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Stereo-EEG Ictal Spectral Power Patterns are Associated with Radiofrequency Thermocoagulation Outcome in Epilepsy Related to Periventricular Nodular Heterotopia.

Abstract number : 1.463
Submission category : 2. Translational Research / 2C. Biomarkers
Year : 2022
Submission ID : 2232931
Source : www.aesnet.org
Presentation date : 12/3/2022 12:00:00 PM
Published date : Nov 22, 2022, 05:28 AM

Authors :
Simon Tousseyn, MD, PhD – Academic Center for Epileptology, Kempenhaeghe & MUMC+; Rutger Slegers, MD – Department of Neurosurgery, Maastricht University Medical Center+, Maastricht, The Netherlands; Louis Wagner, MD – Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands; Albert Colon, MD, PhD – Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands; Olaf Schijns, MD, PhD – Department of Neurosurgery, Maastricht University Medical Center+, Maastricht, The Netherlands; Kim Rijkers, MD, PhD – Department of Neurosurgery, Maastricht University Medical Center+, Maastricht, The Netherlands; Danny Hilkman, MD – Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands; Karolina Gasztych, Ms – Laboratory technician clinical neurophysiology, Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands; Balu Krishnan, PhD – Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA; Raf van Hoof, PhD – Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands; Simon Tousseyn, MD, PhD – Academic Center for Epileptology, Kempenhaeghe & Maastricht University Medical Center+, Heeze and Maastricht, The Netherlands

This is a Late Breaking abstract

Rationale: Stereo-electroencephalography (SEEG) is an established diagnostic tool in identifying the epileptogenic zone (EZ) in patients with periventricular nodular heterotopia (PVNH)-related drug-resistant epilepsy. The outcome of seizures after radiofrequency thermocoagulation (RFTC) is variable in this patient group and the search for SEEG biomarkers that may improve treatment is ongoing. The aim of this study was to assess the association between SEEG spectral power patterns and seizure outcome after RFTC.

Methods: We retrospectively included 27 SEEG registrations of 21 consecutive patients with PVNH performed between January 2016 and February 2022 with at least one recorded spontaneous electroclinical seizure and subsequent RFTC of epileptogenic nodules. A spectral decomposition analysis for the entire seizure period and an interictal baseline period was performed. Boost power (1), which indicates the increase in ictal SEEG power compared to baseline and normalized for the duration of the seizure, was calculated across delta to ripple frequency band. Boost power scores were compared (Mann Whitney U test, false detection rate adjusted) based on the coagulation status of the electrode contact pairs, and seizure outcome after RFTC, defined as ILAE 1 or ILAE ≥ 2. Study protocol was reviewed and approved by a local ethical standards committee.

Results: RFTC resulted in an ILAE 1 outcome after 7 of the 27 SEEG registrations. Patient characteristics did not differ statistically in outcome groups except for the follow-up period which was significantly longer in the ILAE 1 outcome group (Table 1). Significant increase of median boost power was seen in coagulated vs. non-coagulated contact pairs in alpha (p=0.005) and beta (p=0.007) frequency band, which was specific for the ILAE 1 outcome group (Figure 1A). Within the coagulated contact pairs, the median boost power was significantly higher in ILAE 1 compared to ILAE ≥ 2 outcome in delta to alpha (p < 0.001) and beta (p=0.004) frequency band. This significantly increased boost power in beta frequency band was specific for coagulated contact pairs (Figure 1C) and absent in non-coagulated contact pairs (Figure 1D).
Translational Research