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Measuring the effects of first antiepileptic medication in Temporal Lobe Epilepsy: predictive value of quantitative-EEG analysis
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.clinph.2020.10.020
Lorenzo Ricci 1 , Giovanni Assenza 1 , Patrizia Pulitano 2 , Valerio Simonelli 1 , Luca Vollero 3 , Jacopo Lanzone 1 , Oriano Mecarelli 2 , Vincenzo Di Lazzaro 1 , Mario Tombini 1
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OBJECTIVE To determine the quantitative EEG responses in a population of drug-naïve patients with Temporal Lobe Epilepsy (TLE) after Levetiracetam (LEV) initiation as first antiepileptic drug (AED). We hypothesized that the outcome of AED treatment can be predicted from EEG data in patients with TLE. METHODS Twenty-three patients with TLE and twenty-five healthy controls were examined. Clinical outcome was dichotomized into seizure-free (SF) and non-seizure-free (NSF) after two years of LEV. EEG parameters were compared between healthy controls and patients with TLE at baseline (EEGpre) and after three months of AED therapy (EEGpre-post) and between SF and NSF patients. Receiver Operating Characteristic curves models were built to test whether EEG parameters predicted outcome. RESULTS AED therapy induces an increase in EEG power for Alpha (p = 0.06) and a decrease in Theta (p < 0.05). Connectivity values were lower in SF compared to NSF patients (p < 0.001). Quantitative EEG predicted outcome after LEV treatment with an estimated accuracy varying from 65.2% to 91.3% (area under the curve [AUC] = 0.56-0.93) for EEGpre and from 69.9% to 86.9% (AUC = 0.69-0.94) for EEGpre-post. CONCLUSIONS AED therapy induces EEG modifications in TLE patients, and such modifications are predictive of clinical outcome. SIGNIFICANCE Quantitative EEG may help understanding the effect of AEDs in the central nervous system and offer new prognostic biomarkers for patients with epilepsy.

中文翻译:

测量第一种抗癫痫药物对颞叶癫痫的影响:定量脑电图分析的预测价值

目的 确定在首次使用左乙拉西坦 (LEV) 作为第一种抗癫痫药物 (AED) 后,颞叶癫痫 (TLE) 未接受药物治疗的患者群体的定量 EEG 反应。我们假设可以从 TLE 患者的 EEG 数据预测 AED 治疗的结果。方法 对 23 名 TLE 患者和 25 名健康对照者进行了检查。LEV 治疗两年后,临床结果分为无癫痫发作 (SF) 和无癫痫发作 (NSF)。在基线 (EEGpre) 和 AED 治疗三个月后 (EEGpre-post) 以及 SF 和 NSF 患者之间比较健康对照和 TLE 患者的 EEG 参数。建立接收者操作特征曲线模型以测试 EEG 参数是否预测结果。结果 AED 治疗导致 Alpha 的 EEG 功率增加(p = 0. 06) 和 Theta 的减少 (p < 0.05)。与 NSF 患者相比,SF 患者的连通性值较低(p < 0.001)。LEV 治疗后定量 EEG 预测结果的估计准确度为 EEGpre 的 65.2% 至 91.3%(曲线下面积 [AUC] = 0.56-0.93),EEGpre 的估​​计准确度为 69.9% 至 86.9%(AUC = 0.69-0.94)邮政。结论 AED 治疗会导致 TLE 患者的 EEG 改变,并且这种改变可以预测临床结果。意义 定量脑电图可能有助于了解 AEDs 在中枢神经系统中的作用,并为癫痫患者提供新的预后生物标志物。EEGpre 为 3%(曲线下面积 [AUC] = 0.56-0.93),EEGpre-post 为 69.9% 至 86.9%(AUC = 0.69-0.94)。结论 AED 治疗会导致 TLE 患者的 EEG 改变,并且这种改变可以预测临床结果。意义 定量脑电图可能有助于了解 AEDs 在中枢神经系统中的作用,并为癫痫患者提供新的预后生物标志物。EEGpre 为 3%(曲线下面积 [AUC] = 0.56-0.93),EEGpre-post 为 69.9% 至 86.9%(AUC = 0.69-0.94)。结论 AED 治疗会导致 TLE 患者的 EEG 改变,并且这种改变可以预测临床结果。意义 定量脑电图可能有助于了解 AEDs 在中枢神经系统中的作用,并为癫痫患者提供新的预后生物标志物。
更新日期:2021-01-01
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