Interictal and seizure-onset EEG patterns in malformations of cortical development: A systematic review

Lubna Shakhatreh; Mubeen Janmohamed; Ana Antonic Baker; Anna Willard; Joshua Laing; Maria Rychkova; Zhibin Chen; Patrick Kwan; Terence J. O'Brien; Piero Perucca

Neurobiology of Disease (Nov 2022)

Interictal and seizure-onset EEG patterns in malformations of cortical development: A systematic review

Lubna Shakhatreh,
Mubeen Janmohamed,
Ana Antonic Baker,
Anna Willard,
Joshua Laing,
Maria Rychkova,
Zhibin Chen,
Patrick Kwan,
Terence J. O'Brien,
Piero Perucca

Affiliations

Lubna Shakhatreh: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Corresponding author at: The Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia.
Mubeen Janmohamed: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
Ana Antonic Baker: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia
Anna Willard: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
Joshua Laing: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
Maria Rychkova: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia
Zhibin Chen: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia
Patrick Kwan: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Melbourne, Australia
Terence J. O'Brien: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Melbourne, Australia
Piero Perucca: Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Australia

Journal volume & issue: Vol. 174
p. 105863

Abstract

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Objectives: Malformations of cortical development (MCDs) are common causes of drug-resistant epilepsy. The mechanisms underlying the associated epileptogenesis and ictogenesis remain poorly elucidated. EEG can help in understanding these mechanisms. We systematically reviewed studies reporting scalp or intracranial EEG features of MCDs to characterise interictal and seizure-onset EEG patterns across different MCD types. Methods: We conducted a systematic review in accordance with PRISMA guidelines. MEDLINE, PubMed, and Cochrane databases were searched for studies describing interictal and seizure-onset EEG patterns in MCD patients. A classification framework was implemented to group EEG features into 20 predefined patterns, comprising nine interictal (five, scalp EEG; four, intracranial EEG) and 11 seizure-onset (five, scalp EEG; six, intracranial EEG) patterns. Logistic regression was used to estimate the odds ratios (OR) of each seizure-onset pattern being associated with specific MCD types. Results: Our search yielded 1682 studies, of which 27 comprising 936 MCD patients were included. Of the nine interictal EEG patterns, five (three, scalp EEG; two, intracranial EEG) were detected in ≥2 MCD types, while four (rhythmic epileptiform discharges type 1 and type 2 on scalp EEG; repetitive bursting spikes and sporadic spikes on intracranial EEG) were seen only in focal cortical dysplasia (FCD). Of the 11 seizure-onset patterns, eight (three, scalp EEG; five, intracranial EEG) were found in ≥2 MCD types, whereas three were observed only in FCD (suppression on scalp EEG; delta brush on intracranial EEG) or tuberous sclerosis complex (TSC; focal fast wave on scalp EEG). Among scalp EEG seizure-onset patterns, paroxysmal fast activity (OR = 0.13; 95% CI: 0.03–0.53; p = 0.024) and repetitive epileptiform discharges (OR = 0.18; 95% CI: 0.05–0.61; p = 0.036) were less likely to occur in TSC than FCD. Among intracranial EEG seizure-onset patterns, low-voltage fast activity was more likely to be detected in heterotopia (OR = 19.3; 95% CI: 6.22–60.1; p < 0.001), polymicrogyria (OR = 6.70; 95% CI: 2.25–20.0; p = 0.004) and TSC (OR = 4.27; 95% CI: 1.88–9.70; p = 0.005) than FCD. Significance: Different MCD types can share similar interictal or seizure-onset EEG patterns, reflecting common underlying biological mechanisms. However, selected EEG patterns appear to point to distinct MCD types, suggesting certain differences in their neuronal networks.

Published in Neurobiology of Disease

ISSN: 0969-9961 (Print); 1095-953X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/neurobiology-of-disease

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