Epilepsy Research最新文献

{"title":"Advancing thalamic neuromodulation in epilepsy: Bridging adult data to pediatric care","authors":"Debopam Samanta ,&nbsp;Gewalin Aungaroon ,&nbsp;Gregory W. Albert ,&nbsp;Cemal Karakas ,&nbsp;Charuta N. Joshi ,&nbsp;Rani K. Singh ,&nbsp;Chima Oluigbo ,&nbsp;M. Scott Perry ,&nbsp;Sunil Naik ,&nbsp;Puck C. Reeders ,&nbsp;Puneet Jain ,&nbsp;Taylor J. Abel ,&nbsp;Sandipan Pati ,&nbsp;Ammar Shaikhouni ,&nbsp;Zulfi Haneef","doi":"10.1016/j.eplepsyres.2024.107407","DOIUrl":"10.1016/j.eplepsyres.2024.107407","url":null,"abstract":"<div><p>Thalamic neuromodulation has emerged as a treatment option for drug-resistant epilepsy (DRE) with widespread and/or undefined epileptogenic networks. While deep brain stimulation (DBS) and responsive neurostimulation (RNS) depth electrodes offer means for electrical stimulation of the thalamus in adult patients with DRE, the application of thalamic neuromodulation in pediatric epilepsy remains limited. To address this gap, the Neuromodulation Expert Collaborative was established within the Pediatric Epilepsy Research Consortium (PERC) Epilepsy Surgery Special Interest Group. In this expert review, existing evidence and recommendations for thalamic neuromodulation modalities using DBS and RNS are summarized, with a focus on the anterior (ANT), centromedian(CMN), and pulvinar nuclei of the thalamus. To-date, only DBS of the ANT is FDA approved for treatment of DRE in adult patients based on the results of the pivotal SANTE (Stimulation of the Anterior Nucleus of Thalamus for Epilepsy) study. Evidence for other thalamic neurmodulation indications and targets is less abundant. Despite the lack of evidence, positive responses to thalamic stimulation in adults with DRE have led to its off-label use in pediatric patients. Although caution is warranted due to differences between pediatric and adult epilepsy, the efficacy and safety of pediatric neuromodulation appear comparable to that in adults. Indeed, CMN stimulation is increasingly accepted for generalized and diffuse onset epilepsies, with recent completion of one randomized trial. There is also growing interest in using pulvinar stimulation for temporal plus and posterior quadrant epilepsies with one ongoing clinical trial in Europe. The future of thalamic neuromodulation holds promise for revolutionizing the treatment landscape of childhood epilepsy. Ongoing research, technological advancements, and collaborative efforts are poised to refine and improve thalamic neuromodulation strategies, ultimately enhancing the quality of life for children with DRE.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107407"},"PeriodicalIF":2.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic epilepsy: Integrating clinical, inflammatory, and genetic profiles in traumatic brain injury patients","authors":"Amanda C. Mosini ,&nbsp;Viviam Sanabria ,&nbsp;Thábatta K.E. Nakamura ,&nbsp;Michele L. Calió ,&nbsp;Clara Pompeu ,&nbsp;Clivandir S. Silva ,&nbsp;Priscila Nicolicht-Amorim ,&nbsp;Maria da Graça Naffah-Mazzacoratti ,&nbsp;Marimelia A. Porcionatto ,&nbsp;Luiz Eugênio Mello ,&nbsp;Maira L. Foresti","doi":"10.1016/j.eplepsyres.2024.107402","DOIUrl":"10.1016/j.eplepsyres.2024.107402","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to assess the clinical, inflammatory, and genetic profiles of traumatic brain injury (TBI) patients over a 2-year follow-up period, focusing on the development of posttraumatic epilepsy (PTE).</p></div><div><h3>Methods</h3><p>Fifty-nine patients with acute TBI were recruited in the emergency unit of a hospital in Brazil. Clinical data and blood samples were collected after 10 days of hospitalization for posterior genetic profile (Apolipoprotein E- ApoE and Glutamic Acid Descarboxylase-GAD sequencing) analyses. A subset of 19 patients were assessed for cytokine markers (mRNA expression). The development of PTE was investigated for two years following TBI. Statistical analyses including univariate analysis, multiple correspondence analysis, and Mann-Whitney test were performed.</p></div><div><h3>Results</h3><p>Analysis revealed an association between severe TBI and requirement for neurosurgery and polytrauma (<em>p</em>&lt;0.05), as well as the development of PTE over a two-year follow-up period (<em>p</em>&lt;0.05). Multiple correspondence analysis identified two distinct profiles associated with PTE and Non-PTE outcomes. The PTE profile showed a higher prevalence of the ApoE genotype E3/E3 and GAD1 SNP (rs769391) genotype AA in our study, while the Non-PTE profile showed a higher presence of E3/E4. mRNA expression analysis demonstrated acute elevated levels of TNF-α in the PTE group as compared to Non-PTE patients (6.70±1.53 vs 5.31 ±0.33, <em>p</em>&lt;0.01).