Quantitative electrocorticographic biomarkers of clinical outcomes in mesial temporal lobe epileptic patients treated with the RNS® system
Quantitative electrocorticographic biomarkers of clinical outcomes in mesial temporal lobe epileptic patients treated with the RNS® system
复制标题
DOI：
10.1016/j.clinph.2019.05.017
复制
发表时间：
2019-08-01
影响因子：
4.7
通讯作者：
Morrell, Martha J.
中科院分区：
文献类型：
--
作者：
Desai, Sharanya Arcot;Tcheng, Thomas K.;Morrell, Martha J.
目的：寻找中颞叶 (MTL) 癫痫患者临床结果的发作间皮层电图 (ECoG) 生物标志物。方法：在 NeuroPace (R) RNS (R) 系统对 256 名患者进行的临床试验中，与基线相比，第 7 年时，20 名 MTL 患者临床癫痫发作减少最多（上响应四分位数；-96.5% 中位变化），20 名患者临床癫痫发作减少最少（较低响应四分位数；-17.4% 中值变化）进行了评估。比较两个响应四分位数的临床和发作间期 ECoG 特征。结果：上响应四分位数和下响应四分位数的人口统计学和临床特征相似。上四分位数患者的发作间期尖峰率 (ISR) 显着较低 (p < 0.0001)，而两个响应四分位数之间的归一化 theta (4-8 Hz) 和归一化 gamma (> 25 Hz) 也不同 (p < 0.05)。在 71% 的分析通道中，ISR 与临床癫痫发作率呈正相关（p < 0.05）。在没有临床癫痫发作的几个月内捕获的 ECoG 记录具有最低的 ISR。结论：ISR 是 MTL 患者临床反应的一个强有力的区分因素。归一化的 θ 和 γ 也可以区分临床反应。意义：在 MTL 患者中，发作间期尖峰率以及根据慢性动态基线 ECoG 计算的光谱功率可以作为临床结果的生物标志物，并可以用作治疗终点。 (C) 2019 年国际临床神经生理学联合会。由 Elsevier B.V. 出版
Objectives: Find interictal electrocorticographic (ECoG) biomarkers of clinical outcomes in mesiotemporal lobe (MTL) epilepsy patients.Methods: In the NeuroPace (R) RNS (R) System clinical trials with 256 patients, 20 MTL patients with the most reduction in clinical seizures at Year 7 compared to baseline (upper response quartile; -96.5% median change) and 20 with the least reduction in clinical seizures (lower response quartile; -17.4% median change) were evaluated. Clinical and interictal ECoG features from the two response quartiles were compared.Results: Demographic and clinical features were similar in the upper and lower response quartiles. Interictal spike rate (ISR) was substantially lower (p < 0.0001) in the upper quartile patients, while normalized theta (4-8 Hz) and normalized gamma (> 25 Hz) were also different (p < 0.05) between the two response quartiles. ISR was positively correlated (p < 0.05) with clinical seizure rates in 71% of the channels analyzed. ECoG records captured during months with no clinical seizures had the lowest ISR.Conclusions: ISR is a strong differentiator of clinical response in MTL patients. Normalized theta and gamma also differentiates clinical response. Significance: In MTL patients, the interictal spike rate along with spectral power computed from chronic ambulatory baseline ECoGs may serve as biomarkers of clinical outcomes and maybe used as treatment endpoints. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.