Electroencephalography characteristics related to risk of sudden unexpected death in epilepsy in patients with Dravet syndrome

Jeong-Youn Kim; Jeongyoon Shin; Laehyun Kim; Se Hee Kim

doi:10.3389/fneur.2023.1222721

Electroencephalography characteristics related to risk of sudden unexpected death in epilepsy in patients with Dravet syndrome

Front Neurol. 2023 Sep 7:14:1222721. doi: 10.3389/fneur.2023.1222721. eCollection 2023.

Authors

Jeong-Youn Kim¹, Jeongyoon Shin^{2

3}, Laehyun Kim^{4

5}, Se Hee Kim⁶

Affiliations

¹ Electronics and Telecommunication Research Institute (ETRI), Daejeon, Republic of Korea.
² School of Electrical and Electronic Engineering, College of Engineering, Yonsei University, Seoul, Republic of Korea.
³ Yonsei Biomedical Research Institute, College of Medicine, Yonsei University, Seoul, Republic of Korea.
⁴ Center for Bionics, Korea Institute of Science and Technology, Seoul, Republic of Korea.
⁵ Department of HY-KIST Bio-Convergence, Hanyang University, Seoul, Republic of Korea.
⁶ Pediatric Neurology, Department of Pediatrics, Epilepsy Research Institute, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Abstract

Objective: To investigate the quantitative electroencephalography (EEG) features associated with a high risk of sudden unexpected death in epilepsy (SUDEP) in patients with Dravet syndrome (DS).

Methods: Patients with DS and healthy controls (HCs) who underwent EEG were included in the study. EEG signals were recorded using a 21 channel digital EEG system, and pre-processed data were analyzed to identify quantitative EEG features associated with a high SUDEP risk. To assess the risk of SUDEP, SUDEP-7 scores were used.

Results: A total of 64 patients with DS [38 males and 26 females, aged: 128.51 ± 75.50 months (range: 23-380 months)], and 13 HCs [7 males and 6 females, aged: 95.46 ± 86.48 months (range: 13-263 months)] were included. For the absolute band power, the theta power was significantly higher in the high-SUDEP group than in the low-SUDEP group in the central brain region. For the relative band power, the theta power was also significantly higher in the high-SUDEP group than in the low-SUDEP group in the central and occipital brain regions. The alpha power was significantly lower in the high-SUDEP group than in the low-SUDEP group in the central and parietal brain regions.

Conclusion: Patients with high SUDEP-7 scores have different EEG features from those with low SUDEP-7 scores, suggesting that EEG may be used as a biomarker of SUDEP in DS.

Significance: Early intervention in patients with DS at a high risk of SUDEP can reduce mortality and morbidity. Patients with high theta band powers warrant high-level supervision.

Keywords: Dravet syndrome (DS); electroencephalography (EEG); epilepsy; mortality; sudden unexpected death in epilepsy (SUDEP).