</p></div><div><h3>Significance</h3><p>Our findings underscore the multifactorial nature of aspects potentially contributing to PTE. It is unlikely that any single factor might in isolation have a strong causative influence over the development of epilepsy after TBI. Our results provide a suggestion of potential clustering that might be relevant as prognostic factors for PTE.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107402"},"PeriodicalIF":2.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hippocampal activations obtained during language fMRI tasks: a complementary tool for predicting postoperative memory prognosis","authors":"Eve Salleles ,&nbsp;Séverine Samson ,&nbsp;Marisa Denos ,&nbsp;Marie Mere ,&nbsp;Stéphane Lehericy ,&nbsp;Bastien Herlin ,&nbsp;Sophie Dupont","doi":"10.1016/j.eplepsyres.2024.107405","DOIUrl":"10.1016/j.eplepsyres.2024.107405","url":null,"abstract":"<div><p>In medial temporal lobe epilepsy (MTLE), the benefits of surgery must be balanced against the risk of post-operative memory decline. Prediction of postoperative outcomes based on functional magnetic resonance imaging (fMRI) tasks is increasingly common but remains uncertain. The aim of this retrospective study was to determine whether hippocampal activations elicited by fMRI language tasks could enhance or refine memory fMRI in MTLE patients candidates to surgery. Forty-six patients were included: 30 right and 16 left MTLE, mostly with hippocampal sclerosis. Preoperative assessment included neuropsychological tests and fMRI with language (syntactic verbal fluency) and memory tasks (encoding, delayed, and immediate recognition of images of objects). Thirty patients underwent surgery and had neuropsychological evaluations one year after surgery. Worsening was defined as a degradation of more than 10% in postoperative forgetting scores compared to preoperative scores in verbal, non-verbal and global memory. Memory fMRI had the best sensitivity with hippocampal activations obtained in 95% of patients, versus 65% with language fMRI. Considering the patients who elicited an hippocampal activation, language fMRI led to 80%, 65% and 85% of correct predictions for respectively global, verbal and non verbal memory (versus 71%, 64% and 68% with memory fMRI). Memory and language fMRI predictions outperformed those made by neuropsychological tests. In summary, language fMRI was less sensitive than memory fMRI to elicit hippocampal activations but when it did, the proportion of correct memory predictions was better. Moreover, it proved to be an independent predictive factor regardless of the side of the epileptic focus. Given the ease of setting up a language task in fMRI, we recommend the systematic combination of memory and language tasks to predict the post-operative memory outcome of MTLE patients undergoing epilepsy surgery.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107405"},"PeriodicalIF":2.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of electroencephalographic findings in Lennox-Gastaut syndrome","authors":"Firoz M. Nizami,&nbsp;Sweety Trivedi,&nbsp;Jayantee Kalita","doi":"10.1016/j.eplepsyres.2024.107406","DOIUrl":"10.1016/j.eplepsyres.2024.107406","url":null,"abstract":"<div><p>Lennox–Gastaut syndrome (LGS) is a severe form of childhood onset epileptic encephalopathy characterized by multiple drug-resistant seizures, cognitive impairment, and diffuse slow spike and wave (SSW), and generalized paroxysmal fast activity (GPFA) on electroencephalogram (EEG). Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines was done to investigate EEG findings in LGS. PubMed and MEDLINE were systematically searched for English-language studies published until15th may 2023. Original articles and research with patients between age group 1–30 years, and studies with description of EEG findings were included. Search identified 20 studies with 1167 patients. In this analysis 62.6 % of patients were male. The median age was 9.6 years. Etiology was structural abnormality in 42.6 %, genetic in 8.7 % but was unknown in 48.7%. Tonic seizures (74.5 %) were most frequent followed by atypical absences (44.3 %), myoclonic (39.2 %), generalized (38.5 %), atonic (34.8 %), epileptic spasm (15.9 %), focal (11.4 %) and non-convulsive status epilepticus (7.0 %). Out of 20 studies, only 15 studies mentioned GPFA in 46.6 % patients and SSW in 91.7 % patients. Unilateral and focal discharges were more common in patients with unilateral structural abnormalities. Seizure discharges on EEG longer than 10 second duration correlated with seizure diary counts. Combination of atonic, tonic, and atypical absence seizures correlated with SSW, and myoclonic seizures correlated with GPFA. EEG helps in diagnosis and prognosis of LGS. SSW is present in almost all EEG, and GPFA in 46.6 % patients. Longer duration of SSW discharges and disorganized background are associated with poor outcome.