High Frequency Oscillations Mirror Disease Activity in a Children’s Population with Stroke
Abstract number :
1.045
Submission category :
1. Basic Mechanisms / 1C. Electrophysiology/High frequency oscillations
Year :
2024
Submission ID :
1127
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Margarita Maltseva, MD – University of Calgary
Daniel Lachner-Piza, PhD – University of Calgary
Adam Kirton, MD – Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada
Michael Esser, MD, PhD – Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada
Julia Jacobs, MD, PhD – University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada
Rationale: Innovative research has proven High Frequency Oscillations (HFOs) have been reliably detected on scalp electroencephalograms (EEG) in children of various ages. In the past, HFOs have been mainly investigated as EEG markers of epileptic brain activity in the context of presurgical evaluation of the epileptogenic zone. Pediatric patients who experienced arterial ischemic stroke are at risk of developing epilepsy. With potential development of preventive treatment, HFOs could be ultimately used to modify seizure occurrence at an early stage. As a first step towards this, our goal was to investigate whether HFOs can mirror disease activity in a pediatric patient cohort with underlying stroke.
Methods: In this pilot study, continuous scalp EEGs of 35 patients were analyzed visually. Per patient 600 seconds of quiet sleep, preferably sleep Stage II, with low level of artifacts and at least one hour apart from electroclinical seizures were selected. The patient population was divided into three groups: Group 1 included patients with a history of Developmental/Epileptic Encephalopathy with Spike Wave Activation on Sleep (DEE-SWAS). Group 2 included patients who have been seizure free an received an EEG for any other reasons than seizures (e.g. cognitive decline, follow-up for possible medication weaning). Group 3 included patients with an EEG due to recent seizures. The Kruskal-Wallis Test was used to asses statistically significant differences in HFO rates between the three groups.
Results: The average age of our study population was 9.1 ± 5.9 years (Range 1-18). In total, 630 channels were used for analysis and showed a mean HFO rate of 0.82/min (SD 1.32/min; Range 0-11.74/min). Patients with DEE-SWAS showed significantly higher HFO occurrence rates than patients who have been seizure free (group 1 vs. group 2; p< 0.001). Patients with DEE-SWAS also showed significantly higher HFO occurrence rates than patients with recent seizures only (group 1 vs. group 3; p< 0.001). There was no significant difference in HFO occurrence rates between patients with recent seizures and patients without seizures (group 2 vs. group 3; p=0.569).
Conclusions: Scalp HFO rates are significantly higher in children with DEE-SWAS than in children without seizures or children with active epilepsy and recent seizures, indicating that HFOs can mirror epileptic disease activity in a pediatric patient population with stroke. As a next step, investigations, whether high HFO rates precede the development of recurring seizures, will allow the development of a non-invasive biomarker identifying patients at risk of developing epilepsy.
Funding: This work was supported by the Canadian Institutes of Health Research, grant number 480576 and by the German Research Foundation, grant number 530582215.
Basic Mechanisms