Automatic Detection of Interictal Ripples in Scalp EEG to Evaluate the Effect and Prognosis of ACTH Therapy in Patients with Infantile Spasms
Abstract number :
3.128
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2021
Submission ID :
1826031
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Wei Wang, PHD - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Hua Li - Department of Neurology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China; Jiaqing Yan - College of Electrical and Control Engineering, North China University of Technology, Beijing, China; Herui Zhang - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Xiaonan Li - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Su Zheng - Department of Neurology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China; Jiaoyang Wang - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Yue Xing - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Lipeng Cheng - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Donghong Li - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Huanling Lai - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Junda Qu - Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, School of Biomedical Engineering, Capital Medical University, Beijing, China; Horace Loh - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; Fang Fang - Department of Neurology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China; Xiaofeng Yang - Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
Rationale: Infantile spasms (IS) is a catastrophic epileptic encephalopathy during infancy and childhood with a variety of etiologies, and it often features a poor response to traditional antiepileptics. As the first-line drug of IS, adrenocorticotropic hormone (ACTH) is highly effective but still suffers from a high relapse risk. Thus, the development of a biomarker to accurately assess patients' seizure risk has important clinical significance in guiding the diagnosis and treatment of epilepsy. For this purpose, high frequency oscillations (HFOs) can be a potential candidate, for it’s closely related to epilepsy. In this study, we developed an automatic scalp HFOs detection system and investigated the feasibility of evaluating the efficacy and long-term prognosis of ACTH treatment in IS based on non-invasive scalp HFOs.
Methods: Thirty-nine children with infantile spasm were enrolled and divided into seizure-free and non-seizure-free groups after ACTH treatment. Patients who were seizure-free were further divided into relapse and non-relapse subgroups based on the observations made during a 6-month follow-up period. The efficacy value of scalp HFO was evaluated by comparing the characteristics of and changes in ripples before and after ACTH treatment in the seizure-free and non-seizure-free groups. The clinical application value of scalp ripples in predicting the prognosis of epilepsy was explored by comparing the characteristics of and changes in ripples in the relapse and non-relapse groups before and after ACTH treatment.
Results: Five patients were included in the first group. The sensitivity and specificity of our optimized high-frequency oscillation automatic detection method were 82.666 ± 5.428% and 63.352 ± 10.424%, respectively. The second group included 39 patients. After ACTH treatment, both the number of ripples (P=0.031) and the number of ripple channels (P=0.011) were significantly lower in the non-seizure group (N=17) than in the seizure group (N=22), while the percentage of decline in the number of ripples (P=0.017), spectral power (P=0.027), and the number of ripple channels (P=0.025) were significantly higher in the non-seizure group than in the seizure group. After ACTH treatment, the relapse group had higher number of ripples (P=0.002), higher spectral power (P=0.048), and wider channel distribution (P=0.019) than the non-relapse group.The number of ripples (P＜0.001), spectral power (P=0.001), and the number of channels (P=0.001) were significantly lower in the non-relapse group than in the relapse group.
Conclusions: As a non-invasive diagnosis and treatment technique, scalp HFOs can reflect the therapeutic effect of patients with epilepsy and has guiding significance for the prognosis of patients with epilepsy. It can be used as a potential biomarker in the diagnosis and treatment of epilepsy.
Funding: Please list any funding that was received in support of this abstract.: The National Natural Science Foundation of China [grant numbers 81971202, 81671367, 81790653].
Neurophysiology