Measuring Real-Time Medication Effects From Electroencephalography.

Aarti Sathyanarayana, Rima El Atrache, M. Jackson, Sarah Cantley, Latania Reece, Claire Ufongene, T. Loddenkemper, K. Mandl, W. Bosl
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Abstract

PURPOSE Evaluating the effects of antiseizure medication (ASM) on patients with epilepsy remains a slow and challenging process. Quantifiable noninvasive markers that are measurable in real-time and provide objective and useful information could guide clinical decision-making. We examined whether the effect of ASM on patients with epilepsy can be quantitatively measured in real-time from EEGs. METHODS This retrospective analysis was conducted on 67 patients in the long-term monitoring unit at Boston Children's Hospital. Two 30-second EEG segments were selected from each patient premedication and postmedication weaning for analysis. Nonlinear measures including entropy and recurrence quantitative analysis values were computed for each segment and compared before and after medication weaning. RESULTS Our study found that ASM effects on the brain were measurable by nonlinear recurrence quantitative analysis on EEGs. Highly significant differences (P < 1e-11) were found in several nonlinear measures within the seizure zone in response to antiseizure medication. Moreover, the size of the medication effect correlated with a patient's seizure frequency, seizure localization, number of medications, and reported seizure frequency reduction on medication. CONCLUSIONS Our findings show the promise of digital biomarkers to measure medication effects and epileptogenicity.
通过脑电图实时测量药物效果。
目的评估抗癫痫药物(ASM)对癫痫患者的影响仍然是一个缓慢而具有挑战性的过程。可量化的无创标志物可以实时测量,提供客观有用的信息,可以指导临床决策。我们研究了ASM对癫痫患者的影响是否可以通过脑电图实时定量测量。方法对波士顿儿童医院长期监护病房的67例患儿进行回顾性分析。分别从患者用药前和停药后各选取2段30秒脑电图进行分析。计算各时间段的熵值、递归定量分析值等非线性测度,并对停药前后进行比较。结果通过脑电图的非线性递归定量分析,我们的研究发现ASM对大脑的影响是可以测量的。抗癫痫药物对癫痫发作区的几种非线性测量结果存在显著差异(P < 1e-11)。此外,药物效应的大小与患者的癫痫发作频率、癫痫发作定位、药物数量以及药物治疗后报告的癫痫发作频率降低相关。结论该研究结果显示了数字生物标志物在测量药物效果和致痫性方面的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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