癫痫发作持续时间可预测电休克治疗诱发癫痫发作后的发作后脑电图恢复情况。

Seizure duration predicts postictal electroencephalographic recovery after electroconvulsive therapy-induced seizures.

作者信息

C M Pottkämper Julia, P A J Verdijk Joey, Stuiver Sven, Aalbregt Eva, Schmettow Martin, Hofmeijer Jeannette, van Waarde Jeroen A, J A M van Putten Michel

机构信息

Clinical Neurophysiology, Technical Medical Centre, Faculty of Science and Technology, University of Twente, Hallenweg 15, 7522NB, Enschede, the Netherlands; Rijnstate Hospital, Department of Psychiatry, Wagnerlaan 55, 6815AD, Arnhem, the Netherlands; Rijnstate Hospital, Department of Neurology, Wagnerlaan 55, 6815AD, Arnhem, the Netherlands.

出版信息

Clin Neurophysiol. 2023 Apr;148:1-8. doi: 10.1016/j.clinph.2023.01.008. Epub 2023 Jan 26.

DOI:10.1016/j.clinph.2023.01.008

PMID:36773503

Abstract

OBJECTIVE

We aim to provide a quantitative description of the relation between seizure duration and the postictal state using features extracted from the postictal electroencephalogram (EEG).

METHODS

Thirty patients with major depressive disorder treated with electroconvulsive therapy (ECT) were studied with continuous EEG before, during, and after ECT-induced seizures. EEG recovery was quantified as the spectral difference between postictal and baseline EEG using the temporal brain symmetry index (BSI). The postictal temporal EEG evolution was modeled with a single exponential. The parameters of the model, including the time constant τ, describe the change and speed of postictal EEG recovery. The change from baseline EEG at t = 60 minutes post-seizure (ΔBSI) was calculated from the exponential fit. Postictal clinical reorientation time (ROT) was clinically established. A multivariate generalized multi-level Bayesian model was estimated with seizure duration and ROT as predictors of τ and ΔBSI.

RESULTS

EEG features of 290 seizures and postictal states were used for analyses. The model faithfully described the dynamics of the postictal EEG in nearly all patients. Seizure duration was associated with the recovery time constant, τ, and ΔBSI. ROT was associated with τ, but not with ΔBSI.

CONCLUSIONS

Longer seizures are associated with slower postictal EEG recovery and more enduring EEG changes compared to baseline.

SIGNIFICANCE

Quantitative EEG allows objective assessment of the postictal state.

摘要

目的

我们旨在利用从发作后脑电图（EEG）中提取的特征，对发作持续时间与发作后状态之间的关系进行定量描述。

方法

对30例接受电休克治疗（ECT）的重度抑郁症患者在ECT诱发发作前、发作期间和发作后进行连续脑电图研究。使用颞脑对称指数（BSI）将脑电图恢复量化为发作后脑电图与基线脑电图之间的频谱差异。发作后颞叶脑电图演变用单指数模型进行模拟。该模型的参数，包括时间常数τ，描述了发作后脑电图恢复的变化和速度。根据指数拟合计算发作后60分钟时（ΔBSI）与基线脑电图的变化。临床上确定发作后临床重新定向时间（ROT）。以发作持续时间和ROT作为τ和ΔBSI的预测因子，估计多元广义多级贝叶斯模型。