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Ye H, He C, Hu W, Xiong K, Hu L, Chen C, Xu S, Xu C, Wang Y, Ding Y, Wu Y, Zhang K, Wang S, Wang S. Pre-ictal fluctuation of EEG functional connectivity discriminates seizure phenotypes in mesial temporal lobe epilepsy. Clin Neurophysiol 2023; 151:107-115. [PMID: 37245497 DOI: 10.1016/j.clinph.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/29/2023] [Accepted: 05/10/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE We explored whether quantifiable differences between clinical seizures (CSs) and subclinical seizures (SCSs) occur in the pre-ictal state. METHODS We analyzed pre-ictal stereo-electroencephalography (SEEG) retrospectively across mesial temporal lobe epilepsy patients with recorded CSs and SCSs. Power spectral density and functional connectivity (FC) were quantified within and between the seizure onset zone (SOZ) and the early propagation zone (PZ), respectively. To evaluate the fluctuation of neural connectivity, FC variability was computed. Measures were further verified by a logistic regression model to evaluate their classification potentiality through the area under the receiver-operating-characteristics curve (AUC). RESULTS Fifty-four pre-ictal SEEG epochs (27 CSs and 27 SCSs) were selected among 14 patients. Within the SOZ, pre-ictal FC variability of CSs was larger than SCSs in 1-45 Hz during 30 seconds before seizure onset. Pre-ictal FC variability between the SOZ and PZ was larger in SCSs than CSs in 55-80 Hz within 1 minute before onset. Using these two variables, the logistic regression model achieved an AUC of 0.79 when classifying CSs and SCSs. CONCLUSIONS Pre-ictal FC variability within/between epileptic zones, not signal power or FC value, distinguished SCSs from CSs. SIGNIFICANCE Pre-ictal epileptic network stability possibly marks seizure phenotypes, contributing insights into ictogenesis and potentially helping seizure prediction.
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Affiliation(s)
- Hongyi Ye
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenmin He
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenhan Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai Xiong
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, China
| | - Lingli Hu
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sha Xu
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cenglin Xu
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Basic Medical College, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yi Wang
- Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Basic Medical College, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yao Ding
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yingcai Wu
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, China
| | - Kai Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shan Wang
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Shuang Wang
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Cox BC, Khattak JF, Starnes K, Brinkmann BH, Tatum WO, Noe KH, Van Gompel JJ, Miller KJ, Marsh WR, Grewal SS, Zimmerman RS, So EL, Wong-Kisiel LC, Burkholder DB. Subclinical seizures on stereotactic EEG: characteristics and prognostic value. Seizure 2022; 101:96-102. [DOI: 10.1016/j.seizure.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/14/2022] [Accepted: 07/24/2022] [Indexed: 12/01/2022] Open
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He C, Chen C, Yang Y, Hu L, Jin B, Ming W, Wang Z, Ding Y, Ding M, Wang S, Wang S. Clinical Characteristics and Prognostic Significance of Subclinical Seizures in Focal Epilepsy: A Retrospective Study. Neurol Ther 2022; 11:763-779. [PMID: 35378679 PMCID: PMC9095772 DOI: 10.1007/s40120-022-00342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim was to evaluate the clinical characteristics and prognostic significance of subclinical seizures (SCSs) on scalp video-electroencephalogram (VEEG) monitoring with or without intracranial electroencephalogram (IEEG) monitoring in patients who had epilepsy surgery. METHODS We reviewed 286 epileptic patients who underwent subsequent epilepsy surgery during scalp-VEEG evaluation with or without IEEG monitoring between 2013 and 2020, with a minimum follow-up of 1 year. The prevalence and clinical characteristics of SCSs, as well as their prognostic significance, were analyzed. RESULTS A total of 286 patients were enrolled for analysis, and 80 patients had IEEG implanted. SCSs were recorded in 9.79% of the patients based on VEEG and 50% based on IEEG. In the VEEG group (n = 286), younger seizure onset (P = 0.004) was associated with the presence of s-SCSs (SCSs detected on scalp VEEG). In the IEEG group (n = 80), temporal lobe epilepsy (P = 0.015) was associated with the presence of i-SCSs (SCSs detected on IEEG). Of 286 patients, 208 (72.73%) were seizure-free in the VEEG group, and 56 0f 80 patients (70%) were seizure-free in the IEEG group through the last follow-up. In the VEEG group, the presence of s-SCSs did not affect seizure outcome; predictors of seizure recurrence were longer epilepsy duration (P = 0.003, OR 1.003, 95% CI 1.001-1.005), history of focal to bilateral tonic-clonic seizure (P = 0.027, OR 1.665, 95% CI 1.060-2.613), nonspecific pathology (P = 0.018, OR 2.184, 95% CI 1.145-4.163), and incomplete resection (P = 0.004, OR 2.705, 95% CI 1.372-5.332). In the IEEG group, i-SCSs were significantly associated with seizure outcome (P = 0.028, OR 0.371, 95% CI 0.153-0.898). CONCLUSION The rate of SCSs captured on IEEG monitoring was higher than that on VEEG monitoring during presurgical evaluation. SCSs detected on VEEG monitoring were associated with younger seizure onset. SCSs detected on IEEG monitoring were associated with temporal lobe epilepsy and also predicted surgical outcomes in focal epilepsy.
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Affiliation(s)
- Chenmin He
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Cong Chen
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Yuyu Yang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Lingli Hu
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Bo Jin
- Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Wenjie Ming
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Zhongjin Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Meiping Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Shuang Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
| | - Shan Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
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