Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, U.S.A.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, U.S.A.
J Clin Neurophysiol. 2024 Jan 1;41(1):72-82. doi: 10.1097/WNP.0000000000000946. Epub 2022 May 17.
Evaluating the effects of antiseizure medication (ASM) on patients with epilepsy remains a slow and challenging process. Quantifiable noninvasive markers that are measurable in real-time and provide objective and useful information could guide clinical decision-making. We examined whether the effect of ASM on patients with epilepsy can be quantitatively measured in real-time from EEGs.
This retrospective analysis was conducted on 67 patients in the long-term monitoring unit at Boston Children's Hospital. Two 30-second EEG segments were selected from each patient premedication and postmedication weaning for analysis. Nonlinear measures including entropy and recurrence quantitative analysis values were computed for each segment and compared before and after medication weaning.
Our study found that ASM effects on the brain were measurable by nonlinear recurrence quantitative analysis on EEGs. Highly significant differences ( P < 1e-11) were found in several nonlinear measures within the seizure zone in response to antiseizure medication. Moreover, the size of the medication effect correlated with a patient's seizure frequency, seizure localization, number of medications, and reported seizure frequency reduction on medication.
Our findings show the promise of digital biomarkers to measure medication effects and epileptogenicity.
评估抗癫痫药物（ASM）对癫痫患者的影响仍然是一个缓慢而具有挑战性的过程。能够实时测量的、具有可量化的、无创性的标志物，可以提供客观有用的信息，从而指导临床决策。我们研究了从 EEG 中是否可以实时定量测量 ASM 对癫痫患者的影响。
本回顾性分析在波士顿儿童医院的长期监测病房中对 67 名患者进行。在每个患者的药物预治疗和药物逐渐减停后，分别选择两个 30 秒的 EEG 片段进行分析。对每个片段计算了包括熵和递归定量分析值在内的非线性测量值，并比较了药物逐渐减停前后的变化。
我们的研究发现，通过 EEG 上的非线性递归定量分析可以测量 ASM 对大脑的影响。在抗癫痫药物作用下，癫痫区域内的几个非线性测量指标存在非常显著的差异（P<1e-11）。此外，药物作用的大小与患者的癫痫发作频率、癫痫发作部位、药物种类以及药物治疗后癫痫发作频率的降低相关。
我们的研究结果表明，数字生物标志物具有测量药物疗效和致痫性的潜力。
