Strength and stability of EEG functional connectivity predict treatment response in infants with epileptic spasms
Strength and stability of EEG functional connectivity predict treatment response in infants with epileptic spasms
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DOI：
10.1016/j.clinph.2018.07.017
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发表时间：
2018-10-01
影响因子：
4.7
通讯作者：
Lopour, Beth A.
中科院分区：
文献类型：
--
作者：
Shrey, Daniel W.;McManus, Olivia Kim;Lopour, Beth A.
目的：癫痫性痉挛（ES）与病理神经网络相关，这可能是特征脑电图模式（如心律失常）的基础。在这里，我们评估脑电图功能连通性作为治疗反应的定量标记，与经典视觉脑电图特征进行比较。方法：回顾性分析21例ES患者和21例健康对照。治疗前和治疗后>= 10天的脑电图数据进行盲法视觉评估，并使用互相关技术测量功能连通性。收集短期治疗反应和长期结局数据。结果：ES患者的功能网络比对照组更强、更稳定。在治疗开始后，所有应答者（通过痉挛停止来定义）都表现出功能连接强度的下降，而连接强度的增加仅发生在无应答者中。有6名受试者具有异常强的治疗前功能连通性，并且都是应答者。视觉评估的脑电图特征不能预测治疗反应。结论：网络连通性和稳定性的变化与ES的治疗反应相关，高的治疗前连通性可能预示着良好的短期治疗反应。定量测量优于脑电图的视觉分析。意义：功能网络可能作为ES治疗反应的客观标记物具有价值，具有促进快速识别个性化有效治疗的潜力。(C) 2018年国际临床神经生理学联合会。Elsevier B.V.版权所有。
Objective: Epileptic spasms (ES) are associated with pathological neuronal networks, which may underlie characteristic EEG patterns such as hypsarrhythmia. Here we evaluate EEG functional connectivity as a quantitative marker of treatment response, in comparison to classic visual EEG features.Methods: We retrospectively identified 21 ES patients and 21 healthy controls. EEG data recorded before treatment and after >= 10 days of treatment underwent blinded visual assessment, and functional connectivity was measured using cross-correlation techniques. Short-term treatment response and long-term outcome data were collected.Results: Subjects with ES had stronger, more stable functional networks than controls. After treatment initiation, all responders (defined by cessation of spasms) exhibited decreases in functional connectivity strength, while an increase in connectivity strength occurred only in non-responders. There were six subjects with unusually strong pre-treatment functional connectivity, and all were responders. Visually assessed EEG features were not predictive of treatment response.Conclusions: Changes in network connectivity and stability correlate to treatment response for ES, and high pre-treatment connectivity may predict favorable short-term treatment response. Quantitative measures outperform visual analysis of the EEG.Significance: Functional networks may have value as objective markers of treatment response in ES, with potential to facilitate rapid identification of personalized, effective treatments. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.