Lin Wan1,2,3, Chu-Ting Zhang4, Gang Zhu1,2,3, Jian Chen1,2, Xiu-Yu Shi1,2,3,5, Jing Wang1,2, Li-Ping Zou1,2,3,5, Bo Zhang6, Wen-Bin Shi4, Chien-Hung Yeh7, Guang Yang8,9,10,11. 1. Senior Department of Pediatrics, Chinese PLA General Hospital, Beijing, 100000, China. 2. Department of Pediatrics, the First Medical Centre, Chinese PLA General Hospital, Beijing, China. 3. Medical School of Chinese People's Liberation Army, Beijing, China. 4. School of Information and Electronics, Beijing Institute of Technology, Beijing, 100081, China. 5. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. 6. Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 7. School of Information and Electronics, Beijing Institute of Technology, Beijing, 100081, China. nzdiw1120@gmail.com. 8. Senior Department of Pediatrics, Chinese PLA General Hospital, Beijing, 100000, China. yangg301@126.com. 9. Department of Pediatrics, the First Medical Centre, Chinese PLA General Hospital, Beijing, China. yangg301@126.com. 10. Medical School of Chinese People's Liberation Army, Beijing, China. yangg301@126.com. 11. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. yangg301@126.com.
Abstract
BACKGROUND: Even though adrenocorticotropic hormone (ACTH) demonstrated powerful efficacy in the initially successful treatment of infantile spasms (IS), nearly half of patients have experienced a relapse. We sought to investigate whether features of electroencephalogram (EEG) predict relapse in those IS patients without structural brain abnormalities. METHODS: We retrospectively reviewed data from children with IS who achieved initial response after ACTH treatment, along with EEG recorded within the last two days of treatment. The recurrence of epileptic spasms following treatment was tracked for 12 months. Subjects were categorized as either non-relapse or relapse groups. General clinical and EEG recordings were collected, burden of amplitudes and epileptiform discharges (BASED) score and multiscale entropy (MSE) were carefully explored for cross-group comparisons. RESULTS: Forty-one patients were enrolled in the study, of which 26 (63.4%) experienced a relapse. The BASED score was significantly higher in the relapse group. MSE in the non-relapse group was significantly lower than the relapse group in the γ band but higher in the lower frequency range (δ, θ, α). Sensitivity and specificity were 85.71% and 92.31%, respectively, when combining MSE in the δ/γ frequency of the occipital region, plus BASED score were used to distinguish relapse from non-relapse groups. CONCLUSIONS: BASED score and MSE of EEG after ACTH treatment could be used to predict relapse for IS patients without brain structural abnormalities. Patients with BASED score ≥ 3, MSE increased in higher frequency, and decreased in lower frequency had a high risk of relapse.
BACKGROUND: Even though adrenocorticotropic hormone (ACTH) demonstrated powerful efficacy in the initially successful treatment of infantile spasms (IS), nearly half of patients have experienced a relapse. We sought to investigate whether features of electroencephalogram (EEG) predict relapse in those IS patients without structural brain abnormalities. METHODS: We retrospectively reviewed data from children with IS who achieved initial response after ACTH treatment, along with EEG recorded within the last two days of treatment. The recurrence of epileptic spasms following treatment was tracked for 12 months. Subjects were categorized as either non-relapse or relapse groups. General clinical and EEG recordings were collected, burden of amplitudes and epileptiform discharges (BASED) score and multiscale entropy (MSE) were carefully explored for cross-group comparisons. RESULTS: Forty-one patients were enrolled in the study, of which 26 (63.4%) experienced a relapse. The BASED score was significantly higher in the relapse group. MSE in the non-relapse group was significantly lower than the relapse group in the γ band but higher in the lower frequency range (δ, θ, α). Sensitivity and specificity were 85.71% and 92.31%, respectively, when combining MSE in the δ/γ frequency of the occipital region, plus BASED score were used to distinguish relapse from non-relapse groups. CONCLUSIONS: BASED score and MSE of EEG after ACTH treatment could be used to predict relapse for IS patients without brain structural abnormalities. Patients with BASED score ≥ 3, MSE increased in higher frequency, and decreased in lower frequency had a high risk of relapse.
Authors: Finbar J K O'Callaghan; Stuart W Edwards; Fabienne Dietrich Alber; Mario Cortina Borja; Eleanor Hancock; Anthony L Johnson; Colin R Kennedy; Marcus Likeman; Andrew L Lux; Mark T Mackay; Andrew A Mallick; Richard W Newton; Melinda Nolan; Ronit Pressler; Dietz Rating; Bernhard Schmitt; Christopher M Verity; John P Osborne Journal: Lancet Child Adolesc Health Date: 2018-08-29
Authors: Ingrid E Scheffer; Samuel Berkovic; Giuseppe Capovilla; Mary B Connolly; Jacqueline French; Laura Guilhoto; Edouard Hirsch; Satish Jain; Gary W Mathern; Solomon L Moshé; Douglas R Nordli; Emilio Perucca; Torbjörn Tomson; Samuel Wiebe; Yue-Hua Zhang; Sameer M Zuberi Journal: Epilepsia Date: 2017-03-08 Impact factor: 5.864
Authors: Shaun A Hussain; Grace Kwong; John J Millichap; John R Mytinger; Nicole Ryan; Joyce H Matsumoto; Joyce Y Wu; Jason T Lerner; Raman Sankar Journal: Epilepsia Date: 2014-11-10 Impact factor: 5.864
Authors: Anne T Berg; Samuel F Berkovic; Martin J Brodie; Jeffrey Buchhalter; J Helen Cross; Walter van Emde Boas; Jerome Engel; Jacqueline French; Tracy A Glauser; Gary W Mathern; Solomon L Moshé; Douglas Nordli; Perrine Plouin; Ingrid E Scheffer Journal: Epilepsia Date: 2010-02-26 Impact factor: 5.864