Abnormal EEG features are a hallmark of epilepsy, and abnormal frequency and network features are apparent in EEGs from people with idiopathic generalised epilepsy in both ictal and interictal states. Here, we characterise differences in the resting-state EEG of individuals with juvenile myoclonic epilepsy and assess factors influencing the heterogeneity of EEG features. We collected EEG data from 147 participants with juvenile myoclonic epilepsy through the Biology of Juvenile Myoclonic Epilepsy study. 95 control EEGs were acquired from two independent studies (Chowdhury et al. (2014) and EU-AIMS Longitudinal European Autism Project). We extracted frequency and functional network-based features from 10-20 s epochs of resting-state EEG, including relative power spectral density, peak alpha frequency, network topology measures and brain network ictogenicity: a computational measure of the propensity of networks to generate seizure dynamics. We tested for differences between epilepsy and control EEGs using univariate, multivariable and receiver operating curve analysis. Additionally, we explored the heterogeneity of EEG features within and between cohorts by testing for associations with potentially influential factors such as age, sex, epoch length and time, as well as testing for associations with clinical phenotypes including anti-seizure medication, and seizure characteristics in the epilepsy cohort. P-values were corrected for multiple comparisons. Univariate analysis showed significant differences in power spectral density in delta (2-5 Hz) (p = 0.0007, hedges’ g = 0.55) and low-alpha (6-9 Hz) (p = 2.9 × 10−8, g = 0.80) frequency bands, peak alpha frequency (p = 0.000007, g = 0.66), functional network mean degree (p = 0.0006, g = 0.48) and brain network ictogenicity (p = 0.00006, g = 0.56) between epilepsy and controls. Since age (p = 0.009) and epoch length (p = 1.7 × 10−8) differed between the two groups and were potential confounders, we controlled for these covariates in multivariable analysis where disparities in EEG features between epilepsy and controls remained. Receiver operating curve analysis showed low-alpha power spectral density was optimal at distinguishing epilepsy from controls, with an area under the curve of 0.72. Lower average normalized clustering coefficient and shorter average normalized path length were associated with poorer seizure control in epilepsy patients. To conclude, individuals with juvenile myoclonic epilepsy have increased power of neural oscillatory activity at low-alpha frequencies, and increased brain network ictogenicity compared to controls, supporting evidence from studies in other epilepsies with considerable external validity. In addition, the impact of confounders on different frequency-based and network-based EEG features observed in this study highlights the need for careful consideration and control of these factors in future EEG research in idiopathic generalised epilepsy particularly for their use as biomarkers.
We are pleased to introduce a new series of Commentaries from the Primary Care Neurology Society (P‐CNS). These aim to provide a primary care perspective on the neurology articles featured in each issue of Progress. Here, Dr Alistair Church provides a commentary on our Review ‘Diagnosis and management of psychosis in Parkinson's disease’ (see page 7 of this issue) and Dr Karen Lanyon gives her perspective on ‘Improving quality of care for epilepsy patients using a pharmacist review service’ (page 12).
Our series of Commentaries from the Primary Care Neurology Society (P‐CNS) aim to provide a primary care perspective on the neurology articles featured in each issue of Progress. Here, Dr Karen Lanyon provides a commentary on our Review ‘What do we know about depression in people with epilepsy?’ (see page 20 of this issue) and Dr Ian Greaves gives his perspective on ‘Clarifying the link between Alzheimer's and vascular disease’ (page 27).
Our Commentaries from the Primary Care Neurology Society (P‐CNS) provide a primary care perspective on the neurology articles in Progress. Here, Dr Karen Lanyon considers ‘Food for thought ‐ the ketogenic diet for epilepsy’
Our series of Commentaries from the Primary Care Neurology Society (P‐CNS) provide a primary care perspective on neurology articles featured in Progress. Here, Dr Karen Lanyon discusses the issues raised in ‘Beyond seizures: understanding cognitive deficits in epilepsy’ (see page 31 of this issue).
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