Einfluss antiepileptischer Medikamente auf die funktionelle Konnektivität im Routine-EEG bei Patienten mit fokaler nicht-läsioneller Epilepsie

Influence of antiepileptic drugs on functional connectivity in routine EEG in patients with focal non-lesional epilepsy

by Anna Reidenbach
Doctoral thesis
Date of Examination:2024-09-05
Date of issue:2024-09-04
Advisor:Prof. Dr. Niels Focke
Referee:Prof. Dr. Niels Focke
Referee:Prof. Dr. Dirk Wedekind
Persistent Address: http://dx.doi.org/10.53846/goediss-10711

 

 

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Abstract

English

Epilepsy is one of the most important neurological disorders and affects up to 1% of the population in Germany (Brandt 2016). It is currently not possible to make a reliable statement on the prognosis and effectiveness of antiepileptic therapy using established diagnostic methods. Studies have shown that epilepsy disorders are often associated with aberrant network organization (Tracy and Doucet 2015) and changes in the functional network (Li Hegner et al. 2018, Arzy et al. 2010; Pellegrino et al. 2018; Ricci et al. 2021). This study investigates the differences in the functional network by means of functional connectivity in patients with focal non-lesional epilepsy compared to healthy controls and the influence of the antiepileptic drugs Lamotrigine and Levetiracetam on functional connectivity. For this purpose, the EEG data as well as clinical patient data of 33 patients and 33 healthy controls were analyzed. Uncorrected analyses showed a tendency towards altered functional connectivity in patients with focal non-lesional epilepsy compared to healthy controls. Furthermore, a tendency towards functional changes in epilepsy patients after starting or increasing the dosage of antiepileptic medication was shown. In addition, there was a tendency towards normalization of functional connectivity in theta in the drug-naive cohort after starting antiepileptic medication. These changes could be due to the effect of the antiepileptic medication. An uncorrected analysis on changes in functional connectivity due to antiepileptic medication in seizure-free (= responders) and non-seizure-free patients (= non-responders) showed a reduction in functional connectivity in delta over almost the entire left cerebral hemisphere in seizure-free patients. These changes could not be reproduced in the cohort of non-seizure-free patients. In agreement with other studies, it can be assumed that the changes found in delta correlate with the seizure freedom of patients with focal epilepsy. This provides initial indications of the extent to which changes in the functional network could help to objectify the response to therapy in the future and thus enable better treatment of patients with epilepsy.
Keywords: focal non-lesional epilepsy; functional connectivity; antiepileptic drugs