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Interictal EEG and ECG for SUDEP Risk Assessment: A Retrospective Multicenter Cohort Study.
Chen, Zhe Sage; Hsieh, Aaron; Sun, Guanghao; Bergey, Gregory K; Berkovic, Samuel F; Perucca, Piero; D'Souza, Wendyl; Elder, Christopher J; Farooque, Pue; Johnson, Emily L; Barnard, Sarah; Nightscales, Russell; Kwan, Patrick; Moseley, Brian; O'Brien, Terence J; Sivathamboo, Shobi; Laze, Juliana; Friedman, Daniel; Devinsky, Orrin.
Afiliación
  • Chen ZS; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, United States.
  • Hsieh A; Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, United States.
  • Sun G; Tandon School of Engineering, New York University, New York, NY, United States.
  • Bergey GK; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, United States.
  • Berkovic SF; Johns Hopkins University School of Medicine, Baltimore, MD, United States.
  • Perucca P; Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, VIC, Australia.
  • D'Souza W; Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
  • Elder CJ; Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, VIC, Australia.
  • Farooque P; Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
  • Johnson EL; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
  • Barnard S; Department of Neurology, Alfred Health, Melbourne, VIC, Australia.
  • Nightscales R; Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
  • Kwan P; Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC, Australia.
  • Moseley B; Division of Epilepsy and Sleep, Columbia University, New York, NY, United States.
  • O'Brien TJ; Yale University School of Medicine, New Haven, CT, United States.
  • Sivathamboo S; Johns Hopkins University School of Medicine, Baltimore, MD, United States.
  • Laze J; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
  • Friedman D; Department of Neurology, Alfred Health, Melbourne, VIC, Australia.
  • Devinsky O; Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States.
Front Neurol ; 13: 858333, 2022.
Article en En | MEDLINE | ID: mdl-35370908
Objective: Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality. Although lots of effort has been made in identifying clinical risk factors for SUDEP in the literature, there are few validated methods to predict individual SUDEP risk. Prolonged postictal EEG suppression (PGES) is a potential SUDEP biomarker, but its occurrence is infrequent and requires epilepsy monitoring unit admission. We use machine learning methods to examine SUDEP risk using interictal EEG and ECG recordings from SUDEP cases and matched living epilepsy controls. Methods: This multicenter, retrospective, cohort study examined interictal EEG and ECG recordings from 30 SUDEP cases and 58 age-matched living epilepsy patient controls. We trained machine learning models with interictal EEG and ECG features to predict the retrospective SUDEP risk for each patient. We assessed cross-validated classification accuracy and the area under the receiver operating characteristic (AUC) curve. Results: The logistic regression (LR) classifier produced the overall best performance, outperforming the support vector machine (SVM), random forest (RF), and convolutional neural network (CNN). Among the 30 patients with SUDEP [14 females; mean age (SD), 31 (8.47) years] and 58 living epilepsy controls [26 females (43%); mean age (SD) 31 (8.5) years], the LR model achieved the median AUC of 0.77 [interquartile range (IQR), 0.73-0.80] in five-fold cross-validation using interictal alpha and low gamma power ratio of the EEG and heart rate variability (HRV) features extracted from the ECG. The LR model achieved the mean AUC of 0.79 in leave-one-center-out prediction. Conclusions: Our results support that machine learning-driven models may quantify SUDEP risk for epilepsy patients, future refinements in our model may help predict individualized SUDEP risk and help clinicians correlate predictive scores with the clinical data. Low-cost and noninvasive interictal biomarkers of SUDEP risk may help clinicians to identify high-risk patients and initiate preventive strategies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza