranks the relative influence that subject-specific factors have on IED rates and highlights the importance of considering certain factors, such as SOZ location and ASM status, when analyzing IEDs for clinical or research purposes.

Dataset Information

Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings.

Publications

Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings.

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