Predicting seizure freedom with AED treatment in newly diagnosed patients with MRI-negative epilepsy: A large cohort and multicenter study.

Autor: Yang S; Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province 450003, China., Han X; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China. Electronic address: hanxiong7589@126.com., Wang N; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China., Gu R; Department of Neurology, the Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, Henan Province 543002, China. Electronic address: gurenjun1961@163.com., Chen W; Department of Neurology, the First Affiliated Hospital of Henan University, Kaifeng, Henan Province 475000, China., Wang E; Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan Province 450003, China., Chen Y; Clinical Research Service Center, Henan Provincial People's Hospital, Zhengzhou, Henan Province 450003, China., He G; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China., Zhu X; Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province 450003, China., Ma B; Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province 450003, China., Li M; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China., Zhao P; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China., Han J; Department of Clinical Medicine, Zhengzhou University, Zhengzhou, Henan Province 450003, China., Fang Y; Department of Neurology, the First Affiliated Hospital of Henan University, Kaifeng, Henan Province 475000, China., Zeng J; Department of Neurology, the Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, Henan Province 543002, China., Bai Y; Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan Province 450003, China., Zhao T; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China., Chen Y; Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan Province 450003, China.
Jazyk: angličtina
Zdroj: Epilepsy & behavior : E&B [Epilepsy Behav] 2020 May; Vol. 106, pp. 107022. Date of Electronic Publication: 2020 Mar 24.
DOI: 10.1016/j.yebeh.2020.107022
Abstrakt: Objective: We developed and validated a prediction score for predicting the probability of 6-month and 12-month seizure freedom of antiepileptic drug (AED) treatment in newly diagnosed patients with magnetic resonance imaging (MRI)-negative epilepsy.
Methods: The development cohort included 543 consecutive patients from the Epilepsy Center of Henan Provincial People's Hospital, while the validation cohorts included 493 consecutive patients in two independent cohorts. Univariate analysis and a forward and backward elimination of multivariate Cox regression analysis were used to select predictive factors. The performance of the score was evaluated with C-index, calibration plots, and decision curve analysis. The risk stratification was also performed.
Results: The score included five routinely available predictors including Circadian rhythms, Electroencephalography before AED treatment, Neuropsychiatric disorders, Perinatal brain injury, and History of central nervous system infection (CENPH score). When applied to the external validation cohort, the score showed good discrimination with C-index (development group: 0.83; validation group: 0.78), and calibration plots indicated well calibration, as well as the decision curve analysis showed good predictive accuracy and clinical values in four cohorts. The points of the score were categorized to the following three probability levels for predicting seizure freedom: high probability (0-83.11 points), medium probability (83.11-122.71 points), and low probability (>122.71 points). And online calculator was established to make this score easily applicable in clinical practice.
Conclusions: We established a simple, practical, and evidence-based prediction score for predicting seizure freedom with AEDs to aid in the clinical consultation and treatment decision for the newly diagnosed patients with MRI-negative epilepsy.
Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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