Functional Connectivity of Interictal Discharges on EEG correlates with treatment response to Vigabatrin in Infantile spasms.
Abstract number :
1.413
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2021
Submission ID :
1886512
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:56 AM
Authors :
Arjun Nair, - McMaster University; Kevin Jones, M.D FRCPC – Pediatric Neurologist and Epileptologist, Pediatrics, McMaster Children's Hospital
Rationale: Infantile spasms are associated with abnormal neuronal networks, during a critical age of synaptogenesis and brain plasticity. Existing literature surrounding hypsarrhythmia scarcely mention the relevance of interictal source coherence as a measure of brain connectivity. In this study, we hypothesize that the degree of interictal spike source connectivity and the lag time of source connections in the brain decreases in children with infantile spasms with hypsarrhythmia or modified hypsarrhythmia who respond to treatment with vigabatrin.
Methods: We collected an initial EEG of a core group of 18 patients with infantile spasms and hypsarrhythmia or modified hypsarrhythmia who were all treated with vigabatrin. After 2 weeks of treatment, we analyzed their clinical and EEG responses using source coherence of interictal spikes that were mapped onto a standard pediatric MRI head model using the Curry 8 software.
Results: All 18 patients in the initial cohort showed hypsarrhythmia or modified hypsarrhythmia on the EEG. 9 patients showed an EEG response to treatment, and 7 patients showed a clinical response. Among those patients who responded, 9 showed a decrease in source coherence. Pearson correlation analysis showed a significant (P = 0.006) negative (R = -0.62) association between follow-up EEG response and source coherence increase in lag time at follow-up. Treatment response and source coherence lag range at follow-up showed a significant (P = 0.035) negative (R = -0.5) association. Correlation analysis also showed a significant (P = 0.022) negative (R = -0.54) association between follow-up EEG response and source coherence. Multiple regression analysis showed source coherence lag range at follow-up and source coherence at follow-up to be the strongest predictors of follow-up EEG response.
Conclusions: In this pilot study we show that we can measure the electrographical response to treatment of hypsarrhythmia using source connectivity as it negatively correlates with EEG responses. Although this seems to be a promising tool, future studies should further explore the dynamics of source coherence as a method to assess treatment responses in hypsarrhythmia and modified hypsarrhythmia.
Funding: Please list any funding that was received in support of this abstract.: No funding received.
Clinical Epilepsy