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107406"},"PeriodicalIF":2.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localization of epileptogenic zone based on time-varying effective networks","authors":"Ning Yin (尹宁) ,&nbsp;Yamei Han (韩雅美) ,&nbsp;Le Wang (王乐) ,&nbsp;Fan Yang (杨帆) ,&nbsp;Jicheng Li (李济丞) ,&nbsp;Guizhi Xu (徐桂芝)","doi":"10.1016/j.eplepsyres.2024.107409","DOIUrl":"10.1016/j.eplepsyres.2024.107409","url":null,"abstract":"<div><p>Surgical resection of the epileptogenic zone (EZ) is an effective method for treating drug-resistant epilepsy. At present, the accuracy of EZ localization needs to be further improved. The characteristics of graph theory based on partial directed coherence networks have been applied to the localization of EZ, but the application of network control theory to effective networks to locate EZ is rarely reported. In this study, the method of partial directed coherence analysis was utilized to construct the time-varying effective brain networks of stereo-electroencephalography (SEEG) signals from 20 seizures in 12 patients. Combined with graph theory and network control theory, the differences in network characteristics between epileptogenic and non-epileptogenic zones during seizures were analyzed. We also used dung beetle optimized support vector machine classification model to evaluate the localization effect of EZ based on brain network characteristics of graph theory and controllability. The results showed that the classification of the average controllability feature was the best, and the area under the receiver operating characteristic (ROC) curve (AUC) was 0.9505, which is 1.32 % and 1.97 % higher than the traditional methods. The AUC value increased to 0.9607 after integrating the average controllability with other features. This study proved the effectiveness of controllability characteristic in identifying the EZ and provided a theoretical basis for the clinical application of network controllability in the EZ.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107409"},"PeriodicalIF":2.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A medico-legal perspective on postictal violence: A case study and systematic review of postictal delirium","authors":"Mark Quigg ,&nbsp;Richard Bonnie ,&nbsp;Derek Bauer ,&nbsp;Howard P. Goodkin ,&nbsp;Jaideep Kapur","doi":"10.1016/j.eplepsyres.2024.107398","DOIUrl":"10.1016/j.eplepsyres.2024.107398","url":null,"abstract":"<div><p>Detailed descriptions of violent postictal episodes are rare. We provide evidence from an index case and from a systematic review of violent postictal episodes that demonstrates the encephalopathic features of some violent postictal behaviors. We discuss how these cases may fit in the legal framework of culpability. The data support the view that some episodes of violent postictal behavior are more accurately classified as a neurological delirium or encephalopathy rather than as a postictal psychosis. Current medical terminology may present unwarranted (and presumably unintended) barriers to exculpation for patients who exhibit post-ictal violence during an episode of delirium during which the patient was unaware of his or her violent conduct.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107398"},"PeriodicalIF":2.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting efficacy of antiseizure medication treatment with machine learning algorithms in North Indian population","authors":"Mahima Kaushik ,&nbsp;Siddhartha Mahajan ,&nbsp;Nitin Machahary ,&nbsp;Sarita Thakran ,&nbsp;Saransh Chopra ,&nbsp;Raj Vardhan Tomar ,&nbsp;Suman S. Kushwaha ,&nbsp;Rachna Agarwal ,&nbsp;Sangeeta Sharma ,&nbsp;Ritushree Kukreti ,&nbsp;Bibhu Biswal","doi":"10.1016/j.eplepsyres.2024.107404","DOIUrl":"https://doi.org/10.1016/j.eplepsyres.2024.107404","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to develop a classifier using supervised machine learning to effectively assess the impact of clinical, demographical, and biochemical factors in accurately predicting the antiseizure medications (ASMs) treatment response in people with epilepsy (PWE).