Objective interictal electrophysiology biomarkers optimize prediction of epilepsy surgery outcome
| العنوان: | Objective interictal electrophysiology biomarkers optimize prediction of epilepsy surgery outcome |
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| المؤلفون: | Eishi Asano, Masaki Sonoda, Naoto Kuroda, Hiroki Nariai, Sandeep Sood, Aimee F. Luat, Hirotaka Motoi, Jeong-Won Jeong, Makoto Miyakoshi |
| المصدر: | Brain communications, vol 3, iss 2 Brain Communications |
| بيانات النشر: | Oxford University Press (OUP), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, phase-amplitude coupling, electrocorticography (ECoG), modulation index (MI), modulation index, Modulation index, Neurodegenerative, Logistic regression, high-frequency oscillation (HFO), 03 medical and health sciences, high-frequency oscillation, 0302 clinical medicine, Neuroimaging, Clinical Research, Ictal, Epilepsy surgery, phase-amplitude coupling (PAC), electrocorticography, Mathematics, Epilepsy, AcademicSubjects/SCI01870, business.industry, Oscillation, Neurosciences, General Engineering, Subtraction, Pattern recognition, Brain Disorders, Coupling (physics), 030104 developmental biology, Original Article, AcademicSubjects/MED00310, Artificial intelligence, business, 030217 neurology & neurosurgery, invasive recording |
| الوصف: | Researchers have looked for rapidly- and objectively-measurable electrophysiology biomarkers that accurately localize the epileptogenic zone. Promising candidates include interictal high-frequency oscillation and phase-amplitude coupling. Investigators have independently created the toolboxes that compute the high-frequency oscillation rate and the severity of phase-amplitude coupling. This study of 135 patients determined what toolboxes and analytic approaches would optimally classify patients achieving post-operative seizure control. Four different detector toolboxes computed the rate of high-frequency oscillation at ≥80 Hz at intracranial EEG channels. Another toolbox calculated the modulation index reflecting the strength of phase-amplitude coupling between high-frequency oscillation and slow-wave at 3–4 Hz. We defined the completeness of resection of interictally-abnormal regions as the subtraction of high-frequency oscillation rate (or modulation index) averaged across all preserved sites from that averaged across all resected sites. We computed the outcome classification accuracy of the logistic regression-based standard model considering clinical, ictal intracranial EEG and neuroimaging variables alone. We then determined how well the incorporation of high-frequency oscillation/modulation index would improve the standard model mentioned above. To assess the anatomical variability across non-epileptic sites, we generated the normative atlas of detector-specific high-frequency oscillation and modulation index. Each atlas allowed us to compute the statistical deviation of high-frequency oscillation/modulation index from the non-epileptic mean. We determined whether the model accuracy would be improved by incorporating absolute or normalized high-frequency oscillation/modulation index as a biomarker assessing interictally-abnormal regions. We finally determined whether the model accuracy would be improved by selectively incorporating high-frequency oscillation verified to have high-frequency oscillatory components unattributable to a high-pass filtering effect. Ninety-five patients achieved successful seizure control, defined as International League against Epilepsy class 1 outcome. Multivariate logistic regression analysis demonstrated that complete resection of interictally-abnormal regions additively increased the chance of success. The model accuracy was further improved by incorporating z-score normalized high-frequency oscillation/modulation index or selective incorporation of verified high-frequency oscillation. The standard model had a classification accuracy of 0.75. Incorporation of normalized high-frequency oscillation/modulation index or verified high-frequency oscillation improved the classification accuracy up to 0.82. These outcome prediction models survived the cross-validation process and demonstrated an agreement between the model-based likelihood of success and the observed success on an individual basis. Interictal high-frequency oscillation and modulation index had a comparably additive utility in epilepsy presurgical evaluation. Our empirical data support the theoretical notion that the prediction of post-operative seizure outcomes can be optimized with the consideration of both interictal and ictal abnormalities. Kuroda et al. report the results of the computational analysis of intracranial EEG data from a cohort of 135 patients with drug-resistant focal epilepsy. Both interictal HFO and phase-amplitude coupling measures were found to improve the prediction of post-operative seizure outcome. Graphical Abstract Graphical Abstract |
| وصف الملف: | application/pdf |
| تدمد: | 2632-1297 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c747a1149de03ae5f870bebf11a3bcbcTest https://doi.org/10.1093/braincomms/fcab042Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c747a1149de03ae5f870bebf11a3bcbc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 26321297 |
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