Generalized polyspike train

An EEG biomarker of drug-resistant idiopathic generalized epilepsy

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

OBJECTIVE: To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. METHODS: We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort. Factors associated with drug resistance in multivariable analysis were tested in the replication cohort. RESULTS: The discovery cohort included 85 patients (29% drug-resistant and 71% drug-responsive). Their median age at assessment was 32 years and 50.6% were female. Multivariable analysis showed that higher number of seizure types ever experienced (3 vs 1: odds ratio [OR] = 31.1, 95% confidence interval [CI]: 4.5-214, p < 0.001; 3 vs 2: OR = 14.6, 95% CI: 2.3-93.1, p = 0.004) and generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep were associated with drug resistance (OR = 10.8, 95% CI: 2.4-49.4, p = 0.002). When these factors were tested in the replication cohort of 80 patients (27.5% drug-resistant and 72.5% drug-responsive; 71.3% female; median age 27.5 years), the proportion of patients with generalized polyspike train during sleep was also higher in the drug-resistant group (OR = 4.0, 95% CI: 1.35-11.8, p = 0.012). CONCLUSION: Generalized polyspike train during sleep may be an EEG biomarker for drug resistance in adults with idiopathic generalized epilepsy.

Original languageEnglish
Pages (from-to)e1822-e1830
Number of pages9
JournalNeurology
Volume91
Issue number19
DOIs
Publication statusPublished - 6 Nov 2018

Cite this

@article{9e5ea76faa3542968f2e4c21ef245b64,
title = "Generalized polyspike train: An EEG biomarker of drug-resistant idiopathic generalized epilepsy",
abstract = "OBJECTIVE: To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. METHODS: We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort. Factors associated with drug resistance in multivariable analysis were tested in the replication cohort. RESULTS: The discovery cohort included 85 patients (29{\%} drug-resistant and 71{\%} drug-responsive). Their median age at assessment was 32 years and 50.6{\%} were female. Multivariable analysis showed that higher number of seizure types ever experienced (3 vs 1: odds ratio [OR] = 31.1, 95{\%} confidence interval [CI]: 4.5-214, p < 0.001; 3 vs 2: OR = 14.6, 95{\%} CI: 2.3-93.1, p = 0.004) and generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep were associated with drug resistance (OR = 10.8, 95{\%} CI: 2.4-49.4, p = 0.002). When these factors were tested in the replication cohort of 80 patients (27.5{\%} drug-resistant and 72.5{\%} drug-responsive; 71.3{\%} female; median age 27.5 years), the proportion of patients with generalized polyspike train during sleep was also higher in the drug-resistant group (OR = 4.0, 95{\%} CI: 1.35-11.8, p = 0.012). CONCLUSION: Generalized polyspike train during sleep may be an EEG biomarker for drug resistance in adults with idiopathic generalized epilepsy.",
author = "Yanping Sun and Seneviratne, {Udaya Kumara} and Perucca, {Piero Cesare} and Zhibin Chen and Meng Tan and O'Brien, {Terence John} and Wendyl D'souza and Kwan, {Kwok Leung Patrick}",
year = "2018",
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doi = "10.1212/WNL.0000000000006472",
language = "English",
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pages = "e1822--e1830",
journal = "Neurology",
issn = "0028-3878",
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Generalized polyspike train : An EEG biomarker of drug-resistant idiopathic generalized epilepsy. / Sun, Yanping; Seneviratne, Udaya Kumara; Perucca, Piero Cesare; Chen, Zhibin; Tan, Meng; O'Brien, Terence John; D'souza, Wendyl; Kwan, Kwok Leung Patrick.

In: Neurology, Vol. 91, No. 19, 06.11.2018, p. e1822-e1830.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Generalized polyspike train

T2 - An EEG biomarker of drug-resistant idiopathic generalized epilepsy

AU - Sun, Yanping

AU - Seneviratne, Udaya Kumara

AU - Perucca, Piero Cesare

AU - Chen, Zhibin

AU - Tan, Meng

AU - O'Brien, Terence John

AU - D'souza, Wendyl

AU - Kwan, Kwok Leung Patrick

PY - 2018/11/6

Y1 - 2018/11/6

N2 - OBJECTIVE: To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. METHODS: We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort. Factors associated with drug resistance in multivariable analysis were tested in the replication cohort. RESULTS: The discovery cohort included 85 patients (29% drug-resistant and 71% drug-responsive). Their median age at assessment was 32 years and 50.6% were female. Multivariable analysis showed that higher number of seizure types ever experienced (3 vs 1: odds ratio [OR] = 31.1, 95% confidence interval [CI]: 4.5-214, p < 0.001; 3 vs 2: OR = 14.6, 95% CI: 2.3-93.1, p = 0.004) and generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep were associated with drug resistance (OR = 10.8, 95% CI: 2.4-49.4, p = 0.002). When these factors were tested in the replication cohort of 80 patients (27.5% drug-resistant and 72.5% drug-responsive; 71.3% female; median age 27.5 years), the proportion of patients with generalized polyspike train during sleep was also higher in the drug-resistant group (OR = 4.0, 95% CI: 1.35-11.8, p = 0.012). CONCLUSION: Generalized polyspike train during sleep may be an EEG biomarker for drug resistance in adults with idiopathic generalized epilepsy.

AB - OBJECTIVE: To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. METHODS: We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort. Factors associated with drug resistance in multivariable analysis were tested in the replication cohort. RESULTS: The discovery cohort included 85 patients (29% drug-resistant and 71% drug-responsive). Their median age at assessment was 32 years and 50.6% were female. Multivariable analysis showed that higher number of seizure types ever experienced (3 vs 1: odds ratio [OR] = 31.1, 95% confidence interval [CI]: 4.5-214, p < 0.001; 3 vs 2: OR = 14.6, 95% CI: 2.3-93.1, p = 0.004) and generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep were associated with drug resistance (OR = 10.8, 95% CI: 2.4-49.4, p = 0.002). When these factors were tested in the replication cohort of 80 patients (27.5% drug-resistant and 72.5% drug-responsive; 71.3% female; median age 27.5 years), the proportion of patients with generalized polyspike train during sleep was also higher in the drug-resistant group (OR = 4.0, 95% CI: 1.35-11.8, p = 0.012). CONCLUSION: Generalized polyspike train during sleep may be an EEG biomarker for drug resistance in adults with idiopathic generalized epilepsy.

UR - http://www.scopus.com/inward/record.url?scp=85056265453&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000006472

DO - 10.1212/WNL.0000000000006472

M3 - Article

VL - 91

SP - e1822-e1830

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 19

ER -