Quantitative Pharmaco-Electroencephalography in Antiepileptic Drug Research

Höller, Yvonne; Helmstaedter, Christoph; Lehnertz, Klaus

doi:10.1007/s40263-018-0557-x

Cited by 56 publications

(29 citation statements)

References 71 publications

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“…However, some studies report increased connectivity (5, 7), and other studies report decreased connectivity (6, 73) or complex patterns of increased and decreased connectivity (24). It is likely that these differences are influenced by the type of epilepsy studied (genetic/idiopathic vs. focal/lesional epilepsy), clinical differences (e.g., seizure rate/freedom), the methods such as the choice of the frequency band, processing variants used and, possibly, medication (74). All these factors will need to be better addressed in future studies to allow better comparability.…”

Section: Source Connectomes In Epilepsymentioning

confidence: 99%

Network Perspectives on Epilepsy Using EEG/MEG Source Connectivity

et al. 2019

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The evolution of EEG/MEG source connectivity is both, a promising, and controversial advance in the characterization of epileptic brain activity. In this narrative review we elucidate the potential of this technology to provide an intuitive view of the epileptic network at its origin, the different brain regions involved in the epilepsy, without the limitation of electrodes at the scalp level. Several studies have confirmed the added value of using source connectivity to localize the seizure onset zone and irritative zone or to quantify the propagation of epileptic activity over time. It has been shown in pilot studies that source connectivity has the potential to obtain prognostic correlates, to assist in the diagnosis of the epilepsy type even in the absence of visually noticeable epileptic activity in the EEG/MEG, and to predict treatment outcome. Nevertheless, prospective validation studies in large and heterogeneous patient cohorts are still lacking and are needed to bring these techniques into clinical use. Moreover, the methodological approach is challenging, with several poorly examined parameters that most likely impact the resulting network patterns. These fundamental challenges affect all potential applications of EEG/MEG source connectivity analysis, be it in a resting, spiking, or ictal state, and also its application to cognitive activation of the eloquent area in presurgical evaluation. However, such method can allow unique insights into physiological and pathological brain functions and have great potential in (clinical) neuroscience.

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Section: Source Connectomes In Epilepsymentioning

confidence: 99%

Network Perspectives on Epilepsy Using EEG/MEG Source Connectivity

et al. 2019

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“…Therefore, the detection of EEG during and after drug withdrawal is also worthy of attention. In recent years, the value of quantitative pharmaco-EEG in predicting and evaluating treatment response and side effects of ASM has started to gain scientific interest ( 40 ). Studies of patients with temporal lobe epilepsy have shown that quantitative EEG at both resting state and after treatment has a high predictive significance for the effect of drug treatment, which may offer new prognostic biomarkers for patients with epilepsy ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Long-Term Outcomes of Monotherapy and Polytherapy in Seizure-Free Patients With Epilepsy Following Antiseizure Medication Withdrawal

Wang

et al. 2021

Front. Neurol.

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Objective: The objectives of this study were to compare the risk and timing of seizure relapse in seizure-free patients with epilepsy following the withdrawal of monotherapy or polytherapy and to identify relevant influencing factors.Methods: Patients who had achieved at least a 2-year seizure remission and started the withdrawal of antiseizure medication (ASM) were enrolled in this study. All patients were followed for at least 3 years or until seizure relapse. According to the number of ASMs at the time of withdrawalwas about twice than that, patients were divided into two groups: monotherapy group and polytherapy group. The Cox proportional hazards model was used to compare the recurrence risk of the two groups. Univariate analysis and multiple logistic regression analysis were used to analyze potential confounding variables between patients treated with monotherapy and polytherapy.Results: A total of 188 patients (119 males and 69 females) were included. The average prescribed daily dose of most ASMs at the time of withdrawal was moderate or low (30–50% defined daily dose). The recurrence of most patients (89.2%) occurred within the first 3 years after withdrawal. The recurrence risk in patients treated with polytherapy at the time of withdrawal was about twice than that of the monotherapy group [p = 0.001, hazard ratio (HR) = 2.152, 95% confidence interval (CI) = 1.350–3.428]. Multivariate analysis showed that patients treated with polytherapy were significantly older at seizure onset [p = 0.024, odd ratio (OR) = 1.027, 95% CI = 1.004–1.052] and had a significantly longer duration of epilepsy before treatment (p = 0.004, OR = 1.009, 95% CI = 1.003–1.015) compared to patients in the monotherapy group. In addition, a history of perinatal injury was found to be an independent risk factor of seizure relapse in patients with ASM withdrawal.Conclusion: The average prescribed daily dose of most ASMs at the time of withdrawal was moderate or low. Patients who received polytherapy at the time of withdrawal, particularly those with later seizure onset age and longer epilepsy duration before treatment, had a higher recurrence risk after ASMs withdrawal compared to patients treated with monotherapy.

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“…Finally, we provide more information about epilepsy onset, duration, seizure type, seizure frequency, and medication in Supplementary Table 2. Höller et al (2018) provides an overview of pharmaco-EEG studies with anti-epileptic drugs (AEDs) based on 37 studies. Different AEDs had different effects on oscillatory activity.…”

Section: The Effect Of Epilepsy On Wave Occurrence Ratesmentioning

confidence: 99%

Low frequency traveling waves in the human cortex coordinate neural activity across spatial scales

Sreekumar

Wittig

Chapeton

et al. 2020

Preprint

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Traveling waves of oscillatory activity are thought to influence neuronal spiking, providing a spatiotemporal frame-work for neural communication. However, no direct link has been established between traveling waves and single unit spiking in humans. We examined traveling waves in the human lateral temporal lobe by using recordings from intracranial electrodes implanted in twenty participants for seizure monitoring as they performed a paired-associates verbal memory task. We observed ubiquitous low frequency traveling waves across the temporal lobe. Long-range alpha waves were more likely to occur during word pairs that were subsequently remembered relative to those that were not. In a subset of participants with microelectrode recordings, macro-scale waves co-occurred with micro-scale waves, which in turn were temporally locked to single unit spiking. This temporal coordination between traveling waves at different spatial scales and between waves and neuronal spiking in the human brain suggests a role for traveling waves in neural communication.

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Quantitative Pharmaco-Electroencephalography in Antiepileptic Drug Research

Cited by 56 publications

References 71 publications

Network Perspectives on Epilepsy Using EEG/MEG Source Connectivity

Network Perspectives on Epilepsy Using EEG/MEG Source Connectivity

Comparison of Long-Term Outcomes of Monotherapy and Polytherapy in Seizure-Free Patients With Epilepsy Following Antiseizure Medication Withdrawal

Low frequency traveling waves in the human cortex coordinate neural activity across spatial scales

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