Theta Power Spectral Analysis of Electroencephalography in Infantile Spasms: Before and After ACTH Treatment

Kuo, Yung Ting; Chen, Ying Tzu; Yeh, Geng Chang; Chou, Hsiao Feng; Wang, Chuan Yu; Chiueh, Chuang C.

doi:10.1016/j.jecm.2012.10.009

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…22 In another study, theta power spectral analysis was used in evaluating IS, which showed that theta power was reduced after synthetic RCI treatment. 12 Coherence may be a helpful biomarker to assess functional connectivity in patients with IS. Another study evaluated coherence and power spectral analysis in patients with IS as compared with controls and found that coherence and spectral power on all frequency bands were higher than in a control group.…”

Section: Discussionmentioning

confidence: 99%

“…In one study, spectral power in the theta band was higher in IS cases as compared with controls and reduced after RCI treatment. 12 In another study, coherence in all frequency bands in children with IS was higher than those in normal children of similar age. 13 Also, spike quantification (SQ) was used after RCI treatment in patients with epileptic encephalopathy.…”

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confidence: 88%

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EEG Biomarkers of Repository Corticotropin Injection Treatment

Tanritanir

Vieluf

Jafarpour

et al. 2021

Journal of Clinical Neurophysiology

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Hypsarrhythmia is one of the major diagnostic and treatment response criteria in infantile spasms (IS). The clinical and electrophysiological effect of repository corticotropin injection treatment on IS was evaluated using electrophysiological biomarkers.Methods: Consecutive infants (,24 months) treated with repository corticotropin injection for IS were included in this retrospective descriptive study. Inclusion criteria were (1) clinical IS diagnosis, (2) repository corticotropin injection treatment, and (3) consecutive EEG recordings before and after repository corticotropin injection treatment. Patients with tuberous sclerosis complex were excluded. Response to treatment was defined as freedom from IS for at least 7 consecutive days during the treatment and resolution of hypsarrhythmia. The authors defined "relapse" as the recurrence of seizures after an initial response. Electrophysiological biomarker assessment included evaluation of semiautomatic spike counting algorithm, delta power, and delta coherence calculation during non-REM sleep EEG.Results: One hundred fifty patients (83 males; 55%; median age of IS onset: 5.9 months) with complete data were included, including 101 responders (67%, 71 with sustained response, and 30 relapses). Fifty patients (33%) with complete EEG data also underwent advanced EEG analysis. Baseline delta coherence was higher in sustained responders than in nonresponders or patients who relapsed. Greater decreases in semiautomatic spike counting algorithm, delta power, and delta coherence were found in sustained responders compared with nonresponders or patients who relapsed.Conclusions: Repository corticotropin injection treatment was associated with a 67% response rate in patients with IS. Computational biomarkers beyond hypsarrhythmia may provide additional information during IS treatment, such as early determination of treatment response and outcome assessment.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 88%

EEG Biomarkers of Repository Corticotropin Injection Treatment

Tanritanir

Vieluf

Jafarpour

et al. 2021

Journal of Clinical Neurophysiology

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“…Hormone therapy has been demonstrated to improve hypsarrhythmia scores, including the background organization, background slowing, amplitude, and spike index . It also has induced a significant decrease in the theta wave power on EEG . Focal discharges or normal EEG often appear after the disappearance of hypsarrhythmia on EEG…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of corticosteroids versus adrenocorticotropic hormone for infantile spasms: a systematic review and meta‐analysis

Chang

Chen

et al. 2019

Ann Clin Transl Neurol

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ObjectiveTo compare the therapeutic effectiveness of oral corticosteroids with that of adrenocorticotrophic hormone for infantile spasms.MethodsPubMed, Embase, Scopus, and the Cochrane library were searched to retrieve studies published before December 2018 to identify pediatric patients with a diagnosis of infantile spasms. The interventions of oral corticosteroids and adrenocorticotrophic hormone were compared. We included only randomized controlled trials that reported the cessation of spasms as treatment response. The primary outcome was clinical spasm cessation on day 13 or 14. The secondary outcomes were the resolution of hypsarrhythmia, side effects, continued spasm control, spasm relapse rate, and subsequent epilepsy rate. Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses, the study‐level quality assessment was conducted using the Cochrane risk‐of‐bias tool.ResultsAfter extensive review, 39 articles were included for meticulous evaluation. Five randomized controlled trials with a total of 239 individuals were eligible for further analysis. No significant difference was detected between the corticosteroids and adrenocorticotrophic hormone in the cessation of clinical spasms (odds ratio [OR]: 0.54; 95% confidence interval [CI]: 0.16 to 1.81; P = 0.32). The subgroups of high‐dose prednisolone versus adrenocorticotrophic hormone and low‐dose prednisone versus adrenocorticotrophic hormone also exhibited no significant difference. Furthermore, the two subgroups did not differ in terms of hypsarrhythmia resolution, side effects, relapse rate, or subsequent epilepsy rate.InterpretationThis meta‐analysis suggests that high‐dose prednisolone is not inferior to adrenocorticotrophic hormone and that it be considered a safe and effective alternative treatment.

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