Automated Analysis of Risk Factors for Postictal Generalized EEG Suppression

作者：Xiuhe Zhao, Laura Vilella, Liang Zhu, M.R. Sandhya Rani, Johnson P. Hampson, Jaison S. Hampson, Norma J. Hupp, Rup K. Sainju, Daniel Friedman, Maromi Nei, Catherine Scott, Luke A. Allen, Brian K. Gehlbach, Stephan Schuele, Ronald M. Harper, Beate Diehl, Lisa M. Bateman, Orrin Devinsky, George B. Richerson, Guo‐Qiang Zhang, Samden D. Lhatoo, Nuria Lacuey · 发表于：Frontiers in Neurology · 年份：2021 · DOI：10.3389/fneur.2021.669517 · 被引用次数：13 · 研究领域：EEG and Brain-Computer Interfaces、Epilepsy research and treatment、Functional Brain Connectivity Studies

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...