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Tufa U, Gravitis A, Zukotynski K, Chinvarun Y, Devinsky O, Wennberg R, Carlen PL, Bardakjian BL. A Peri-Ictal EEG-Based Biomarker for Sudden Unexpected Death in Epilepsy (SUDEP) Derived From Brain Network Analysis. Front Netw Physiol 2022; 2:866540. [PMID: 36926093 PMCID: PMC10013055 DOI: 10.3389/fnetp.2022.866540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022]
Abstract
Sudden unexpected death in epilepsy (SUDEP) is the leading seizure-related cause of death in epilepsy patients. There are no validated biomarkers of SUDEP risk. Here, we explored peri-ictal differences in topological brain network properties from scalp EEG recordings of SUDEP victims. Functional connectivity networks were constructed and examined as directed graphs derived from undirected delta and high frequency oscillation (HFO) EEG coherence networks in eight SUDEP and 14 non-SUDEP epileptic patients. These networks were proxies for information flow at different spatiotemporal scales, where low frequency oscillations coordinate large-scale activity driving local HFOs. The clustering coefficient and global efficiency of the network were higher in the SUDEP group pre-ictally, ictally and post-ictally (p < 0.0001 to p < 0.001), with features characteristic of small-world networks. These results suggest that cross-frequency functional connectivity network topology may be a non-invasive biomarker of SUDEP risk.
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Affiliation(s)
- Uilki Tufa
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Adam Gravitis
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Katherine Zukotynski
- Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada.,Department of Radiology and Medicine, McMaster University, Hamilton, ON, Canada
| | - Yotin Chinvarun
- Comprehensive Epilepsy Program and Neurology Unit, Phramongkutklao Hospital, Bangkok, Thailand
| | - Orrin Devinsky
- Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - Richard Wennberg
- Division of Neurology, Toronto Western Hospital, Toronto, ON, Canada
| | - Peter L Carlen
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Department of Neurology, New York University School of Medicine, New York, NY, United States.,Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Berj L Bardakjian
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada
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