Does glucose influence multidien cycles of interictal and/or ictal activities?

Abstract

There are multidien patterns of seizure occurrence. Predicting seizure risk may be easier with biomarker correlates to multidien patterns. We hypothesize multiday hyper or hypoglycemia contributes to seizure risk. Methods: In a type I diabetic (T1D) with focal onset epilepsy with continuous glucose monitoring (CGM) and responsive neurostimulation (RNS) devices, we studied multiday interictal activities (IEA), seizures, and glucose. Hourly CGM data was matched to hourly RNS captures of interictal and ictal activities over 33 months. RNS detection settings were unchanged. Multidien cycles were analyzed, active blocks of IEA and ictal episodes defined, and tissue glucose averages studied. Results: Average glucose was 161 mg/dl. A 40-day cycle of interictal and ictal activities occurred, though no similar glucose cycle was evident. Glucose elevations relative to patient average were associated with increases in IEA but not seizure. Frequent seizures were not associated with obvious elevations or decreases of glucose from baseline, most seizures occurred at +/-10 mg/dl of average daily glucose (i.e. 150− 170 mg/dl). Conclusion: Tissue glucose may influence IEA but may not influence multiday seizure activity or very frequent seizures. In an ambulatory T1D patient multiday hypo or hyperglycemic extremes do not appear to provoke seizure activities.

Spectro-spatial features in distributed human intracranial activity proactively encode peripheral metabolic activity

“…1H, Paired t-test: all P < 0.05). As there have been studies associating interictal epileptiform discharges (IEDs) to glucose levels 19 , we evaluated the extent to which IEDs were correlated to glucose levels in our dataset. In Subject 1 and Subject 3 with epilepsy, we found that IEDs in the seizure onset zone had lag-corrected correlation 0.22 and 0.20 with interstitial glucose variations, respectively (Supplementary Fig.…”

“…Thus, the HFA at any given point represents an average of one-minute recording. Similarly, the analytic signals of delta (1-4 Hz), theta (4-8 Hz), alpha (8)(9)(10)(11)(12), beta (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), and gamma bands (25-70 Hz) were obtained using the same approach, except 4th order Butterworth filter was used as the bandpass filter. Interictal epileptiform discharges (IEDs) were computed using an automated algorithm as previously described 53 .…”