Valuation of burden of amplitudes and epileptiform discharges score in the efficacy of adrenocorticotropic hormone therapy for infantile epileptic spasms syndrome_Journal of Epilepsy

Authors：

 TANG Zhihong , CHEN Weigang , YIN Yingyi , PENG Qian , DENG Haohui

Department of Pediatric Neurology, Dongguan Maternal and Child Health Care Hospital, Dongguan 523000, China;

Corresponding author：

TANG Zhihong, Email: zhihong46@163.com

Keywords：

Infantile epileptic spasms syndrome; Burden of amplitudes and epileptiform discharges score; Adrenocorticotrophic hormone

DOI：

10.7507/2096-0247.202404005

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Objective To explore the evaluation value of burden of amplitudes and epileptiform discharges score (BASED) in the efficacy of adrenocorticotropic hormone (ACTH) combined with magnesium sulfate therapy for infantile epileptic spasms syndrome (IESS). Methods Retrospective collection the clinical and EEG data of 124 patients admitted to the Dongguan Maternal and Child Health Care Hospital from 2015 to 2023, who were diagnosed with IESS and treated with ACTH combined with magnesium sulfate. According to whether there were epileptic seizures 14 days after ACTH treatment, the patients were divided into two groups: non seizure group (n=74 cases) and seizure group (n=50 cases). The BASED system was used to evaluate the relationship between changes in EEG before and after ACTH treatment and clinical efficacy in both groups. The analysis of electroencephalogram included: ① abnormally high amplitude background waves, ② >3 spike foci , ③ grouped multifocal spikes, ④ paroxysmal voltage attenuation. Result The control rate of ACTH combined with magnesium sulfate in the treatment of IESS was 59.7% (74/124), and there was no statistically significant difference in the control rate among children with different etiologies (P=0.09). The BASED score suggests that the overall response rate of electroencephalogram (EEG) in infants with epileptic spasm syndrome after treatment was 57.2%. The EEG remission rate in the seizure control group was 81% (60/74), while in the uncontrolled group was 22% (11/50). The EEG remission rate in the seizure control group was significantly higher than that in the uncontrolled group after treatment (P<0.001), and the EEG score was closely related to clinical efficacy (Spearman correlation coefficient rp=0.601, P<0.001). Conclusion The BASED score is related to clinical efficacy, and it can provide a quantitative basis for evaluating the efficacy of ACTH combined with magnesium sulfate in the treatment of IESS.

Citation： TANG Zhihong, CHEN Weigang, YIN Yingyi, PENG Qian, DENG Haohui. Valuation of burden of amplitudes and epileptiform discharges score in the efficacy of adrenocorticotropic hormone therapy for infantile epileptic spasms syndrome. Journal of Epilepsy, 2024, 10(4): 308-312. doi: 10.7507/2096-0247.202404005 Copy

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2.	季涛云, 冯卫星, 张凯, 等. 《新生儿和婴儿期起病的癫痫综合征的ILAE分类与定义: ILAE疾病分类和定义工作组的立场声明》的解读. 癫痫杂志, 2022, 8(5): 395-399.
3.	黄茜, 彭镜, 潘邹, 等. 首次促肾上腺皮质激素治疗婴儿癫痫痉挛综合征疗效的影响因素分析. 中国当代儿科杂志, 2023, 25(1): 60-66.
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8.	Puneet Jain, Jitendra K Sahu, Paul S Horn, et al, Treatment of children with infantile spasms: a network meta-analysis. Developmental Medicine and Child Neurology, 2022, 64(11): 1330-1343.
9.	Christopher J Yuskaitis, John R Mytinger, Fiona M Baumer, et al. Association of time to clinical remission with sustained resolution in children with new-onset infantile spasms. Neurology, 2022, 99(22): 2494-2503.
10.	Kelly G Knupp, Jason Coryell, Katherine C Nickels, et al. Response to treatment in a prospective national infantile spasms cohort. Annals of Neurology, 2016, 79(3): 475-484.
11.	Zachary M Grinspan, Kelly G Knupp, Anup D Patel, et al. Comparative effectiveness of initial treatment for infantile spasms in a contemporary US cohort. Neurology, 2021, 97(12): 1217-1228.
12.	Wang QH , He W, Wang YY , et al, Response to magnesium sulfate and adrenocorticotropic hormone combination therapy for infantile spasms with failed first-line treatments. Pediatric Investigation, 2023, 7(1): 29-35.
13.	He W, Wang QH, Li JW, et al, Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome: a real-world study. World Journal of Pediatrics, 2023, 9(9): 1-14.
14.	刘秀国, 李久伟, 石秀玉, 等. 硫酸镁预防婴儿痉挛症ACTH治疗相关性高血压病例对照研究. 临床儿科杂志, 2014, 32(11): 1013-1015.
15.	Fan YY, Chen D, Wang H, et al. Automatic BASED scoring on scalp EEG in children with infantile spasms using convolutional neural network. Frontiers in Molecular Biosciences, 2022, 9: 931688.
16.	郑苏, 陈述花, 李华, 等. 脑电变化和BASED评分与54例婴儿痉挛症促肾上腺皮质激素疗效的相关性. 山东大学学报(医学版), 2022, 60(9): 91-96+101.

