Abstract
Objective: To investigate the diagnostic utility of high frequency oscillations (HFOs) via scalp electroencephalogram (EEG) in infantile spasms. Methods: We retrospectively analyzed interictal slow-wave sleep EEGs sampled at 2,000 Hz recorded from 30 consecutive patients who were suspected of having infantile spasms. We measured the rate of HFOs (80–500 Hz) and the strength of the cross-frequency coupling between HFOs and slow-wave activity (SWA) at 3–4 Hz and 0.5–1 Hz as quantified with modulation indices (MIs). Results: Twenty-three patients (77%) exhibited active spasms during the overnight EEG recording. Although the HFOs were detected in all children, increased HFO rate and MIs correlated with the presence of active spasms (p < 0.001 by HFO rate; p < 0.01 by MIs at 3–4 Hz; p = 0.02 by MIs at 0.5–1 Hz). The presence of active spasms was predicted by the logistic regression models incorporating HFO-related metrics (AUC: 0.80–0.98) better than that incorporating hypsarrhythmia (AUC: 0.61). The predictive performance of the best model remained favorable (87.5% accuracy) after a cross-validation procedure. Conclusions: Increased rate of HFOs and coupling between HFOs and SWA are associated with active epileptic spasms. Significance: Scalp-recorded HFOs may serve as an objective EEG biomarker for active epileptic spasms.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2527-2536 |
| Number of pages | 10 |
| Journal | Clinical Neurophysiology |
| Volume | 131 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2020 |
Funding
HN is supported by the Susan Spencer Clinical Research Training Fellowship in Epilepsy from the American Academy of Neurology, with funding from the American Epilepsy Society, the American Brain Foundation, and the Epilepsy Foundation. HN also has received research support from the Pediatric Victory Foundation. RS, as well as HN, have received research support from Sudha Neelakantan & Venky Harinarayan Charitable Fund. SAH has received research support from the Epilepsy Therapy Project, the Milken Family Foundation, the Hughes Family Foundation, the Elsie and Isaac Fogelman Endowment, Eisai, Lundbeck, Insys, Zogenix, GW Pharmaceuticals, UCB, and has received honoraria for service on the scientific advisory boards of Questcor, Mallinckrodt, Insys, UCB, and Upsher-Smith, for service as a consultant to Eisai, UCB, GW Pharmaceuticals, Insys, and Mallinckrodt, and for service on the speakers' bureaus of Mallinckrodt and Greenwich Bioscience. RS serves on scientific advisory boards and speakers bureaus for and has received honoraria and funding for travel from Eisai, Greenwich Biosciences, UCB Pharma, Sunovion, Supernus, Lundbeck Pharma, Liva Nova, and West Therapeutics (advisory only); receives royalties from the publication of Pellock's Pediatric Neurology (Demos Publishing, 2016) and Epilepsy: Mechanisms, Models, and Translational Perspectives (CRC Press, 2011). RJS is funded by NINDS R01 NS106957, NS33310, NS084017, U54 100064, and Department of Defense EP180003. JYW has received research funding from Novartis, GW Pharmaceutical, NINDS/NIH (R01 NS082649, U01 NS082320, U54 NS092090, U01 NS092595), and Tuberous Sclerosis Alliance, and serves on the scientific advisory boards and speakers\u2019 bureaus for Novartis and GW Pharmaceuticals. The research described was also supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881. We are indebted to Jason T. Lerner, Joyce H. Matsumoto, Lekha M. Rao, Rajsekar R. Rajaraman, Conrad Szeliga, Maria Garcia Roca, Richard Le, Patrick Wilson, and Kristina Murata for their assistance in the study and sample acquisition.
Keywords
- FR
- HFO
- Modulation index
- Physiological HFO
- Ripple
ASJC Scopus subject areas
- Sensory Systems
- Neurology
- Clinical Neurology
- Physiology (medical)