Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago 683-8503, Japan.
Department of Medical Technology, Kagawa Prefectural University of Health Sciences, 281-1 Mure-cho, Takamatsu 761-0123, Japan.
Clin Neurophysiol. 2024 Nov;167:37-48. doi: 10.1016/j.clinph.2024.08.016. Epub 2024 Aug 30.
This study aims to delineate the electrophysiological variances between patients with infantile epileptic spasms syndrome (IESS) and healthy controls and to devise a predictive model for long-term seizure outcomes.
The cohort consisted of 30 individuals in the seizure-free group, 23 in the seizure-residual group, and 20 in the control group. We conducted a comprehensive analysis of pretreatment electroencephalography, including the relative power spectrum (rPS), weighted phase-lag index (wPLI), and network metrics. Follow-up EEGs at 2 years of age were also analyzed to elucidate physiological changes among groups.
Infants in the seizure-residual group exhibited increased rPS in theta and alpha bands at IESS onset compared to the other groups (all p < 0.0001). The control group showed higher rPS in fast frequency bands, indicating potentially enhanced cognitive function. The seizure-free group presented increased wPLI across all frequency bands (all p < 0.0001). Our predictive model utilizing wPLI anticipated long-term outcomes at IESS onset (area under the curve 0.75).
Our findings demonstrated an initial "hypersynchronous state" in the seizure-free group, which was ameliorated following successful treatment.
This study provides a predictive model utilizing functional connectivity and insights into the diverse electrophysiology observed among outcome groups of IESS.
本研究旨在描绘婴儿痉挛症（IESS）患者与健康对照组之间的电生理差异，并制定一种用于预测长期癫痫发作结局的模型。
该队列包括无发作组 30 例、残留发作组 23 例和对照组 20 例。我们对治疗前的脑电图进行了全面分析，包括相对功率谱（rPS）、加权相位滞后指数（wPLI）和网络指标。还对 2 岁时的随访 EEG 进行了分析，以阐明组间的生理变化。
与其他组相比，残留发作组在 IESS 发作时的θ和α频段的 rPS 增加（均 p<0.0001）。对照组在快频段的 rPS 较高，表明可能具有增强的认知功能。无发作组在所有频段的 wPLI 均增加（均 p<0.0001）。我们的 wPLI 预测模型在 IESS 发作时预测了长期结局（曲线下面积 0.75）。
我们的研究结果表明，无发作组在初始时表现出一种“过度同步状态”，这种状态在成功治疗后得到改善。
本研究提供了一种利用功能连接的预测模型，并深入了解了 IESS 不同结局组观察到的多样化电生理学。
