Measuring spike strength in patients with continuous spikes and waves during sleep: Comparison of methods for prospective use as a clinical index |
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| Institution: | 1. Department of Clinical Neurophysiology, Hospital for Children and Adolescents, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland;2. Department of Clinical Neurophysiology, Turku University Hospital, University of Turku, Turku, Finland;3. Department of Pediatric Neurology, Hospital for Children and Adolescents, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland;4. Department of Neurological Sciences, 00014 University of Helsinki, Helsinki, Finland;5. Department of Physics, 00014 University of Helsinki, Helsinki, Finland;1. Centre for Offshore Engineering and Safety Technology, China University of Petroleum, Qingdao 266580, China;2. Research Institute of China National Offshore Oil Corporation, Beijing 100027, China;1. Neurology-Immunology and Endocrinology Unit, University of Siena, Italy;2. Child Neurology, Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, “Sapienza University”, Rome, Italy;3. Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy;4. Department of Pediatrics, University of Siena, Italy;1. Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;2. Department of Radiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;3. Department of Anesthesiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;4. Department of Anaesthesiology, Catharina Hospital, Michelangelolaan 2, 5623 EJ Eindhoven |
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| Abstract: | ObjectiveTo compare methods of estimating spike strength as a potential index in the assessment of continuous spikes and waves during sleep (CSWS).MethodsSpikes were searched and averaged automatically from pre- and postoperative EEGs of ten patients with CSWS who underwent corpus callosotomy (eight) or resective epilepsy surgery (two). From the most prominent spike, we measured peak amplitude and root mean square (RMS) over ±150 ms window around the peak. In order to compensate for spatiotemporal instability of spikes, the cumulative amplitude and RMS were computed from the highest quartile of electrodes (Ampl-Q and RMS-Q, respectively). The stability of parameters was studied by comparing two ten minute epochs during the first hour of NREM sleep, as well as by analyzing overnight variation of indices in further ten patients with CSWS. The Ampl-Q and RMS-Q were compared between pre- and postoperative recordings.ResultsAll four measures, amplitude, RMS, Ampl-Q and RMS-Q, were correlated with each other and highly dependent on NREM/REM-sleep stage and arousals. Expectedly, Ampl-Q and RMS-Q had the greatest intra-individual stability. The amplitude had up to 71% intra-individual variation making it unhelpful for clinical use. Ampl-Q and RMS-Q were comparable in assessing change following surgical treatment.ConclusionsComputing an integrated RMS over multiple electrodes during steady NREM sleep offers a stable and reliable parameter for evaluating the strength of spikes in CSWS.SignificanceAnalyzing spike strength with RMS-Q may offer a clinically useful, supplementary index for EEG monitoring of CSWS where spike index has been of limited value. |
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| Keywords: | CSWS Electrical status epilepticus during sleep ESES Spike amplitude RMS |
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