Pretreatment Topological Disruptions of Whole-brain Networks Exist in Childhood Absence Epilepsy: A Resting-state EEG-fMRI Study

Exploring brain network oscillations during seizures in drug-naïve patients with juvenile absence epilepsy

OBJECTIVE

We aimed to investigate the brain network activity during seizures in patients with untreated juvenile absence epilepsy.

METHODS

Thirty-six juvenile absence epilepsy (JAE) patients with a current high frequency of seizures (more than five seizures during a 2 h EEG examination) were included. Each participant underwent a 2 h video EEG examination. Five 10 s EEG epochs for inter-ictal, pre-ictal, and post-ictal, and five 5 s EEG epochs for ictal states were extracted. Five 10 s resting-state EEG epochs for each participant from a sex- and age-matched healthy control (HC) were enrolled. The topological parameters of the brain networks were calculated using a graph theory analysis.

RESULTS

Compared with the resting state of the HC group, the global efficiency, local efficiency, and clustering coefficients of the JAE group decreased in the inter-ictal state. In addition, the ictal state showed significantly increased global and local efficiency and clustering coefficients (p < 0.05) and a decreased small-world index and the shortest path length (p < 0.05) in the theta and alpha bands, compared to the remaining states within the JAE group. Moreover, subgroup analysis revealed that those JAE patients with typical 3 Hz discharges had upgraded global efficiency, local efficiency, and clustering coefficients in both delta and beta1 bands, compared to those JAE patients with non-3 Hz discharges during seizures.

CONCLUSION

The present study supported the idea that the changes in the EEG brain networks in JAE patients are characterized by decreased global and local efficiency and clustering coefficient in the alpha band. Moreover, the onset of seizures is accompanied by excessively enhanced network efficiency. JAE patients with different ictal discharge patterns may have different functional network oscillations.

EEG based brain functional connectivity analysis for post-autoimmune encephalitis (AE) patients with epilepsy

Autoimmune Encephalitis (AE) refers to a group of conditions that occur when the body's immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain. Seizures are a common symptom of AE and more than a third of patients experiencing seizures secondary to AE become epileptic over time. The objective of the present study is to identify biomarkers that can be used to identify those patients in whom AE will evolve into epilepsy. The bursts of abnormal electrical activity that occur during a seizure can be recorded by using Electroencephalography (EEG). In this work, common EEG (cEEG) and ambulatory EEG (aEEG) were recorded to compare the brain functional connectivity (FC) properties in post-AE patients with epilepsy patients and post-AE patients without epilepsy. The brain functional networks of spike waves were first constructed on the basis of Phase Locking Value (PLV). An analysis was then performed of the differences which existed in the FC properties of clustering coefficient, characteristic path length, global efficiency, local efficiency, and node degree between post-AE patients with epilepsy patients and post-AE patients without epilepsy. From the perspective of brain functional network analysis, post-AE patients with epilepsy showed a more complex network structure. Furthermore, the five FC properties have been found signification different, all FC property values of post-AE patients with epilepsy are higher than those of post-AE patients without epilepsy of cEEG and aEEG. Based on the extracted FC properties, five classifiers were used to classify them, and the results showed that all five FC properties could effectively distinguish between post-AE patients with epilepsy patients and post-AE patients without epilepsy in both cEEG and aEEG. These findings are potentially helpful for diagnosing whether a patient with AE will become epileptic.