Interictal spectral EEG features associated with thalamocortical dysfunction and seizure burden in childhood absence
Arwa Yahyaoui1, Nouha Gammoudi2, Ghazi Sakly2
1Neurophysiology Department, University Hospital of Sahloul, Sousse, Tunisia.
Background:
Childhood Absence Epilepsy (CAE) is characterized by spike-and-wave discharges arising from thalamocortical network dysfunction. Quantitative EEG (qEEG) analysis may reveal interictal markers of this instability and its clinical relevance.
Objective:
To identify interictal spectral EEG alterations in untreated CAE and examine their association with seizure burden, quantified by Percentage of Time in Seizure (PTS).
Methods:
In this retrospective case-control study, 21 children with newly diagnosed, untreated CAE and 24 age- and sex-matched healthy controls underwent spectral analysis of artifact-free interictal EEG segments. Absolute power (delta, theta, alpha, low-beta, high-beta) and the beta/theta (β/θ) ratio were computed. Spearman's correlation assessed associations with PTS.
Results:
Compared with controls, CAE patients showed significant interictal spectral abnormalities. Beta power demonstrated regional modulation, with decreases in the left frontal region and increases in right frontopolar and temporal areas. Widespread increases in theta and alpha power were observed over fronto-central regions. The β/θ ratio was significantly reduced in left central (C3-Cz) and parietal (P3-Cz) regions. Theta and alpha power over the right frontopolar (FP2-Cz) region positively correlated with PTS.
Conclusion:
CAE is associated with distinct interictal spectral alterations, including reduced β/θ ratio and increased frontal theta and alpha power, which correlate with seizure burden. These findings suggest potential electrophysiological correlates of thalamocortical dysfunction that warrant validation in larger prospective studies.
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