机构：[1]Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China[2]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China神经内科首都医科大学宣武医院[3]Departments of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Victoria[4]Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Victoria[5]Department of Medicine, St. Vincent’s Hospital Melbourne, The University of Melbourne, Victoria[6]Department of Medicine, The School of Clinical Sciences at Monash Health, Victoria[7]Departments of Neuroscience, The Central Clinical School, Monash University, Victoria[8]Department of Neurology, The Alfred Hospital, Victoria, Australia.
Objective To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. Methods We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort. Factors associated with drug resistance in multivariable analysis were tested in the replication cohort. Results The discovery cohort included 85 patients (29% drug-resistant and 71% drug-responsive). Their median age at assessment was 32 years and 50.6% were female. Multivariable analysis showed that higher number of seizure types ever experienced (3 vs 1: odds ratio [OR] = 31.1, 95% confidence interval [CI]: 4.5-214, p < 0.001; 3 vs 2: OR = 14.6, 95% CI: 2.3-93.1, p = 0.004) and generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep were associated with drug resistance (OR = 10.8, 95% CI: 2.4-49.4, p = 0.002). When these factors were tested in the replication cohort of 80 patients (27.5% drug-resistant and 72.5% drug-responsive; 71.3% female; median age 27.5 years), the proportion of patients with generalized polyspike train during sleep was also higher in the drug-resistant group (OR = 4.0, 95% CI: 1.35-11.8, p = 0.012). Conclusion Generalized polyspike train during sleep may be an EEG biomarker for drug resistance in adults with idiopathic generalized epilepsy.
基金：
This study was supported in part by Qingdao Municipal
Science and Technology Bureau, Qingdao, Shandong, China
(funding number 15-9-2-85-nsh).
第一作者机构：[1]Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China[2]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China[3]Departments of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Victoria
通讯作者：
通讯机构：[3]Departments of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Victoria[4]Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Victoria[7]Departments of Neuroscience, The Central Clinical School, Monash University, Victoria[8]Department of Neurology, The Alfred Hospital, Victoria, Australia.
推荐引用方式(GB/T 7714)：
Yanping Sun,Udaya Seneviratne,Piero Perucca,et al.Generalized polyspike train An EEG biomarker of drug-resistant idiopathic generalized epilepsy[J].NEUROLOGY.2018,91(19):e1822-e1830.doi:10.1212/WNL.0000000000006472.
APA：
Yanping Sun,Udaya Seneviratne,Piero Perucca,Zhibin Chen,Meng Kee Tan...&Patrick Kwan.(2018).Generalized polyspike train An EEG biomarker of drug-resistant idiopathic generalized epilepsy.NEUROLOGY,91,(19)
MLA：
Yanping Sun,et al."Generalized polyspike train An EEG biomarker of drug-resistant idiopathic generalized epilepsy".NEUROLOGY 91..19(2018):e1822-e1830
医学