EEG markers predictive of epilepsy risk in pediatric cerebral malaria - A feasibility study.
Biomarkers
Cerebral malaria
EEG
Epilepsy
Pediatric
Journal
Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
04
09
2020
revised:
27
09
2020
accepted:
28
09
2020
pubmed:
25
11
2020
medline:
15
4
2021
entrez:
24
11
2020
Statut:
ppublish
Résumé
Cerebral malaria (CM) affects 500,000 million children annually, 10% whom develop epilepsy within two years. Acute identification of biomarkers for post-CM epilepsy would allow for follow-up of the highest risk populations in resource-limited regions. We investigated the utility of electroencephalogram (EEG) and clinical metrics obtained during acute CM infection for predicting epilepsy. We analyzed 70 EEGs recorded within 24 h of admission for CM hospitalization obtained during the Blantyre Malaria Project Epilepsy Study (2005-2007), a prospective cohort study of pediatric CM survivors. While all studies underwent spectral analyses for comparisons of mean power band frequencies, a subset of EEGs from the 10 subjects who developed epilepsy and 10 age- and sex-matched controls underwent conventional visual analysis. Findings were tested for relationships to epilepsy outcomes. Ten of the 70 subjects developed epilepsy. There were no significant differences between groups that were analyzed via visual EEG review; however, spectral EEG analyses revealed a significantly higher gamma-delta power ratio in CM survivors who developed epilepsy (0.23 ± 0.10) than in those who did not (0.16 ± 0.06), p = 0.003. Excluding potential confounders, multivariable logistic-regression analyses found relative gamma power (p = 0.003) and maximum temperature during admission (p = 0.03) significant and independent predictors of post-CM epilepsy, with area under receiver operating characteristics (AUROC) curve of 0.854. We found that clinical and EEG metrics acquired during acute CM presentation confer risk of post-CM epilepsy. Further studies are required to investigate the utility of gamma activity as a potential biomarker of epileptogenesis and study this process over time. Additionally, resource limitations currently prevent follow-up of all CM cases to surveil for epilepsy, and identification of acute biomarkers in this population would offer the opportunity to allocate resources more efficiently.
Identifiants
pubmed: 33232892
pii: S1525-5050(20)30716-2
doi: 10.1016/j.yebeh.2020.107536
pmc: PMC7736081
mid: NIHMS1633198
pii:
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
107536Subventions
Organisme : NINDS NIH HHS
ID : K23 NS046086
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES026317
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH100186
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS088583
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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