</p></div><div><h3>Methods</h3><p>Data was collected from 786 PWE at the Outpatient Department of Neurology, Institute of Human Behavior and Allied Sciences (IHBAS), New Delhi, India from 2005 to 2015. Patients were followed up at the 2nd, 4th, 8th, and 12th month over the span of 1 year for the drugs being administered and their dosage, the serum drug levels, the frequency of seizure control, drug efficacy, the adverse drug reactions (ADRs), and their compliance to ASMs. Several features, including demographic details, medical history, and auxiliary examinations electroencephalogram (EEG) or Computed Tomography (CT) were chosen to discern between patients with distinct remission outcomes. Remission outcomes were categorized into ‘good responder (GR)’ and ‘poor responder (PR)’ based on the number of seizures experienced by the patients over the study duration. Our dataset was utilized to train seven classical machine learning algorithms i.e Extreme Gradient Boost (XGB), K-Nearest Neighbor (KNN), Support Vector Classifier (SVC), Decision Tree (DT), Random Forest (RF), Naïve Bayes (NB) and Logistic Regression (LR) to construct classification models.</p></div><div><h3>Results</h3><p>Our research findings indicate that 1) among the seven algorithms examined, XGB and SVC demonstrated superior predictive performances of ASM treatment outcomes with an accuracy of 0.66 each and ROC-AUC scores of 0.67 (XGB) and 0.66 (SVC) in distinguishing between PR and GR patients. 2) The most influential factor in discerning PR to GR patients is a family history of seizures (no), education (literate) and multitherapy with Chi-square (χ2) values of 12.1539, 8.7232 and 13.620 respectively and odds ratio (OR) of 2.2671, 0.4467, and 1.9453 each. 3). Furthermore, our surrogate analysis revealed that the null hypothesis for both XGB and SVC was rejected at a 100 % confidence level, underscoring the significance of their predictive performance. These findings underscore the robustness and reliability of XGB and SVC in our predictive modelling framework.</p></div><div><h3>Significance</h3><p>Utilizing XG Boost and SVC-based machine learning classifier, we successfully forecasted the likelihood of a patient's response to ASM treatment, categorizing them as either PR or GR, post-completion of standard epilepsy examinations. The classifier’s predictions were found to be statistically significant, suggesting their potential utility in improving treatment strategies, particularly in the personalized selection of ASM regimens for individual epilepsy patients.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107404"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An rs-fMRI based neuroimaging marker for adult absence epilepsy","authors":"Ruoshi Liu ,&nbsp;Guozhong Zhu ,&nbsp;Yujun Gao ,&nbsp;Dongbin Li","doi":"10.1016/j.eplepsyres.2024.107400","DOIUrl":"https://doi.org/10.1016/j.eplepsyres.2024.107400","url":null,"abstract":"<div><h3>Objective</h3><p>Approximately 20–30 % of epilepsy patients exhibit negative findings on routine magnetic resonance imaging, and this condition is known as nonlesional epilepsy. Absence epilepsy (AE) is a prevalent form of nonlesional epilepsy. This study aimed to investigate the clinical diagnostic utility of regional homogeneity (ReHo) assessed through the support vector machine (SVM) approach for identifying AE.</p></div><div><h3>Methods</h3><p>This research involved 102 healthy individuals and 93 AE patients. Resting-state functional magnetic resonance imaging was employed for data acquisition in all participants. ReHo analysis, coupled with SVM methodology, was utilized for data processing.</p></div><div><h3>Results</h3><p>Compared to healthy control individuals, AE patients demonstrated significantly elevated ReHo values in the bilateral putamen, accompanied by decreased ReHo in the bilateral thalamus. SVM was used to differentiate patients with AE from healthy control individuals based on rs-fMRI data. A composite assessment of altered ReHo in the left putamen and left thalamus yielded the highest accuracy at 81.64 %, with a sensitivity of 95.41 % and a specificity of 69.23 %.</p></div><div><h3>Significance</h3><p>According to the results, altered ReHo values in the bilateral putamen and thalamus could serve as neuroimaging markers for AE, offering objective guidance for its diagnosis.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"204 ","pages":"Article 107400"},"PeriodicalIF":2.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foramen ovale electrode investigation in the era of SEEG: Results and a reappraisal","authors":"Rohan Jha ,&nbsp;Melissa MJ Chua ,&nbsp;Noah Nawabi ,&nbsp;Sydney S. Cash ,&nbsp;John D. Rolston ,&nbsp;Andrew J. Cole","doi":"10.1016/j.eplepsyres.2024.107401","DOIUrl":"10.1016/j.eplepsyres.2024.107401","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with medication-resistant disabling epilepsy should be considered for potential epilepsy surgery. If noninvasive techniques are unable to identify the location of the seizure onset zone (SOZ), it becomes necessary to consider intracranial investigations. Stereo-electroencephalography (SEEG) is currently the preferred method for such monitoring, however foramen ovale (FO) electrodes offer a less invasive alternative that may be suitable in certain situations. Previous studies have demonstrated the effectiveness of FO electrodes in suspected mesial temporal epilepsy, nevertheless, increased experience with FO electrode use could further enhance their safety and efficacy. Therefore, we conducted an analysis of recent FO electrode investigations to assess their utility in surgical decision making, post resection outcomes, and complication rates.