Lu Wen-Yu, Chen Jyun-Yu, Chang Chi-Feng, Weng Wen-Chin, Lee Wang-Tso, Shieh Jiann-Shing
Department of Pediatrics, New Taipei City Hospital, Taipei, Taiwan.
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2015 Dec 11;10(12):e0144732. doi: 10.1371/journal.pone.0144732. eCollection 2015.
Increasing animal studies supported the harmful effects of prolonged or frequent neonatal seizures in developing brain, including increased risk of later epilepsy. Various nonlinear analytic measures had been applied to investigate the change of brain complexity with age. This study focuses on clarifying the relationship between later epilepsy and the changes of electroencephalogram (EEG) complexity in neonatal seizures.
EEG signals from 19 channels of the whole brain from 32 neonates below 2 months old were acquired. The neonates were classified into 3 groups: 9 were normal controls, 9 were neonatal seizures without later epilepsy, and 14 were neonatal seizures with later epilepsy. Sample entropy (SamEn), multiscale entropy (MSE) and complexity index (CI) were analyzed.
Although there was no significant change in SamEn, the CI values showed significantly decreased over Channels C3, C4, and Cz in patients with neonatal seizures and later epilepsy compared with control group. More multifocal epileptiform discharges in EEG, more abnormal neuroimaging findings, and higher incidence of future developmental delay were noted in the group with later epilepsy.
Decreased MSE and CI values in patients with neonatal seizures and later epilepsy may reflect the mixed effects of acute insults, underlying brain immaturity, and prolonged seizures-related injuries. The analysis of MSE and CI can therefore provide a quantifiable and accurate way to decrypt the mystery of neonatal seizures, and could be a promising predictor.
越来越多的动物研究支持新生儿长期或频繁发作癫痫对发育中的大脑具有有害影响，包括日后患癫痫的风险增加。各种非线性分析方法已被用于研究大脑复杂性随年龄的变化。本研究旨在阐明新生儿癫痫发作与日后癫痫之间的关系以及新生儿癫痫发作时脑电图（EEG）复杂性的变化。
采集了32名2个月以下新生儿全脑19个通道的EEG信号。将新生儿分为3组：9名是正常对照组，9名是无日后癫痫的新生儿癫痫患者，14名是有日后癫痫的新生儿癫痫患者。分析了样本熵（SamEn）、多尺度熵（MSE）和复杂性指数（CI）。
虽然SamEn没有显著变化，但与对照组相比，有日后癫痫的新生儿癫痫患者在C3、C4和Cz通道上的CI值显著降低。有日后癫痫的组在EEG中出现更多的多灶性癫痫样放电、更多异常的神经影像学表现以及更高的未来发育迟缓发生率。
有日后癫痫的新生儿癫痫患者的MSE和CI值降低可能反映了急性损伤、潜在的大脑不成熟以及与癫痫发作持续时间相关的损伤的综合影响。因此，MSE和CI分析可以提供一种可量化且准确的方法来解开新生儿癫痫之谜，并且可能是一种有前景的预测指标。
