Konnektivitätsanalyse des Routine-EEGs bei idiopathisch generalisierter Epilepsie

by Carmen Juliana Löw née Löw
Doctoral thesis
Date of Examination:2025-12-02
Date of issue:2025-12-03
Advisor:Prof. Dr. Niels Focke
Referee:Prof. Dr. Melanie Wilke
Referee:Prof. Dr. Ralf Dressel
Persistent Address: http://dx.doi.org/10.53846/goediss-11669

 

 

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Abstract

English

Epilepsy is one of the most common neurological disorders and is characterized by a persistent predisposition to excessive synchronous neuronal activity leading to epileptic seizures. Idiopathic generalized epilepsy (IGE) accounts for approximately one-third of all epilepsy syndromes. Diagnostic accuracy may be constrained by limited clinical or electrophysiological information. This study investigated whether functional brain networks in patients with IGE can be detected using routine EEG recordings with 21 electrodes. In a retrospective case–control design, routine EEGs from 79 patients with IGE and 43 healthy controls were analyzed. EEG data were processed using the FieldTrip toolbox, epochs containing epileptiform discharges were excluded, and source reconstruction was performed using a standardized MRI template. Functional activity was quantified using spectral power, and functional connectivity was assessed using the imaginary part of coherence across multiple frequency bands. Group comparisons additionally considered seizure freedom, antiseizure medication (ASM), presence of interictal epileptiform potentials, and disease duration. IGE patients showed significantly increased global and region-specific spectral power across all frequency bands, with posterior predominance, and elevated functional connectivity in theta, alpha, and gamma frequencies in frontal, central, and posterior regions. ASM load, disease duration, and duration of seizure freedom showed no significant effects on functional measures. Patients with interictal epileptiform potentials exhibited higher delta power than those without. The pattern of altered connectivity overlapped with subregions of the default mode network, consistent with previous high-density EEG and MEG studies implicating thalamocortical and DMN-related network alterations in IGE. These findings demonstrate that functional network abnormalities in IGE can be detected even in routine EEG recordings with low electrode density. Routine-EEG–based connectivity analysis may therefore represent a promising, widely accessible tool to support the diagnostic workup of epilepsy and to differentiate epilepsy subtypes, including potential subsyndromes of IGE.
Keywords: EEG; idiopathic generalized epilepsy; functional connectivity
 
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