Novel Seizure Biomarkers in Continuous Electrocardiograms from Pediatric Epilepsy Patients.
Novel Seizure Biomarkers in Continuous Electrocardiograms from Pediatric Epilepsy Patients.
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DOI：
10.1109/embc46164.2021.9629760
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Stamoulis C
中科院分区：
文献类型：
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作者：
Cheung F;Pearl PL;Stamoulis C
越来越多的证据表明，癫痫发作伴随着多系统的变化，不仅是大脑的变化，还包括其控制下的器官和系统的变化。这些系统的非脑电图测量可用于改善癫痫发作预测，这虽然很困难，但对于下一代癫痫疗法的成功至关重要。术前患者评估期间的临床电生理学研究通常会收集连续的脑电图以及跨越多天的心电图数据。先前的工作报告了心电图变化，但主要集中在心室活动和短暂的发作期间隔。本研究利用新颖的数据驱动分类和心电图高维信号空间的分离，研究了心室和心房活动中与癫痫发作相关的变化。研究人员对 22 名患有耐药性癫痫发作且未诊断出心血管异常的儿科患者的连续心电图随时间的推移分析了复杂性、心率和 R-R 间期长度的测量结果。 15 名患者 (>68%) 在包含癫痫发作的时间间隔内心房或心室活动（或两者）有显着变化。因此，对于大量患者来说，心脏标志物可能会受到癫痫发作的具体调节，并可用于改善和个性化癫痫发作预测。
There is growing evidence that seizures are accompanied by multi-system changes, not only in the brain but also in organs and systems under its control. Non-EEG measurements from these systems could be leveraged to improve seizure prediction, which is difficult but critical to the success of next-generation epilepsy therapies. Clinical electrophysiology studies during presurgical patient evaluations routinely collect continuous EEG but also ECG data that span multiple days. Prior work has reported electrocardiographic changes but has primarily focused on ventricular activity and brief peri-ictal intervals. Using novel data-driven classification and separation of the ECG high-dimensional signal space, this study investigated seizure-related changes in both ventricular and atrial activity. Measures of complexity as well as heart rate and R-R interval length were analyzed over time in continuous ECGs from 22 pediatric patients with pharmacoresistant seizures and no diagnosed cardiovascular anomalies. Fifteen patients (>68%) had significant changes in atrial or ventricular activity (or both) in intervals containing seizures. Thus, for a substantial number of patients, cardiac markers may be specifically modulated by seizures and could be leveraged to improve and personalize seizure prediction.