1. Zuberi SM, Wirrell E, Yozawitz E, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia, 2022, 63(6): 1349-1397.
2. 季涛云, 冯卫星, 张凯, 等. 《新生儿和婴儿期起病的癫痫综合征的ILAE分类与定义: ILAE疾病分类和定义工作组的立场声明》的解读. 癫痫杂志, 2022, 8(5): 395-399.
3. 黄茜, 彭镜, 潘邹, 等. 首次促肾上腺皮质激素治疗婴儿癫痫痉挛综合征疗效的影响因素分析. 中国当代儿科杂志, 2023, 25(1): 60-66.
4. John R Mytinger, Jorge Vidaurre, et al. A reliable interictal EEG grading scale for children with infantile spasms - The 2021 BASED score. Epilepsy Research, 2021, 7: 173.
5. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
6. Raili Riikonen. Biochemical mechanisms in pathogenesis of infantile epileptic spasm syndrome. Seizure, 2023, 105(2): 1-9.
7. Nitish Chourasia, Christopher J Yuskaitis, Mark H Libenson, et al. Infantile spasms: assessing the diagnostic yield of an institutional guideline and the impact of etiology on long-term treatment response. Epilepsia, 2022, 63(5): 1164-1176.
8. Puneet Jain, Jitendra K Sahu, Paul S Horn, et al, Treatment of children with infantile spasms: a network meta-analysis. Developmental Medicine and Child Neurology, 2022, 64(11): 1330-1343.
9. Christopher J Yuskaitis, John R Mytinger, Fiona M Baumer, et al. Association of time to clinical remission with sustained resolution in children with new-onset infantile spasms. Neurology, 2022, 99(22): 2494-2503.
10. Kelly G Knupp, Jason Coryell, Katherine C Nickels, et al. Response to treatment in a prospective national infantile spasms cohort. Annals of Neurology, 2016, 79(3): 475-484.
11. Zachary M Grinspan, Kelly G Knupp, Anup D Patel, et al. Comparative effectiveness of initial treatment for infantile spasms in a contemporary US cohort. Neurology, 2021, 97(12): 1217-1228.
12. Wang QH , He W, Wang YY , et al, Response to magnesium sulfate and adrenocorticotropic hormone combination therapy for infantile spasms with failed first-line treatments. Pediatric Investigation, 2023, 7(1): 29-35.
13. He W, Wang QH, Li JW, et al, Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome: a real-world study. World Journal of Pediatrics, 2023, 9(9): 1-14.
14. 刘秀国, 李久伟, 石秀玉, 等. 硫酸镁预防婴儿痉挛症ACTH治疗相关性高血压病例对照研究. 临床儿科杂志, 2014, 32(11): 1013-1015.
15. Fan YY, Chen D, Wang H, et al. Automatic BASED scoring on scalp EEG in children with infantile spasms using convolutional neural network. Frontiers in Molecular Biosciences, 2022, 9: 931688.
16. 郑苏, 陈述花, 李华, 等. 脑电变化和BASED评分与54例婴儿痉挛症促肾上腺皮质激素疗效的相关性. 山东大学学报(医学版), 2022, 60(9): 91-96+101.

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Valuation of burden of amplitudes and epileptiform discharges score in the efficacy of adrenocorticotropic hormone therapy for infantile epileptic spasms syndrome

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