Electroencephalography complexity in infantile spasms and its association with treatment response

Yen-Ju Chu; Chi-Feng Chang; Wen-Chin Weng; Pi-Chuan Fan; Jiann-Shing Shieh; Wang-Tso Lee

doi:10.1016/j.clinph.2020.12.006

Electroencephalography complexity in infantile spasms and its association with treatment response

Clin Neurophysiol. 2021 Feb;132(2):480-486. doi: 10.1016/j.clinph.2020.12.006. Epub 2020 Dec 29.

Authors

Yen-Ju Chu¹, Chi-Feng Chang², Wen-Chin Weng³, Pi-Chuan Fan³, Jiann-Shing Shieh⁴, Wang-Tso Lee⁵

Affiliations

¹ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatric Neurology, National Taiwan University Children's Hospital, Taipei, Taiwan.
² Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
³ Department of Pediatric Neurology, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University College of Medicine, Taipei, Taiwan.
⁴ Department of Mechanical Engineering, Yuan Ze University, Taoyuan, Taiwan; Innovation Center for Biomedical and Healthcare Technology, Yuan Ze University, Taoyuan, Taiwan; Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan, Taiwan.
⁵ Department of Pediatric Neurology, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: wangtsolee@ntu.edu.tw.

PMID: 33450568
DOI: 10.1016/j.clinph.2020.12.006

Abstract

Objective: To investigate the potential of EEG multiscale entropy and complexity as biomarkers in infantile spasms.

Methods: We collected EEG data retrospectively from 16 newly diagnosed patients, 16 age- and gender-matched healthy controls, and 15 drug-resistant patients. The multiscale entropy (MSE) and total EEG complexity before anti-epileptic drug (AED) treatment, before adrenocorticotropic hormone (ACTH) treatment, 14 days after ACTH therapy, and after 6 months of follow-up were calculated.

Results: The total EEG complexity of 16 newly diagnosed infantile spasms patients was lower than the 16 healthy controls (median [IQR]: 351.5 [323.1-388.1] vs 461.6 [407.7-583.4]). The total EEG complexity before treatment was higher in the six patients with good response to AED than the 10 patients without response (median [IQR]: 410.0 [388.1-475.0] vs 344.5 [319.6-352.0]). The total EEG complexity before and after 14-days of ACTH therapy was not different between 13 ACTH therapy responders and nine non-responders. After 6-months follow-up, the total EEG complexity of ACTH therapy responders were higher than non-responders (median [IQR]: 598.5 [517.4-623.3] vs 448.6 [347.1-536.3]).

Conclusions: The total EEG complexity before AED and 6 months after ACTH are associated with spasm-freedom.

Significance: The total EEG complexity is a potential biomarker to predict and monitor the treatment effect in infantile spasms.

Keywords: EEG complexity; Epilepsy; Multiscale entropy; West syndrome.

MeSH terms

Adolescent
Anticonvulsants / therapeutic use
Child
Drug Resistant Epilepsy / diagnosis
Drug Resistant Epilepsy / drug therapy
Drug Resistant Epilepsy / physiopathology*
Electroencephalography / methods*
Female
Humans
Infant
Male
Prognosis
Spasms, Infantile / diagnosis
Spasms, Infantile / drug therapy
Spasms, Infantile / physiopathology*

Substances

Anticonvulsants