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机器学习预测颞叶癫痫左乙拉西坦治疗反应。

Machine learning for predicting levetiracetam treatment response in temporal lobe epilepsy.

机构信息

Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.

Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo, 21, 00128, Rome, Italy.

出版信息

Clin Neurophysiol. 2021 Dec;132(12):3035-3042. doi: 10.1016/j.clinph.2021.08.024. Epub 2021 Oct 13.

DOI:10.1016/j.clinph.2021.08.024
PMID:34717224
Abstract

OBJECTIVE

To determine the predictive power for seizure-freedom of 19-channels EEG, measured both before and after three months the initiation of the use of Levetiracetam (LEV), in a cohort of people after a new diagnosis of temporal-lobe epilepsy (TLE) using a machine-learning approach.

METHODS

Twenty-three individuals with TLE were examined. We dichotomized clinical outcome into seizure-free (SF) and non-seizure-free (NSF) after two years of LEV. EEG effective power in different frequency bands was compared using baseline EEG (T0) and the EEG after three months of LEV therapy (T1) between SF and NSF patients. Partial Least Square (PLS) analysis was used to test and validate the prediction of the model for clinical outcome.

RESULTS

A total of 152 features were extracted from the EEG recordings. When considering only the features calculated at T1, a predictive power for seizure-freedom (AUC = 0.750) was obtained. When employing both T0 and T1 features, an AUC = 0.800 was obtained.

CONCLUSIONS

This study provides a proof-of-concept pipeline for predicting the clinical response to anti-seizure medications in people with epilepsy.

SIGNIFICANCE

Future studies may benefit from the pipeline proposed in this study in order to develop a model that can match each patient to the most effective anti-seizure medication.

摘要

目的

使用机器学习方法,在新诊断为颞叶癫痫(TLE)的患者队列中,确定在开始使用左乙拉西坦(LEV)三个月前后测量的 19 通道 EEG 对无癫痫发作的预测能力。

方法

对 23 名 TLE 患者进行了检查。我们将两年后 LEV 的临床结果分为无癫痫发作(SF)和有癫痫发作(NSF)两组。通过比较 SF 和 NSF 患者的基线 EEG(T0)和 LEV 治疗三个月后的 EEG(T1),比较不同频段 EEG 有效功率的差异。采用偏最小二乘法(PLS)分析对模型进行测试和验证,以预测临床结果。

结果

从 EEG 记录中提取了总共 152 个特征。仅考虑 T1 计算的特征时,获得了无癫痫发作的预测能力(AUC=0.750)。当同时使用 T0 和 T1 的特征时,AUC 为 0.800。

结论

本研究为预测癫痫患者抗癫痫药物的临床反应提供了概念验证的管道。

意义

未来的研究可能会受益于本研究提出的管道,以开发一种能够将每个患者与最有效的抗癫痫药物相匹配的模型。

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