</p></div><div><h3>Methods</h3><p>We conducted a retrospective analysis of 61 patients who underwent FO placement at Mass General Brigham between 2009 and 2020. Patient and seizure characteristics, preoperative investigation data, and seizures outcomes were collected. In addition, identified predictors of FO utility using logistic regression.</p></div><div><h3>Results</h3><p>A total of 61 patients were identified. FO evaluation localized the SOZ in 56 % of patients. Complications were encountered in 1.6 % of patients. Subsequent surgical resection was pursued by 49 % of patients, with 56 % becoming seizure free, and 67 % having favorable seizure outcomes at last follow-up. Multivariate analysis identified younger patients with a higher number of preoperative ASMs as more likely to undergo subsequent treatment, however, these features were not predictive features of SOZ localization, seizure freedom, or favorable seizure outcomes. In patients with bitemporal or cross-over onsets on scalp EEG, FO was able to identify the SOZ in 79 %, whereas in patients with discordant or unclear onset, the rates were 71 % and 45 %, respectively.</p></div><div><h3>Conclusion</h3><p>In a contemporary cohort, FO electrode placement had a low complication rate and a high utility primarily in cases of unclear laterality of mesial temporal onsets or discordance between scalp EEG and other pre-FO investigation data in cases of suspected mesial temporal onsets.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"205 ","pages":"Article 107401"},"PeriodicalIF":2.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI in ECG: Validating an ambulatory semiology labeller and predictor","authors":"Pooja Muralidharan ,&nbsp;Ravi Sankaran ,&nbsp;Perraju Bendapudi ,&nbsp;C. Santhosh Kumar ,&nbsp;A. Anand Kumar","doi":"10.1016/j.eplepsyres.2024.107403","DOIUrl":"10.1016/j.eplepsyres.2024.107403","url":null,"abstract":"<div><h3>Objectives</h3><p>Early prediction of epileptic seizures can help reduce morbidity and mortality. In this work, we explore using electrocardiographic (ECG) signal as input to a seizure prediction system and note that the performance can be improved by using selected signal processing techniques.</p></div><div><h3>Methods</h3><p>We used frequency domain analysis with a deep neural network backend for all our experiments in this work. We further analysed the effect of the proposed system for different seizure semiologies and prediction horizons. We explored refining the signal using signal processing to enhance the system's performance.</p></div><div><h3>Results</h3><p>Our final system using the Temple University Hospital’s Seizure (TUHSZ) corpus gave an overall prediction accuracy of 84.02 %, sensitivity of 87.59 %, specificity of 81.9 %, and an area under the receiver operating characteristic curve (AUROC) of 0.9112. Notably, these results surpassed the state-of-the-art outcomes reported using the TUHSZ database; all findings are statistically significant. We also validated our study using the Siena scalp EEG database. Using the frequency domain data, our baseline system gave a performance of 75.17 %, 79.17 %, 70.04 % and 0.82 for prediction accuracy, sensitivity, specificity and AUROC, respectively. After selecting the optimal frequency band of 0.8–15 Hz, we obtained a performance of 80.49 %, 89.51 %, 75.23 % and 0.89 for prediction accuracy, sensitivity, specificity and AUROC, respectively which is an improvement of 5.32 %, 10.34 %, 5.19 % and 0.08 for prediction accuracy, sensitivity, specificity and AUROC, respectively.</p></div><div><h3>Conclusions</h3><p>The seizure information in ECG is concentrated in a narrow frequency band. Identifying and selecting that band can help improve the performance of seizure detection and prediction.</p></div><div><h3>Significance</h3><p>EEG is susceptible to artefacts and is not preferred in a low-cost ambulatory device. ECG can be used in wearable devices (like chest bands) and is feasible for developing a low-cost ambulatory device for seizure prediction. Early seizure prediction can provide patients and clinicians with the required alert to take necessary precautions and prevent a fatality, significantly improving the patient’s quality of life.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"204 ","pages":"Article 107403"},"PeriodicalIF":2.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}