Interictal intracranial EEG asymmetry lateralizes temporal lobe epilepsy.

Autor:	Conrad EC; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA., Lucas A; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Department of Bioengineering, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA., Ojemann WKS; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Department of Bioengineering, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA., Aguila CA; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Department of Bioengineering, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA., Mojena M; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA., LaRocque JJ; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA., Pattnaik AR; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Department of Bioengineering, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA., Gallagher R; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA., Greenblatt A; Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA., Tranquille A; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA., Parashos A; Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA., Gleichgerrcht E; Department of Neurology, Emory University, Atlanta, GA 30325, USA., Bonilha L; Department of Neurology, Emory University, Atlanta, GA 30325, USA., Litt B; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.; Department of Bioengineering, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA., Sinha S; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA., Ungar L; Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA 19104, USA., Davis KA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2023 Dec 14. Date of Electronic Publication: 2023 Dec 14.
DOI:	10.1101/2023.12.13.23299907
Abstrakt:	Patients with drug-resistant temporal lobe epilepsy often undergo intracranial EEG recording to capture multiple seizures in order to lateralize the seizure onset zone. This process is associated with morbidity and often ends in postoperative seizure recurrence. Abundant interictal (between-seizure) data is captured during this process, but these data currently play a small role in surgical planning. Our objective was to predict the laterality of the seizure onset zone using interictal (between-seizure) intracranial EEG data in patients with temporal lobe epilepsy. We performed a retrospective cohort study (single-center study for model development; two-center study for model validation). We studied patients with temporal lobe epilepsy undergoing intracranial EEG at the University of Pennsylvania (internal cohort) and the Medical University of South Carolina (external cohort) between 2015 and 2022. We developed a logistic regression model to predict seizure onset zone laterality using interictal EEG. We compared the concordance between the model-predicted seizure onset zone laterality and the side of surgery between patients with good and poor surgical outcomes. 47 patients (30 women; ages 20-69; 20 left-sided, 10 right-sided, and 17 bilateral seizure onsets) were analyzed for model development and internal validation. 19 patients (10 women; ages 23-73; 5 left-sided, 10 right-sided, 4 bilateral) were analyzed for external validation. The internal cohort cross-validated area under the curve for a model trained using spike rates was 0.83 for a model predicting left-sided seizure onset and 0.68 for a model predicting right-sided seizure onset. Balanced accuracies in the external cohort were 79.3% and 78.9% for the left- and right-sided predictions, respectively. The predicted concordance between the laterality of the seizure onset zone and the side of surgery was higher in patients with good surgical outcome. In conclusion, interictal EEG signatures are distinct across seizure onset zone lateralities. Left-sided seizure onsets are easier to distinguish than right-sided onsets. A model trained on spike rates accurately identifies patients with left-sided seizure onset zones and predicts surgical outcome. Competing Interests: Competing interests Nothing to report.
Databáze:	MEDLINE
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