A reliable interictal EEG grading scale for children with infantile spasms – The 2021 BASED score

Mytinger, John R.; Vidaurre, Jorge; Moore‐Clingenpeel, Melissa; Stanek, Joseph; Albert, Dara V.F.

doi:10.1016/j.eplepsyres.2021.106631

Cited by 23 publications

(35 citation statements)

References 12 publications

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“…The Burden of Amplitudes and Epileptiform Discharges (BASED) score developed by Mytinger et al. [ 12 ] is a reliable interictal EEG grading scale for children with infantile spasms. It can help determine the presence or absence of epileptic encephalopathy in the setting of infantile spasms in pretreatment and posttreatment studies.…”

Section: Introductionmentioning

confidence: 99%

“…It can help determine the presence or absence of epileptic encephalopathy in the setting of infantile spasms in pretreatment and posttreatment studies. In this convenient and rapid method, clinical electrophysiologists assign a score by examining the EEG recordings with the naked eye without the need for external statistical or analytical tools [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing Risk for Relapse among Children with Infantile Spasms Using the Based Score after ACTH Treatment: A Retrospective Study

Wan

Lei²,

Liu

et al. 2022

Neurol Ther

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Introduction Even though adrenocorticotropic hormone (ACTH) demonstrated powerful efficacy in the initially successful treatment of infantile spasms (IS), nearly one-half of patients whose spasms were once suppressed experienced relapse. There is currently no validated method for the prediction of the risk of relapse. The Burden of Amplitudes and Epileptiform Discharges (BASED) score is an electroencephalogram (EEG) grading scale for children with infantile spasms. We sought to determine whether an association exists between the BASED score after ACTH treatment and relapse after initial response with ACTH. Methods Children with IS who achieved initial response after ACTH treatment were selected as the study subjects. Those who experienced relapse within 12 months after ACTH treatment were categorized as the relapse group, and those who did not were categorized as the non-relapse group. Their general clinical data and EEG data (using BASED scoring) after ACTH treatment were collected, and compared between groups. Cox proportional hazards models were fit to determine factors associated with relapse. Results A total of 64 children with IS were enrolled in the study, of which 37 (57.8%) experienced a relapse, and the median duration after ACTH treatment was 3 (1.5, 6) months. The BASED score was significantly higher in the relapse group than in the non-relapse group. Cox modeling demonstrated that BASED score was independently associated with relapse. The patients with a score greater than or equal to 3 showed a high rate (89.3%) of relapse. The relapse group had stronger, more stable EEG functional networks than the non-relapse group, and there were obvious correlations between BASED score and functional connectivity. Conclusion This study suggests the BASED score after ACTH treatment has potential value as a predictor for relapse after initial response. Children with IS who have a BASED score greater than or equal to 3 after the initial response of ACTH carry a high risk of relapse within 1 year. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00347-7.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Risk for Relapse among Children with Infantile Spasms Using the Based Score after ACTH Treatment: A Retrospective Study

Wan

Lei²,

Liu

et al. 2022

Neurol Ther

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“…We used an interictal EEG grading scale called the B urden of A mplitude s and E pileptiform D ischarges (BASED) score to quantify the electroclinical remission of IS post‐ACTH treatment 44 …”

Section: Methodsmentioning

confidence: 99%

“…We quantified EEG according to the 2021 BASED score 44 in a blinded fashion (Table S2). We found that 25 of 39 patients met the criteria for electroclinical remission.…”

Section: The Based Score Of Ismentioning

confidence: 99%

“…Additional illustrative figures of a total of five relapse and five non-relapse patients were also provided (Figure S2). In applying the 2021 BASED score to the pretreatment EEG studies, 44 relapse patient (Patient 5) met criteria for a score of 4, and non-relapse patient (Patient 6) met criteria for a score of 3 (Table S2). After 2 weeks of ACTH treatment, the patient with relapse still had a large number of ripples (969 ripples, −51.36%) and high spectral power (137.379 μV/s, −50.60%) with wide distribution (18 channels).…”

Section: Two Case Examples From the Relapse And Non-relapse Groupsmentioning

confidence: 99%

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Automatic detection of interictal ripples on scalp EEG to evaluate the effect and prognosis of ACTH therapy in patients with infantile spasms

Wang

Yan

et al. 2021

Epilepsia

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Objective We aimed to explore the feasibility of using scalp‐recorded high‐frequency oscillations (HFOs) to evaluate the efficacy and prognosis of adrenocorticotropic hormone (ACTH) treatment in patients with infantile spasms. Methods Thirty‐nine children with infantile spasms were enrolled and divided into seizure‐free and non–seizure‐free groups after ACTH treatment. Patients who were seizure‐free were further divided into relapse and non‐relapse subgroups based on the observations made during a 6‐month follow‐up period. Scalp ripples were detected and compared during the interictal periods before and after 2 weeks of treatment. Results After ACTH treatment, the number and channels of ripples were significantly lower, whereas the percentage decrease in the number, spectral power, and channels of ripples was significantly higher in the seizure‐free group than in the non–seizure‐free group. In addition, the relapse subgroup showed higher number and spectral power and wider distribution of ripples than did the non‐relapse subgroup. Changes in HFOs in terms of number, spectral power, and channel of ripples were closely related to the severity of epilepsy and can indicate disease susceptibility. Significance Scalp HFOs can be used as an effective biomarker to monitor the effect and evaluate the prognosis of ACTH therapy in patients with infantile spasms.

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Inequities in Therapy for Infantile Spasms: A Call to Action

Bäumer

Mytinger

Neville

et al. 2022

Annals of Neurology

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The aim of this study was to determine whether selection of treatment for children with infantile spasms (IS) varies by race/ethnicity. Methods: The prospective US National Infantile Spasms Consortium database includes children with IS treated from 2012 to 2018. We examined the relationship between race/ethnicity and receipt of standard IS therapy (prednisolone, adrenocorticotropic hormone, vigabatrin), adjusting for demographic and clinical variables using logistic regression. Our primary outcome was treatment course, which considered therapy prescribed for the first and, when needed, the second IS treatment together. Results: Of 555 children, 324 (58%) were non-Hispanic white, 55 (10%) non-Hispanic Black, 24 (4%) non-Hispanic Asian, 80 (14%) Hispanic, and 72 (13%) other/unknown. Most (398, 72%) received a standard treatment course. Insurance type, geographic location, history of prematurity, prior seizures, developmental delay or regression, abnormal head circumference, hypsarrhythmia, and IS etiologies were associated with standard therapy. In adjusted models, non-Hispanic Black children had lower odds of receiving a standard treatment course compared with non-Hispanic white children (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.20-0.89; p = 0.02).

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A reliable interictal EEG grading scale for children with infantile spasms – The 2021 BASED score

Cited by 23 publications

References 12 publications

Assessing Risk for Relapse among Children with Infantile Spasms Using the Based Score after ACTH Treatment: A Retrospective Study

Assessing Risk for Relapse among Children with Infantile Spasms Using the Based Score after ACTH Treatment: A Retrospective Study

Automatic detection of interictal ripples on scalp EEG to evaluate the effect and prognosis of ACTH therapy in patients with infantile spasms

Inequities in Therapy for Infantile Spasms: A Call to Action

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