Premium
Towards prognostic biomarkers from BOLD fluctuations to differentiate a first epileptic seizure from new‐onset epilepsy
Author(s) -
Gupta Lalit,
Janssens Rick,
Vlooswijk Mariëlle C. G.,
Rouhl Rob P. W.,
Louw Anton,
Aldenkamp Albert P.,
Ulman Shrutin,
Besseling René M. H.,
Hofman Paul A. M.,
KranenMastenbroek Vivianne H.,
Hilkman Danny M.,
Jansen Jacobus F. A.,
Backes Walter H.
Publication year - 2017
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13658
Subject(s) - epilepsy , electroencephalography , medicine , magnetic resonance imaging , biomarker , seizure threshold , audiology , neuroscience , psychology , cardiology , radiology , anticonvulsant , biochemistry , chemistry
Summary Objective The diagnosis of epilepsy cannot be reliably made prior to a patient's second seizure in most cases. Therefore, adequate diagnostic tools are needed to differentiate subjects with a first seizure from those with a seizure preceding the onset of epilepsy. The objective was to explore spontaneous blood oxygen level–dependent ( BOLD ) fluctuations in subjects with a first‐ever seizure and patients with new‐onset epilepsy ( NOE ), and to find characteristic biomarkers for seizure recurrence after the first seizure. Methods We examined 17 first‐seizure subjects, 19 patients with new‐onset epilepsy ( NOE ), and 18 healthy controls. All subjects underwent clinical investigation and received electroencephalography and resting‐state functional magnetic resonance imaging (MRI). The BOLD time series were analyzed in terms of regional homogeneity (ReHo) and fractional amplitude of low‐frequency fluctuations ( fALFFs ). Results We found significantly stronger amplitudes (higher fALFFs ) in patients with NOE relative to first‐seizure subjects and healthy controls. The frequency range of 73–198 mH z (slow‐3 subband) appeared most useful for discriminating patients with NOE from first‐seizure subjects. The ReHo measure did not show any significant differences. Significance The fALFF appears to be a noninvasive measure that characterizes spontaneous BOLD fluctuations and shows stronger amplitudes in the slow‐3 subband of patients with NOE relative first‐seizure subjects and healthy controls. A larger study population with follow‐up is required to determine whether fALFF holds promise as a potential biomarker for identifying subjects at increased risk to develop epilepsy.