Robert J Quon1, Stephen Meisenhelter1, Richard H Adamovich-Zeitlin2, Yinchen Song1,2, Sarah A Steimel1, Edward J Camp2, Markus E Testorf2,3, Todd A MacKenzie4,5, Robert E Gross6, Bradley C Lega7, Michael R Sperling8, Michael J Kahana9, Barbara C Jobst1,2. 1. Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA. 2. Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 3. Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, USA. 4. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA. 5. Dartmouth Institute, Dartmouth College, Hanover, New Hampshire, USA. 6. Department of Neurosurgery, Emory University, Atlanta, Georgia, USA. 7. Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA. 8. Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. 9. Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
OBJECTIVE: This study was undertaken to evaluate the influence that subject-specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy. METHODS: One 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. RESULTS: Antiseizure 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). SIGNIFICANCE: The 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.
OBJECTIVE: This study was undertaken to evaluate the influence that subject-specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy. METHODS: One 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. RESULTS: Antiseizure 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). SIGNIFICANCE: The 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.
Authors: Ethan A Solomon; Bradley C Lega; Michael R Sperling; Michael J Kahana Journal: Proc Natl Acad Sci U S A Date: 2019-11-13 Impact factor: 11.205
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Authors: Mustafa Aykut Kural; Lene Duez; Vibeke Sejer Hansen; Pål G Larsson; Stefan Rampp; Reinhard Schulz; Hatice Tankisi; Richard Wennberg; Bo M Bibby; Michael Scherg; Sándor Beniczky Journal: Neurology Date: 2020-04-22 Impact factor: 11.800
Authors: Robert J Quon; Grace A Leslie; Edward J Camp; Stephen Meisenhelter; Sarah A Steimel; Yinchen Song; Alan B Ettinger; Krzysztof A Bujarski; Michael A Casey; Barbara C Jobst Journal: Acta Neurol Scand Date: 2021-04-24 Impact factor: 3.915
Authors: Robert J Quon; Michael A Casey; Edward J Camp; Stephen Meisenhelter; Sarah A Steimel; Yinchen Song; Markus E Testorf; Grace A Leslie; Krzysztof A Bujarski; Alan B Ettinger; Barbara C Jobst Journal: Sci Rep Date: 2021-09-16 Impact factor: 4.379