van Norden S J, Kho K H, Meppelink A M, Ardesch J J, Tjepkema-Cloostermans M C, van Putten M J A M
Departments of Clinical Neurophysiology and Neurology, Medisch Spectrum Twente (MST), Koningstraat 1, 7512KZ Enschede, the Netherlands.
Department of Clinical Neurophysiology, University of Twente (UT), Drienerlolaan 5, 7522NB Enschede, the Netherlands.
Epilepsy Behav Rep. 2025 May 20;31:100781. doi: 10.1016/j.ebr.2025.100781. eCollection 2025 Sep.
Recently, a subcutaneous electroencephalography (sqEEG) electrode became available, enabling ultra-long-term EEG recordings. In our PREDYct study, we aim to predict the efficacy of vagus nerve stimulation (VNS) in epilepsy patients. The study records sqEEG for up to fifteen months, including a 2-3 month period before VNS implantation. Here we report on initial patient experiences, compliance and recordings of epileptiform discharges (EDs). We included the first 10 participants from our ongoing PREDYct study. We calculated recording compliance for each patient. Patients rated their pain during electrode implantation, wearing and explantation using the visual analogue scale (VAS). Approximately two weeks of data from each patient were visually assessed and all EDs were annotated. We used these annotations to evaluate circadian rhythms in ED rate and duration and to compare seizure diaries with annotated ictal patterns. Electrode implantation and explantation were well-tolerated with a median VAS of 4 and 2, respectively. Wearing the electrode was also well-tolerated with median VAS scores of 0 and 0.5 at two and fifteen months, respectively. On average, patients wore the electrode for 441 days with an overall compliance of 27 %, resulting in 28,331 h of EEG. A circadian rhythm in ED rate was observed in three patients, while one patient exhibited a circadian rhythm in ED duration. A comparison of reported seizures and annotated ictal patterns revealed discrepancies. Ultra-long-term sqEEG is well-tolerated and has the potential to be a valuable tool for monitoring treatment. Nevertheless, it remains a challenge but crucial to attain high recording compliance.
最近，一种皮下脑电图（sqEEG）电极问世，可实现超长期脑电图记录。在我们的PREDYct研究中，我们旨在预测癫痫患者迷走神经刺激（VNS）的疗效。该研究记录sqEEG长达15个月，包括VNS植入前2至3个月的时间段。在此，我们报告患者的初始体验、依从性以及癫痫样放电（EDs）的记录情况。我们纳入了正在进行的PREDYct研究中的前10名参与者。我们计算了每位患者的记录依从性。患者使用视觉模拟量表（VAS）对电极植入、佩戴和取出过程中的疼痛程度进行评分。对每位患者大约两周的数据进行了视觉评估，并对所有EDs进行了标注。我们利用这些标注来评估ED发生率和持续时间的昼夜节律，并将癫痫发作日记与标注的发作模式进行比较。电极植入和取出的耐受性良好，VAS评分中位数分别为4和2。佩戴电极的耐受性也良好，在两个月和十五个月时VAS评分中位数分别为0和0.5。患者平均佩戴电极441天，总体依从性为27%，脑电图记录时长达到28331小时。三名患者观察到ED发生率的昼夜节律，一名患者表现出ED持续时间的昼夜节律。报告的癫痫发作与标注的发作模式比较显示存在差异。超长期sqEEG耐受性良好，有可能成为监测治疗的有价值工具。然而，要实现高记录依从性仍然是一项挑战，但至关重要。
