Dataset Information

Scalp EEG interictal high frequency oscillations as an objective biomarker of infantile spasms.

ABSTRACT:

Objective

To investigate the diagnostic utility of high frequency oscillations (HFOs) via scalp electroencephalogram (EEG) in infantile spasms.

Methods

We retrospectively analyzed interictal slow-wave sleep EEGs sampled at 2,000 Hz recorded from 30 consecutive patients who were suspected of having infantile spasms. We measured the rate of HFOs (80-500 Hz) and the strength of the cross-frequency coupling between HFOs and slow-wave activity (SWA) at 3-4 Hz and 0.5-1 Hz as quantified with modulation indices (MIs).

Results

Twenty-three patients (77%) exhibited active spasms during the overnight EEG recording. Although the HFOs were detected in all children, increased HFO rate and MIs correlated with the presence of active spasms (p < 0.001 by HFO rate; p < 0.01 by MIs at 3-4 Hz; p = 0.02 by MIs at 0.5-1 Hz). The presence of active spasms was predicted by the logistic regression models incorporating HFO-related metrics (AUC: 0.80-0.98) better than that incorporating hypsarrhythmia (AUC: 0.61). The predictive performance of the best model remained favorable (87.5% accuracy) after a cross-validation procedure.

Conclusions

Increased rate of HFOs and coupling between HFOs and SWA are associated with active epileptic spasms.

Significance

Scalp-recorded HFOs may serve as an objective EEG biomarker for active epileptic spasms.

SUBMITTER: Nariai H

PROVIDER: S-EPMC7606823 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Scalp EEG interictal high frequency oscillations as an objective biomarker of infantile spasms.

Nariai Hiroki H Hussain Shaun A SA Bernardo Danilo D Motoi Hirotaka H Sonoda Masaki M Kuroda Naoto N Asano Eishi E Nguyen Jimmy C JC Elashoff David D Sankar Raman R Bragin Anatol A Staba Richard J RJ Wu Joyce Y JY

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 20200903 11

<h4>Objective</h4>To investigate the diagnostic utility of high frequency oscillations (HFOs) via scalp electroencephalogram (EEG) in infantile spasms.<h4>Methods</h4>We retrospectively analyzed interictal slow-wave sleep EEGs sampled at 2,000 Hz recorded from 30 consecutive patients who were suspected of having infantile spasms. We measured the rate of HFOs (80-500 Hz) and the strength of the cross-frequency coupling between HFOs and slow-wave activity (SWA) at 3-4 Hz and 0.5-1 Hz as quantified ...[more]

PMID: 32927206

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Project description:IntroductionDespite all the efforts for optimizing epilepsy management in children over the past decades, there is no clear consensus regarding whether to treat or not to treat epileptiform discharges (EDs) after a first unprovoked seizure or the optimal duration of therapy with anti-seizure medication (ASM). It is therefore highly needed to find markers on scalp electroencephalogram (EEG) that can help identify pathological EEG discharges that require treatment.Aim of the studyThis retrospective study aimed to identify whether the coexistence of ripples/high-frequency oscillations (HFOs) with interictal EDs (IEDs) in routinely acquired scalp EEG is associated with a higher risk of seizure recurrence and could be used as a prognostic marker.Methods100 children presenting with new onset seizure to Children's Medical Center- Dallas during 2015-2016, who were not on ASM and had focal EDs on an awake and sleep EEG recorded with sample frequency of 500 HZ, were randomly identified by database review. EEGs were analyzed blinded to the data of the patients. HFOs were visually identified using review parameters including expanded time base and adjusted filter settings.ResultsThe average age of patients was 6.3 years (±4.35 SD). HFOs were visually identified in 19% of the studied patients with an inter-rater reliability of 99% for HFO negative discharges and 78% agreement for identification of HFOs. HFOs were identified more often in the younger age group; however, they were identified in 11% of patients >5 years old. They were more frequently associated with spikes than with sharp waves and more often with higher amplitude EDs. Patients with HFOs were more likely to have a recurrence of seizures in the year after the first seizure (P < 0.05) and to continue to have seizures after 2 years (P < 0.0001). There was no statistically significant difference between the two groups with regards to continuing ASM after 2 years.ConclusionIncluding analysis for HFOs in routine EEG interpretation may increase the yield of the study and help guide the decision to either start or discontinue ASM. In the future, this may also help to identify pathological discharges with deleterious effects on the growing brain and set a new target for the management of epilepsy.

Dataset Information

Scalp EEG interictal high frequency oscillations as an objective biomarker of infantile spasms.

Objective

Methods

Results

Conclusions

Significance

Publications

Scalp EEG interictal high frequency oscillations as an objective biomarker of infantile spasms.

Similar Datasets

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