The appearance of scalp high-frequency oscillations is associated with poor seizure control in pediatric epilepsy patients

IF 2.8 3区医学 Q2 CLINICAL NEUROLOGY

Epilepsia Open Pub Date : 2024-12-03 DOI:10.1002/epi4.13032

Keisuke Maeda, Nami Hosoda, Himari Tsuboi, Honoka Naito, Chiaki Kudo, Junichi Fukumoto, Shiho Fujita, Naohiro Ichino, Keisuke Osakabe, Keiko Sugimoto, Shunta Yamaguchi, Naoko Ishihara

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Abstract

Objective

Epilepsy treatment with anti-seizure medications (ASMs) is based on careful assessment of the balance between the likelihood of further seizures and the risk of side effects of treatment. However, there is currently no established biomarker to ascertain seizure control status with ASMs. High-frequency oscillations (HFOs), transient bursts of EEG activity with frequencies beyond 80 Hz, are a new and promising noninvasive epilepsy biomarker. We compared the risk of scalp HFO appearance between pediatric patients with good and poor seizure control by treatment with ASMs.

Methods

A total of 72 epilepsy patients (aged 0–18 years, 39 males) with good and poor seizure control with ASMs participated in this study. We applied a validated automated detector to determine HFO and spike. We calculated the odds ratios (ORs) for scalp HFO and spike appearance according to seizure control status by multiple logistic regression analysis.

Results

Scalp HFO was seen more commonly and with a significantly higher detection rate in patients with poor seizure control as compared with patients with good seizure control for both ripple and fast ripple. These significant associations were found for both focal and generalized epilepsy. The ORs for scalp HFO appearance adjusted for confounding factors were significantly higher in patients with poor seizure control compared to those with good seizure control (ripple: OR [95% CI] = 11.91 [2.21–64.30], p = 0.004; fast ripple: 4.98 [1.03–24.09], p = 0.046). There were no significant associations between spike appearance and seizure control status.

Significance

We found an increased risk of scalp HFO appearance in patients with poor seizure control. The results of this study support that scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.

Plain Language Summary

This study analyzed scalp high-frequency oscillations and spikes in pediatric patients with various types of epilepsy who were being treated using ASMs. The results showed that an increased risk of scalp HFO appearance was observed in patients with poor seizure control compared to those with good seizure control. These findings were observed in both the ripple (80–250 Hz) and fast ripple (250–500 Hz) bands. The scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.

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小儿癫痫患者出现头皮高频振荡与癫痫发作控制不良有关。

目的：抗癫痫药物治疗癫痫的基础是仔细评估进一步癫痫发作的可能性和治疗副作用的风险之间的平衡。然而，目前还没有确定的生物标志物来确定痉挛发作控制状态。高频振荡（HFOs）是一种频率超过80hz的短暂性脑电图活动爆发，是一种新的、有前途的非侵入性癫痫生物标志物。我们比较了癫痫发作控制良好和癫痫发作控制不佳的儿科患者出现头皮HFO的风险。方法：对72例癫痫患者（年龄0 ~ 18岁，男性39例）进行研究。我们应用了一个经过验证的自动检测器来测定HFO和spike。根据癫痫控制情况，我们通过多元logistic回归分析计算头皮HFO和尖峰出现的比值比（ORs）。结果：与纹波和快速纹波控制良好的患者相比，癫痫控制较差的患者头皮HFO更常见，检出率显著高于癫痫控制良好的患者。这些显著的关联在局灶性和全身性癫痫中都被发现。经混杂因素校正后，癫痫控制不佳的患者头皮HFO外观的OR值明显高于癫痫控制良好的患者(ripple: OR [95% CI] = 11.91 [2.21-64.30], p = 0.004；快速波动：4.98 [1.03-24.09],p = 0.046)。刺突的出现和癫痫控制状态之间没有明显的联系。意义：我们发现癫痫控制不佳的患者出现头皮HFO的风险增加。本研究结果支持头皮HFO与患者在纹波和快速纹波治疗后频繁发作相关。简单的语言总结：本研究分析了使用asm治疗的不同类型癫痫患儿的头皮高频振荡和峰值。结果显示，与癫痫控制良好的患者相比，癫痫控制不佳的患者出现头皮HFO的风险增加。这些发现在纹波（80-250 Hz）和快速纹波（250-500 Hz）波段都观察到了。头皮HFO与患者在纹波和快速纹波治疗后频繁发作有关。

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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