Sharanya Arcot Desai1, Thomas K Tcheng2, Martha J Morrell3. 1. NeuroPace, Inc., Mountain View, CA, USA. Electronic address: sdesai@neuropace.com. 2. NeuroPace, Inc., Mountain View, CA, USA. 3. NeuroPace, Inc., Mountain View, CA, USA; Stanford University, Stanford, CA, USA.
Abstract
OBJECTIVES: Find interictal electrocorticographic (ECoG) biomarkers of clinical outcomes in mesiotemporal lobe (MTL) epilepsy patients. METHODS: In the NeuroPace® RNS® System clinical trials with 256 patients, 20 MTL patients with the most reduction in clinical seizures at Year 7 compared to baseline (upper response quartile; -96.5% median change) and 20 with the least reduction in clinical seizures (lower response quartile; -17.4% median change) were evaluated. Clinical and interictal ECoG features from the two response quartiles were compared. RESULTS: Demographic and clinical features were similar in the upper and lower response quartiles. Interictal spike rate (ISR) was substantially lower (p < 0.0001) in the upper quartile patients, while normalized theta (4-8 Hz) and normalized gamma (>25 Hz) were also different (p < 0.05) between the two response quartiles. ISR was positively correlated (p < 0.05) with clinical seizure rates in 71% of the channels analyzed. ECoG records captured during months with no clinical seizures had the lowest ISR. CONCLUSIONS: ISR is a strong differentiator of clinical response in MTL patients. Normalized theta and gamma also differentiates clinical response. SIGNIFICANCE: In MTL patients, the interictal spike rate along with spectral power computed from chronic ambulatory baseline ECoGs may serve as biomarkers of clinical outcomes and maybe used as treatment endpoints.
OBJECTIVES: Find interictal electrocorticographic (ECoG) biomarkers of clinical outcomes in mesiotemporal lobe (MTL) epilepsypatients. METHODS: In the NeuroPace® RNS® System clinical trials with 256 patients, 20 MTL patients with the most reduction in clinical seizures at Year 7 compared to baseline (upper response quartile; -96.5% median change) and 20 with the least reduction in clinical seizures (lower response quartile; -17.4% median change) were evaluated. Clinical and interictal ECoG features from the two response quartiles were compared. RESULTS: Demographic and clinical features were similar in the upper and lower response quartiles. Interictal spike rate (ISR) was substantially lower (p < 0.0001) in the upper quartile patients, while normalized theta (4-8 Hz) and normalized gamma (>25 Hz) were also different (p < 0.05) between the two response quartiles. ISR was positively correlated (p < 0.05) with clinical seizure rates in 71% of the channels analyzed. ECoG records captured during months with no clinical seizures had the lowest ISR. CONCLUSIONS: ISR is a strong differentiator of clinical response in MTL patients. Normalized theta and gamma also differentiates clinical response. SIGNIFICANCE: In MTL patients, the interictal spike rate along with spectral power computed from chronic ambulatory baseline ECoGs may serve as biomarkers of clinical outcomes and maybe used as treatment endpoints.
Authors: Joline M Fan; Anthony T Lee; Kiwamu Kudo; Kamalini G Ranasinghe; Hirofumi Morise; Anne M Findlay; Heidi E Kirsch; Edward F Chang; Srikantan S Nagarajan; Vikram R Rao Journal: Brain Commun Date: 2022-04-26
Authors: Dileep R Nair; Kenneth D Laxer; Peter B Weber; Anthony M Murro; Yong D Park; Gregory L Barkley; Brien J Smith; Ryder P Gwinn; Michael J Doherty; Katherine H Noe; Richard S Zimmerman; Gregory K Bergey; William S Anderson; Christianne Heck; Charles Y Liu; Ricky W Lee; Toni Sadler; Robert B Duckrow; Lawrence J Hirsch; Robert E Wharen; William Tatum; Shraddha Srinivasan; Guy M McKhann; Mark A Agostini; Andreas V Alexopoulos; Barbara C Jobst; David W Roberts; Vicenta Salanova; Thomas C Witt; Sydney S Cash; Andrew J Cole; Gregory A Worrell; Brian N Lundstrom; Jonathan C Edwards; Jonathan J Halford; David C Spencer; Lia Ernst; Christopher T Skidmore; Michael R Sperling; Ian Miller; Eric B Geller; Michel J Berg; A James Fessler; Paul Rutecki; Alica M Goldman; Eli M Mizrahi; Robert E Gross; Donald C Shields; Theodore H Schwartz; Douglas R Labar; Nathan B Fountain; W Jeff Elias; Piotr W Olejniczak; Nicole R Villemarette-Pittman; Stephan Eisenschenk; Steven N Roper; Jane G Boggs; Tracy A Courtney; Felice T Sun; Cairn G Seale; Kathy L Miller; Tara L Skarpaas; Martha J Morrell Journal: Neurology Date: 2020-07-20 Impact factor: 9.910