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. 2024 Dec 23:17:17562864241307846.
doi: 10.1177/17562864241307846. eCollection 2024.

Intrinsic brain activity differences in drug-resistant epilepsy and well-controlled epilepsy patients: an EEG microstate analysis

Chaofeng Zhu  1 , Jinying Zhang  1 , Shenzhi Fang  1 , Yuying Zhang  1 , Juan Li  1 , Luyan Wu  2 , Huapin Huang  2   3   4 , Wanhui Lin  2   3
Affiliations

Intrinsic brain activity differences in drug-resistant epilepsy and well-controlled epilepsy patients: an EEG microstate analysis

Chaofeng Zhu et al. Ther Adv Neurol Disord. .

Abstract

Background: Drug-resistant epilepsy (DRE) patients exhibit aberrant large-scale brain networks.

Objective: The purpose of investigation is to explore the differences in resting-state electroencephalogram (EEG) microstates between patients with DRE and well-controlled (W-C) epilepsy.

Design: Retrospective study.

Methods: Clinical data of epilepsy patients treated at the Epilepsy Center of Fujian Medical University Union Hospital from January 2020 to May 2023 were collected for a minimum follow-up period of 2 years. Participants meeting inclusion and exclusion criteria were categorized into two groups based on follow-up records: W-C group and DRE group. To ensure that the recorded EEG data were not influenced by medication, all EEG recordings were collected before patients commenced any antiepileptic drug treatment. Resting-state EEG datasets of all participants underwent microstate analysis. This study comprehensively compared the average duration, frequency per second, coverage, and transition probabilities (TPs) of each microstate between the two groups.

Results: A total of 289 individuals who met the criteria were included, categorized into the W-C group (n = 112) and the DRE group (n = 177). EEG microstate analysis revealed substantial variances between the two groups. The analysis highlights differences in three of four microstate classifications. Microstate transition analysis demonstrated altered probabilities in DRE patients. Increased probabilities were observed in TPAB, TPBA, TPBC, TPCB, TPBD, and TPDB. Decreased probabilities included TPCA, TPDA, TPAC, TPAD, TPCD, and TPDC.

Conclusion: This study highlights distinctive EEG microstate parameters and TPs in DRE patients compared to those with W-C epilepsy. The results may potentially advance the clinical application of EEG microstates.

Keywords: EEG; drug-resistant epilepsy; microstate parameter; resting state.

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Figures

Figure 1.
Figure 1.
The flowchart of EEG microstate classification based on the k-means algorithm. (a) Flow chart. (b) Schematic diagram. EEG, electroencephalogram.
Figure 2.
Figure 2.
Microstate topographic maps. DRE group, patients with drug-resistant epilepsy; W-C group, well-controlled epilepsy patients.
Figure 3.
Figure 3.
Temporal features of microstates between two groups. (a) The duration of microstate A–D. (b) The occurrences per second of microstate A–D. (c) The coverage of microstate A–D. The p-values are outcomes of the Mann–Whitney U test for inter-group comparison. *p < 0.05. **p < 0.01. ***p < 0.001.
Figure 4.
Figure 4.
EEG microstate transition probabilities in the two groups. Transition probabilities from microstates A, B, C, D to other microstates in W-C group (a) and DRE group (b).
Figure 5.
Figure 5.
Comparison of the EEG microstate transition probabilities between two groups. Transition probabilities from microstates A to other microstates (a), B to other microstates (b), C to other microstates (c), and D to other microstates (d). The p-values are outcomes of the Mann–Whitney U test for inter-group comparison. *p < 0.05. **p < 0.01. ***p < 0.001.
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