@article{d351238abc6b4a568aa7bad7c3ab069d,
title = "Scalp EEG Ictal gamma and beta activity during infantile spasms: Evidence of focality",
abstract = "Objective: We investigated temporal and spatial characteristics of ictal gamma and beta activity on scalp EEG during spasms in patients with West syndrome (WS) to evaluate potential focal cortical onset. Methods: A total of 1,033 spasms from 34 patients with WS of various etiologies were analyzed on video-electroencephalography (EEG) using time-frequency analysis. Ictal gamma (35–90 Hz) and beta (15–30 Hz) activities were correlated with visual symmetry of spasms, objective EMG (electromyography) analysis, and etiology of WS. Results: Prior to the ictal motor manifestation, focal ictal gamma activity emerged from one hemisphere (71%, 24/34) or from midline (26%, 9/34), and was rarely simultaneously bilateral (3%, 1/34). Focal ictal beta activity emerged from either one hemisphere (68%, 23/34) or from midline (32%, 11/34). Onsets of focal ictal gamma and beta activity were most commonly observed around the parietal areas. Focal ictal gamma activity propagated faster than ictal beta activity to adjacent electrodes (median: 65 vs. 170 msec, p < 0.01), and to contralateral hemisphere (median: 100 vs. 170 msec, p = 0.01). Asymmetric peak amplitude of ictal gamma activity in the centroparietal areas (C3-P3 vs. C4-P4) correlated with asymmetric semiology. On the other hand, most of the visually symmetric spasms showed asymmetry in peak amplitude and interhemispheric onset latency difference in both ictal gamma and beta activity. Significance: Spasms may be a seizure with focal electrographic onset regardless of visual symmetry. Asymmetric involvement of ictal gamma activity to the centroparietal areas may determine the motor manifestations in WS. Scalp EEG ictal gamma and beta activity may be useful to demonstrate localized seizure onset in infants with WS.",
keywords = "Beta activity, Gamma activity, High-frequency oscillations, Infantile spasms, Seizure semiology, West syndrome",
author = "Hiroki Nariai and Jules Beal and Galanopoulou, {Aristea S.} and Mowrey, {Wenzhu B.} and Stephan Bickel and Yoshimi Sogawa and Rana Jehle and Shlomo Shinnar and Mosh{\'e}, {Solomon L.}",
note = "Funding Information: We are grateful to Fred Lado and staff members of The Comprehensive Epilepsy Center at Montefiore Medical Center for the collaboration and assistance in performing the studies described herein. Solomon L. Mosh{\'e} is the Charles Frost Chair in Neurosurgery and Neurology and funded by grants from NIH NS43209, NS20253, NS45911, NS-78333, 1U54NS100064-01, Citizens United for Research in Epilepsy Infantile Spasms Initiative, US Department of Defense (W81XWH-13-1-0180), the Heffer Family and the Segal Family Foundations, and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. He is serving as Associate Editor of Neurobiology of Disease, and is on the editorial board of Epileptic Disorders, Brain and Development, Pediatric Neurology, and Physiological Research. He receives from Elsevier an annual compensation for his work as Associate Editor in Neurobiology of Disease and royalties from two books he co-edited. He received a consultant fee from Eisai and UCB. Aristea S. Galanopoulou receives research funding from NINDS NS091170, 1U54NS100064-01, US Department of Defense (W81XWH-13-1-0180), CURE Infantile Spasms Initiative, the Heffer Family and the Segal Family Foundations and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. She has received honoraria from the Department of Defense (grant reviews), John Libbey Eurotext, and Elsevier (publications). Wenzhu B. Mowrey receives research funding from US Department of Defense (W81XWH-13-1-0180), NINDS 1U54NS100064-01, and CURE Infantile Spasms Initiative. Shlomo Shinnar is funded by NIH grants NS 2R37-NS043209, 2U01-NS045911, U10NS077308, and 1U01NS088034. He serves on the Editorial Board of Pediatric Neurology and serves on Data and Safety Monitoring Board for UCB Pharma. He has received personal compensation for serving on Scientific Advisory Boards for UCB Pharma and Upsher Smith, and for consulting for Neurelis, Questcor, Upsher-Smith, and Xeris. He has received royalties from Elsevier for co-editing the book Febrile Seizures. Publisher Copyright: Wiley Periodicals, Inc. {\textcopyright} 2017 International League Against Epilepsy",
year = "2017",
month = may,
doi = "10.1111/epi.13735",
language = "English (US)",
volume = "58",
pages = "882--892",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "5",
}