Lin Lung-Chang, Chang Ming-Yuh, Chiu Yi-Hung, Chiang Ching-Tai, Wu Rong-Ching, Yang Rei-Cheng, Ouyang Chen-Sen
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Departments of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.
Pediatr Neonatol. 2022 May;63(3):283-290. doi: 10.1016/j.pedneo.2021.12.011. Epub 2022 Mar 15.
The decision to continue or discontinue antiepileptic drug (AED) treatment in patients who are seizure free for a prolonged time is critical. Studies have used certain risk factors or electroencephalogram (EEG) findings to predict seizure recurrence after the withdrawal of AEDs. However, applicable biomarkers to guide the withdrawal of AEDs are lacking.
In this study, we used EEG analysis based on multiscale deep neural networks (MSDNN) to establish a method for predicting seizure recurrence after the withdrawal of AEDs. A total of 60 patients with epilepsy were divided into two groups (30 in the recurrence group and 30 in the non-recurrence group). All patients were seizure free for at least 2 years. Before AED withdrawal, an EEG was performed for each patient, which showed no epileptiform discharges. These EEG recordings were classified using MSDNN.
We found that the performance indices of classification between recurrence and non-recurrence groups had a mean sensitivity, mean specificity, mean accuracy, and mean area under the receiver operating characteristic curve of 74.23%, 75.83%, 74.66%, and 82.66%, respectively.
Our proposed method is a promising tool to help physicians to predict seizure recurrence after AED withdrawal among seizure-free patients.
对于长时间无癫痫发作的患者,决定继续或停用抗癫痫药物(AED)治疗至关重要。已有研究使用某些风险因素或脑电图(EEG)结果来预测停用AED后的癫痫复发。然而,缺乏可用于指导停用AED的生物标志物。
在本研究中,我们使用基于多尺度深度神经网络(MSDNN)的EEG分析来建立一种预测停用AED后癫痫复发的方法。总共60例癫痫患者被分为两组(复发组30例,非复发组30例)。所有患者至少2年无癫痫发作。在停用AED之前,对每位患者进行了一次EEG检查,结果显示无癫痫样放电。这些EEG记录使用MSDNN进行分类。
我们发现,复发组和非复发组之间分类的性能指标的平均灵敏度、平均特异性、平均准确率和受试者操作特征曲线下的平均面积分别为74.23%、75.83%、74.66%和82.66%。
我们提出的方法是一种有前景的工具,可帮助医生预测无癫痫发作患者停用AED后的癫痫复发。