Visual and semi-automatic non-invasive detection of interictal fast ripples: A potential biomarker of epilepsy in children with tuberous sclerosis complex

Publication date: July 2018
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Danilo Bernardo, Hiroki Nariai, Shaun A. Hussain, Raman Sankar, Noriko Salamon, Darcy A. Krueger, Mustafa Sahin, Hope Northrup, E. Martina Bebin, Joyce Y. Wu
ObjectivesWe aim to establish that interictal fast ripples (FR; 250–500 Hz) are detectable on scalp EEG, and to investigate their association to epilepsy.MethodsScalp EEG recordings of a subset of children with tuberous sclerosis complex (TSC)-associated epilepsy from two large multicenter observational TSC studies were analyzed and compared to control children without epilepsy or any other brain-based diagnoses. FR were identified both by human visual review and compared with semi-automated review utilizing a deep learning-based FR detector.ResultsSeven out of 7 children with TSC-associated epilepsy had scalp FR compared to 0 out of 4 children in the control group (p = 0.003). The automatic detector has a sensitivity of 98% and false positive rate with average of 11.2 false positives per minute.ConclusionsNon-invasive detection of interictal scalp FR was feasible, by both visual and semi-automatic detection. Interictal scalp FR occurred exclusively in children with TSC-associated epilepsy and were absent in controls without epilepsy. The proposed detector achieves high sensitivity of FR detection; however, expert review of the results to reduce false positives is advised.SignificanceInterictal FR are detectable on scalp EEG and may potentially serve as a biomarker of epilepsy in children with TSC.



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