Phase-amplitude coupling between interictal high-frequency activity and slow waves in epilepsy surgery.
Phase-amplitude coupling between interictal high-frequency activity and slow waves in epilepsy surgery.
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作者：
Motoi H;Miyakoshi M;Abel TJ;Jeong JW;Nakai Y;Sugiura A;Luat AF;Agarwal R;Sood S;Asano E
我们假设调制指数（MI）是高频活动> 150hz和慢波相位3 - 4hz之间相幅耦合强度的综合度量，可以作为癫痫术前评估的有用间期生物标志物。我们调查了123例在术外皮质电成像记录下行局灶性皮质切除术的患者，并进行了至少一年的术后随访。我们研究了考虑心肌梗死是否能提高对术后癫痫结果的预测。在间隔期慢波睡眠期间，在每个颅电极位置测量心肌梗死。我们比较了包括MI以及常规临床、癫痫发作区（SOZ）和神经影像学变量的完整多变量逻辑回归模型和包含MI以外所有变量的简化逻辑回归模型对达到ILAE 1级结果的患者的预测准确性。在最近一次随访时，90名患者达到了1级结果（平均随访时间：5.7年）。回归模型拟合R2为0.409，受试者工作特征图曲线下面积（AUC）为0.838，表明全模型具有显著的预后预测能力。“SOZ切除不完全（p<0.001）”、“手术时aed数量较多（p=0.007）”和“未切除组织的心肌梗死相对于切除组织的心肌梗死较大（p=0.020）”与1级预后的概率降低独立相关。简化后的模型预测能力较差，R2为0.266，AUC为0.767。心肌梗死的解剖变异存在于非癫痫性电极部位，定义为不受MRI病变、SOZ或间期尖峰放电影响的电极。在考虑解剖变异因素后，完整模型的预后预测能力R2为0.422，AUC为0.844，敏感性/特异性为0.86/0.76。间歇期心肌梗死记录可为预测术后癫痫发作结果提供有用信息。
We hypothesized that the modulation index (MI), a summary measure of the strength of phase-amplitude coupling between high-frequency activity>150 Hz and the phase of slow wave3–4 Hz, would serve as a useful interictal biomarker for epilepsy presurgical evaluation. We investigated 123 patients who underwent focal cortical resection following extraoperative electrocorticography recording and had at least one-year of postoperative follow-up. We examined whether consideration of MI would improve the prediction of postoperative seizure outcome. MI was measured at each intracranial electrode site during interictal slow-wave sleep. We compared the accuracy of prediction of patients achieving ILAE Class-1 outcome between the full multivariate logistic regression model incorporating MI in addition to conventional clinical, seizure-onset zone (SOZ), and neuroimaging variables and the reduced logistic regression model incorporating all variables other than MI. Ninety patients had Class-1 outcome at the time of most recent follow-up (mean follow-up: 5.7 years). The full model had a noteworthy outcome predictive ability, as reflected by regression model fit R2 of 0.409 and area under the curve (AUC) of receiver operating characteristic plot of 0.838. ‘Incomplete resection of SOZ (p<0.001)’, ‘larger number of AEDs at the time of surgery (p=0.007)’, and ‘larger MI in non-resected tissues relative to that in resected tissue (p=0.020)’ were independently associated with a reduced probability of Class-1 outcome. The reduced model had a lower predictive ability as reflected by R2 of 0.266 and AUC of 0.767. Anatomical variability in MI existed among non-epileptic electrode sites, defined as those unaffected by MRI lesion, SOZ, or interictal spike discharges. With MI adjusted for anatomical variability, the full model yielded the outcome predictive ability of R2 of 0.422, AUC of 0.844, and sensitivity/specificity of 0.86/0.76. MI during interictal recording may provide useful information for prediction of postoperative seizure outcome.
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DOI：
10.1109/embc.2013.6610242
发表时间：
2013
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
--
作者：
Miyakoshi M;Delorme A;Mullen T;Kojima K;Makeig S;Asano E
通讯作者：
Asano E
影响因子：
5.6
作者：
Fujiwara H;Greiner HM;Lee KH;Holland-Bouley KD;Seo JH;Arthur T;Mangano FT;Leach JL;Rose DF
通讯作者：
Rose DF
影响因子：
14.5
作者：
Frauscher, Birgit;von Ellenrieder, Nicolas;Gotman, Jean
通讯作者：
Gotman, Jean
影响因子：
11.2
作者：
Jacobs, Julia;Zijlmans, Maeike;Gotman, Jean
通讯作者：
Gotman, Jean
影响因子：
1.7
作者：
Asano, E;Chugani, DC;Chugani, HT
通讯作者：
Chugani, HT