Document Detail

'Functional connectivity' is a sensitive predictor of epilepsy diagnosis after the first seizure.
MedLine Citation:
PMID:  20520774     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although epilepsy affects almost 1% of the world population, diagnosis of this debilitating disease is still difficult. The EEG is an important tool for epilepsy diagnosis and classification, but the sensitivity of interictal epileptiform discharges (IEDs) on the first EEG is only 30-50%. Here we investigate whether using 'functional connectivity' can improve the diagnostic sensitivity of the first interictal EEG in the diagnosis of epilepsy.
METHODOLOGY/PRINCIPAL FINDINGS: Patients were selected from a database with 390 standard EEGs of patients after a first suspected seizure. Patients who were later diagnosed with epilepsy (i.e. > or = two seizures) were compared to matched non-epilepsy patients (with a minimum follow-up of one year). The synchronization likelihood (SL) was used as an index of functional connectivity of the EEG, and average SL per patient was calculated in seven frequency bands. In total, 114 patients were selected. Fifty-seven patients were diagnosed with epilepsy (20 had IEDs on their EEG) and 57 matched patients had other diagnoses. Epilepsy patients had significantly higher SL in the theta band than non-epilepsy patients. Furthermore, theta band SL proved to be a significant predictor of a diagnosis of epilepsy. When only those epilepsy patients without IEDs were considered (n = 74), theta band SL could predict diagnosis with specificity of 76% and sensitivity of 62%.
CONCLUSION/SIGNIFICANCE: Theta band functional connectivity may be a useful diagnostic tool in diagnosing epilepsy, especially in those patients who do not show IEDs on their first EEG. Our results indicate that epilepsy diagnosis could be improved by using functional connectivity.
Linda Douw; Marjolein de Groot; Edwin van Dellen; Jan J Heimans; Hanneke E Ronner; Cornelis J Stam; Jaap C Reijneveld
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-26
Journal Detail:
Title:  PloS one     Volume:  5     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-03     Completed Date:  2010-09-07     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e10839     Citation Subset:  IM    
Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Cortical Synchronization
Middle Aged
Nerve Net / physiopathology*
ROC Curve
Seizures / diagnosis*,  physiopathology*

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