Predictive value of frontal alpha asymmetry in evaluating prognosis of pediatric status epilepticus based on EEG
Liping Xie1,2, Tao Yu1,2, Jielan Zhou1,2
1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
Insights
Frontal alpha asymmetry (FAA) measured by electroencephalogram can predict outcomes in pediatric status epilepticus (SE). Higher FAA levels indicate a better prognosis, aiding clinical decisions for children with SE.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Biomarkers
Background:
- Pediatric status epilepticus (SE) presents significant prognostic challenges.
- Identifying reliable predictors for SE outcomes is crucial for timely clinical intervention.
- Frontal alpha asymmetry (FAA) is a potential electroencephalogram (EEG)-based biomarker.
Purpose of the Study:
- To evaluate the predictive capability of frontal alpha asymmetry (FAA) for the prognosis of pediatric status epilepticus (SE).
- To identify factors influencing the prognosis of pediatric SE.
- To establish the diagnostic accuracy of FAA in predicting SE outcomes.
Main Methods:
- Retrospective analysis of 177 pediatric SE patients.
- Comparison of clinical outcomes between good and poor prognosis groups.
- Univariate, binary logistic regression, and receiver operating characteristic (ROC) curve analyses were performed.
Main Results:
- Significant differences in SE onset, seizure cessation time, and FAA were observed between prognosis groups (P < .05).
- FAA and time to seizure cessation were independent predictors of pediatric SE prognosis (P < .05).
- ROC analysis showed an AUC of 0.805 for FAA, with 90.20% sensitivity and 52.38% specificity.
Conclusions:
- Frontal alpha asymmetry (FAA) demonstrates significant value in predicting the prognosis of pediatric status epilepticus.
- An optimal FAA cutoff value of 88.96 (×10-3 μV) can differentiate between good and poor prognoses.
- Higher FAA levels correlate with favorable clinical outcomes and lower post-treatment biomarker levels.
Abstract:
To investigate the predictive value of frontal alpha asymmetry (FAA) assessed by electroencephalogram in the prognosis of pediatric status epilepticus (SE). A retrospective analysis was conducted on 177 pediatric SE patients admitted to our hospital from January 2021 to December 2024. Patients were divided into a good prognosis group (n = 126) and a poor prognosis group (n = 51) based on their clinical outcomes. Univariate and binary logistic regression analyses were performed to assess the influencing factors. The predictive value of FAA for the prognosis of pediatric status epilepticus was evaluated with receiver operating characteristic curve analysis. Significant differences were found between the 2 groups in terms of SE onset time, time from medication to seizure cessation, and FAA (P < .05). Binary logistics regression analysis indicated that the time from medication to seizure cessation and FAA were independent influencing factors for the prognosis of pediatric SE (P < .05). Receiver operating characteristic analysis revealed an area under the curve of 0.805 for FAA, with a standard error of 0.035 (95% confidence interval: 0.738-0.873), a Youden index of 0.43, a sensitivity of 90.20%, and a specificity of 52.38%. The optimal cutoff value for FAA was 88.96 (×10-3 μV), with a higher probability of good prognosis in patients with FAA > 88.96 in comparison to those with FAA ≤ 88.96 (P < .05). Patients with FAA > 88.96 also had lower levels of glial fibrillary acidic protein, S100-β protein, and gamma-aminobutyric acid after treatment compared to those with FAA ≤ 88.96. There was a statistically significant difference (P < .05). FAA holds certain value in predicting the prognosis of pediatric SE and can provide reference for clinical decision-making.
