Automated Analysis of Risk Factors for Postictal Generalized EEG Suppression.

Autor:	Zhao X; Department of Neurology, Qilu Hospital of Shandong University, Jinan, China., Vilella L; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Zhu L; Biostatistics and Epidemiology Research Design Core, Division of Clinical and Translational Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Rani MRS; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Hampson JP; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Hampson J; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Hupp NJ; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Sainju RK; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, United States., Friedman D; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; New York University (NYU) Grossman School of Medicine, New York, NY, United States., Nei M; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States., Scott C; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, Institute of Neurology, University College London, London, United Kingdom., Allen L; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, Institute of Neurology, University College London, London, United Kingdom., Gehlbach BK; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, United States., Schuele S; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Feinberg School of Medicine, Northwestern University, Chicago, IL, United States., Harper RM; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurobiology and the Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States., Diehl B; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, Institute of Neurology, University College London, London, United Kingdom., Bateman LM; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States., Devinsky O; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; New York University (NYU) Grossman School of Medicine, New York, NY, United States., Richerson GB; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, United States., Zhang GQ; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Lhatoo SD; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States., Lacuey N; National Institute of Neurological Disorders and Stroke (NINDS) Center for Sudden Unexpected Death in Epilepsy (SUDEP) Research, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.; Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2021 May 11; Vol. 12, pp. 669517. Date of Electronic Publication: 2021 May 11 (Print Publication: 2021).
DOI:	10.3389/fneur.2021.669517
Abstrakt:	Rationale: Currently, there is some ambiguity over the role of postictal generalized electro-encephalographic suppression (PGES) as a biomarker in sudden unexpected death in epilepsy (SUDEP). Visual analysis of PGES, known to be subjective, may account for this. In this study, we set out to perform an analysis of PGES presence and duration using a validated signal processing tool, specifically to examine the association between PGES and seizure features previously reported to be associated with visually analyzed PGES. Methods: This is a prospective, multicenter epilepsy monitoring study of autonomic and breathing biomarkers of SUDEP in adult patients with intractable epilepsy. We studied videoelectroencephalogram (vEEG) recordings of generalized convulsive seizures (GCS) in a cohort of patients in whom respiratory and vEEG recording were carried out during the evaluation in the epilepsy monitoring unit. A validated automated EEG suppression detection tool was used to determine presence and duration of PGES. Results: We studied 148 GCS in 87 patients. PGES occurred in 106/148 (71.6%) seizures in 70/87 (80.5%) of patients. PGES mean duration was 38.7 ± 23.7 (37; 1-169) seconds. Presence of tonic phase during GCS, including decerebration, decortication and hemi-decerebration, were 8.29 (CI 2.6-26.39, p = 0.0003), 7.17 (CI 1.29-39.76, p = 0.02), and 4.77 (CI 1.25-18.20, p = 0.02) times more likely to have PGES, respectively. In addition, presence of decerebration ( p = 0.004) and decortication ( p = 0.02), older age ( p = 0.009), and hypoxemia duration ( p = 0.03) were associated with longer PGES durations. Conclusions: In this study, we confirmed observations made with visual analysis, that presence of tonic phase during GCS, longer hypoxemia, and older age are reliably associated with PGES. We found that of the different types of tonic phase posturing, decerebration has the strongest association with PGES, followed by decortication, followed by hemi-decerebration. This suggests that these factors are likely indicative of seizure severity and may or may not be associated with SUDEP. An automated signal processing tool enables objective metrics, and may resolve apparent ambiguities in the role of PGES in SUDEP and seizure severity studies. Competing Interests: OD receives grant support from NINDS, NIMH, MURI, CDC, and NSF. He has equity and/or compensation from the following companies: Tilray, Receptor Life Sciences, Qstate Biosciences, Tevard Biosciences, Script Biosciences, Regel Biosciences, Empatica, Papa & Barkley, Rettco, Silver Spike, and California Cannabis Enterprises (CCE). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Zhao, Vilella, Zhu, Rani, Hampson, Hampson, Hupp, Sainju, Friedman, Nei, Scott, Allen, Gehlbach, Schuele, Harper, Diehl, Bateman, Devinsky, Richerson, Zhang, Lhatoo and Lacuey.)
Databáze:	MEDLINE
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