Antiseizure Medications Normalize Electroencephalographic Functional Connectivity and Power in Children With Benign Epilepsy With Centrotemporal Spikes

Min-Lan Tsai; Chuang-Chin Wang; Andy Yu-Der Wang; Feng-Chin Lee; Hsi Chang; Yen-Lin Liu; Tai-Tong Wong; Syu-Jyun Peng

doi:10.1016/j.pediatrneurol.2024.03.015

Antiseizure Medications Normalize Electroencephalographic Functional Connectivity and Power in Children With Benign Epilepsy With Centrotemporal Spikes

Pediatr Neurol. 2024 Mar 22:156:41-50. doi: 10.1016/j.pediatrneurol.2024.03.015. Online ahead of print.

Authors

Min-Lan Tsai¹, Chuang-Chin Wang², Andy Yu-Der Wang³, Feng-Chin Lee¹, Hsi Chang¹, Yen-Lin Liu¹, Tai-Tong Wong⁴, Syu-Jyun Peng⁵

Affiliations

¹ Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
² School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
³ Department of Neurology, University of California San Francisco, San Francisco, CA.
⁴ Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pediatric Neurosurgery, Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
⁵ Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: sjpeng2019@tmu.edu.tw.

PMID: 38729071
DOI: 10.1016/j.pediatrneurol.2024.03.015

Abstract

Background: The decision to treat children with benign epilepsy with centrotemporal spikes (BECTS) using antiseizure medications (ASM) is controversial. Our goal is to compare the effect of ASM treatment on the alteration of electroencephalographic (EEG) functional connectivity and power across four frequency bands in children with BECTS.

Methods: Children with BECTS with two-year follow-up were retrospectively divided into ASM versus non-ASM groups. The network properties of the EEGs as based on network-based statistic and graph theory were evaluated by the following indices: global efficiency, clustering coefficient, betweenness centrality, and nodal strength in four frequency bands (delta, theta, alpha, and beta). EEG power including absolute power (AP) and relative power (RP) was analyzed in four frequency bands.

Results: In children with BECTS with ASM treatment, there was no significant change in EEG connectivity across all bands before and after two years of ASM. In children with BECTS without ASM treatment, there was a significant increase of global efficiency, clustering coefficient, and nodal strength but not the betweenness centrality in the delta band after two years of follow-up. A decrease in AP in the delta and theta bands and a decrease in RP in the theta band were found in the ASM group after two years of treatment.

Conclusions: Our results suggest that ASM may play a role in modulating the development of increasing overall brain connectivity and in downregulating overt synaptic activity, but not intrinsic focal connectivity, in the early years of BECTS. The changes in the EEG power indicate that ASM significantly normalized slow-wave band power.

Keywords: Antiseizure medication; Benign epilepsy with centrotemporal spikes; Children; EEG functional connectivity; Graph theory; Power analysis.