دورية أكاديمية
أعرض في EDS

Circadian changes in aperiodic activity are correlated with seizure reduction in patients with mesial temporal lobe epilepsy treated with responsive neurostimulation.

التفاصيل البيبلوغرافية
العنوان: Circadian changes in aperiodic activity are correlated with seizure reduction in patients with mesial temporal lobe epilepsy treated with responsive neurostimulation.
المؤلفون: Charlebois CM; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.; Scientific Computing & Imaging Institute, University of Utah, Salt Lake City, Utah, USA., Anderson DN; Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA.; Department of Pharmacology & Toxicology, University of Utah, Salt Lake City, Utah, USA.; School of Biomedical Engineering, University of Sydney, Darlington, New South Wales, Australia., Smith EH; Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA., Davis TS; Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA., Newman BJ; Department of Neurology, University of Utah, Salt Lake City, Utah, USA., Peters AY; Department of Neurology, University of Utah, Salt Lake City, Utah, USA., Arain AM; Department of Neurology, University of Utah, Salt Lake City, Utah, USA., Dorval AD; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.; Scientific Computing & Imaging Institute, University of Utah, Salt Lake City, Utah, USA., Rolston JD; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.; Department of Neurosurgery, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Butson CR; Scientific Computing & Imaging Institute, University of Utah, Salt Lake City, Utah, USA.; Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA.
المصدر: Epilepsia [Epilepsia] 2024 May; Vol. 65 (5), pp. 1360-1373. Date of Electronic Publication: 2024 Mar 22.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE
أسماء مطبوعة: Publication: Malden, MA : Blackwell Science
Original Publication: Copenhagen : Munskgaard
مواضيع طبية MeSH: Epilepsy, Temporal Lobe*/therapy , Epilepsy, Temporal Lobe*/physiopathology , Circadian Rhythm*/physiology , Drug Resistant Epilepsy*/therapy , Drug Resistant Epilepsy*/physiopathology, Humans ; Male ; Female ; Adult ; Retrospective Studies ; Middle Aged ; Seizures/physiopathology ; Seizures/therapy ; Deep Brain Stimulation/methods ; Treatment Outcome ; Young Adult ; Electroencephalography/methods
مستخلص: Objectives: Responsive neurostimulation (RNS) is an established therapy for drug-resistant epilepsy that delivers direct electrical brain stimulation in response to detected epileptiform activity. However, despite an overall reduction in seizure frequency, clinical outcomes are variable, and few patients become seizure-free. The aim of this retrospective study was to evaluate aperiodic electrophysiological activity, associated with excitation/inhibition balance, as a novel electrographic biomarker of seizure reduction to aid early prognostication of the clinical response to RNS.
Methods: We identified patients with intractable mesial temporal lobe epilepsy who were implanted with the RNS System between 2015 and 2021 at the University of Utah. We parameterized the neural power spectra from intracranial RNS System recordings during the first 3 months following implantation into aperiodic and periodic components. We then correlated circadian changes in aperiodic and periodic parameters of baseline neural recordings with seizure reduction at the most recent follow-up.
Results: Seizure reduction was correlated significantly with a patient's average change in the day/night aperiodic exponent (r = .50, p = .016, n = 23 patients) and oscillatory alpha power (r = .45, p = .042, n = 23 patients) across patients for baseline neural recordings. The aperiodic exponent reached its maximum during nighttime hours (12 a.m. to 6 a.m.) for most responders (i.e., patients with at least a 50% reduction in seizures).
Significance: These findings suggest that circadian modulation of baseline broadband activity is a biomarker of response to RNS early during therapy. This marker has the potential to identify patients who are likely to respond to mesial temporal RNS. Furthermore, we propose that less day/night modulation of the aperiodic exponent may be related to dysfunction in excitation/inhibition balance and its interconnected role in epilepsy, sleep, and memory.
(© 2024 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
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معلومات مُعتمدة: F32 NS114322 United States NS NINDS NIH HHS; NS109557 United States NH NIH HHS; NS114178 United States NH NIH HHS; NS114322 United States NH NIH HHS; K23 NS114178 United States NS NINDS NIH HHS; P41 GM103545 United States GM NIGMS NIH HHS; UH3 NS109557 United States NS NINDS NIH HHS; GM103545 United States NH NIH HHS; NS109557 United States NH NIH HHS; GM103545 United States NH NIH HHS; NS114178 United States NH NIH HHS; NS114322 United States NH NIH HHS
فهرسة مساهمة: Keywords: RNS; aperiodic exponent; biomarker; circadian rhythms; neurostimulation
تواريخ الأحداث: Date Created: 20240322 Date Completed: 20240510 Latest Revision: 20240531
رمز التحديث: 20240531
مُعرف محوري في PubMed: PMC11138949
DOI: 10.1111/epi.17938
PMID: 38517356
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1167
DOI:10.1111/epi.17938