Is routine electroencephalography (<scp>EEG</scp>) a useful biomarker for pharmacoresistant epilepsy?

Steinhoff, Bernhard J.; Scholly, Julia; Dentel, Christel; Staack, Anke M.

doi:10.1111/epi.12187

Cited by 13 publications

(14 citation statements)

References 8 publications

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“…However, seizure control was not associated with significantly different network patterns in our cohort and might not be a sensitive marker in a rather well controlled cohort. Similarly, persistent GSWD do not necessarily have an effect on long-term seizure prognosis 46 . Moreover, patients with higher medication load had lower connectivity in the beta1 frequency band.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, persistent GSWD do not necessarily have an effect on long-term seizure prognosis. 46 Moreover, patients with higher medication load had lower connectivity in the β1 frequency band. Because only 6 patients received more than 2 antiepileptic agents at the time of the study, we can only speculate about a network downregulation through antiepileptic treatment.…”

Section: Discussionmentioning

confidence: 99%

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Heritability of Magnetoencephalography Phenotypes Among Patients With Genetic Generalized Epilepsy and Their Siblings

et al. 2021

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ObjectiveTo assess whether neuronal signals in patients with genetic generalized epilepsy (GGE) are heritable, we examined magnetoencephalography (MEG) resting-state recordings in patients and their healthy siblings.MethodsIn a prospective, cross-sectional design, we investigated source-reconstructed power and functional connectivity in patients, siblings and controls. We analyzed 5 minutes of cleaned and awake data without epileptiform discharges in six frequency bands (1-40 Hz). We further calculated intraclass correlations (ICC) to estimate heritability for the imaging patterns within families.ResultsCompared with controls (n = 45), patients with GGE (n = 25) showed widespread increased functional connectivity (theta to gamma frequency bands) and power (delta to gamma frequency bands) across the spectrum. Siblings (n = 18) fell between the levels of patients and controls. Heritability of the imaging metrics was observed in regions, where patients strongly differed from controls, mainly in beta frequencies, but also for delta and theta power. Network connectivity in GGE was heritable in frontal, central and inferior parietal brain areas and power in central, temporo-parietal, and subcortical structures. Presence of generalized spike-wave activity during recordings and medication were associated with the network patterns, whereas other clinical factors such as age of onset, disease duration or seizure control were not.ConclusionMetrics of brain oscillations are well suited to characterize GGE and likely relate to genetic factors rather than the active disease or treatment. High power and connectivity levels co-segregated in patients with GGE and healthy siblings, predominantly in the beta band, representing an endophenotype of GGE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Heritability of Magnetoencephalography Phenotypes Among Patients With Genetic Generalized Epilepsy and Their Siblings

et al. 2021

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“…In addition, patient studies found that IIS do not consistently correspond with disease activity (e.g., occurrence in relation to seizures or changes in anti-seizure medication levels) [11][12][13][14][15] . However, recent work in animals has identified unique aspects of IIS that correspond with experimental epileptogenesis [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological Biomarkers of Epilepsy

2014

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In patients being evaluated for epilepsy and in animal models of epilepsy, electrophysiological recordings are carried to capture seizures to determine the existence of epilepsy. Electroencephalography recordings from the scalp, or sometimes directly from the brain, are also used to locate brain areas where seizure begins, and in surgical treatment help plan the area for resection. As seizures are unpredictable and can occur infrequently, ictal recordings are not ideal in terms of time, cost, or risk when, for example, determining the efficacy of existing or new anti-seizure drugs, evaluating potential anti-epileptogenic interventions, or for prolonged intracerebral electrode studies. Thus, there is a need to identify and validate other electrophysiological biomarkers of epilepsy that could be used to diagnose, treat, cure, and prevent epilepsy. Electroencephalography recordings in the epileptic brain contain other interictal electrophysiological disturbances that can occur more frequently than seizures, such as interictal spikes (IIS) and sharp waves, and from invasive studies using wide bandwidth recording and small diameter electrodes, the discovery of pathological high-frequency oscillations (HFOs) and microseizures. Of IIS, HFOs, and microseizures, a significant amount of recent research has focused on HFOs in the pathophysiology of epilepsy. Results from studies in animals with epilepsy and presurgical patients have consistently found a strong association between HFOs and epileptogenic brain tissue that suggest HFOs could be a potential biomarker of epileptogenicity and epileptogenesis. Here, we discuss several aspects of HFOs, as well as IIS and microseizures, and the evidence that supports their role as biomarkers of epilepsy.

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“…There is a report that EEGs are non-sufficient biomarkers for the prediction of pharmacoresistant epilepsy. Additional factors such as etiology and pathophysiology should also be taken into consideration [ 103 ]. Since neurophysiological and imaging tools have been rapidly improved, new epilepsy biomarkers employing such tools may be developed in the coming years and become clinical routine [ 42 ].…”

Section: Future Prospects On Development Of Rat Models For Epilepsy Rmentioning

confidence: 99%

Advances on genetic rat models of epilepsy

et al. 2015

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Considering the suitability of laboratory rats in epilepsy research, we and other groups have been developing genetic models of epilepsy in this species. After epileptic rats or seizure-susceptible rats were sporadically found in outbred stocks, the epileptic traits were usually genetically-fixed by selective breeding. So far, the absence seizure models GAERS and WAG/Rij, audiogenic seizure models GEPR-3 and GEPR-9, generalized tonic-clonic seizure models IER, NER and WER, and Canavan-disease related epileptic models TRM and SER have been established. Dissection of the genetic bases including causative genes in these epileptic rat models would be a significant step toward understanding epileptogenesis. N-ethyl-N-nitrosourea (ENU) mutagenesis provides a systematic approach which allowed us to develop two novel epileptic rat models: heat-induced seizure susceptible (Hiss) rats with an Scn1a missense mutation and autosomal dominant lateral temporal epilepsy (ADLTE) model rats with an Lgi1 missense mutation. In addition, we have established episodic ataxia type 1 (EA1) model rats with a Kcna1 missense mutation derived from the ENU-induced rat mutant stock, and identified a Cacna1a missense mutation in a N-Methyl-N-nitrosourea (MNU)-induced mutant rat strain GRY, resulting in the discovery of episodic ataxia type 2 (EA2) model rats. Thus, epileptic rat models have been established on the two paths: ‘phenotype to gene’ and ‘gene to phenotype’. In the near future, development of novel epileptic rat models will be extensively promoted by the use of sophisticated genome editing technologies.

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Is routine electroencephalography (EEG) a useful biomarker for pharmacoresistant epilepsy?

Cited by 13 publications

References 8 publications

Heritability of Magnetoencephalography Phenotypes Among Patients With Genetic Generalized Epilepsy and Their Siblings

Heritability of Magnetoencephalography Phenotypes Among Patients With Genetic Generalized Epilepsy and Their Siblings

Electrophysiological Biomarkers of Epilepsy

Advances on genetic rat models of epilepsy

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