ArticleEpilepsia2024
Circadian changes in aperiodic activity are correlated with seizure reduction in patients with mesial temporal lobe epilepsy treated with responsive neurostimulation.
Article in Epilepsia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- A Systematic Review of Aperiodic Neural Activity in Clinical Investigations.The European journal of neuroscience · 2025Pooled it
- Task-Related Aperiodic EEG (1/f) Activity in Autism.Autism research : official journal of the International Society for Autism Research · 2026Article
- Thalamocortical network dynamics in focal epilepsy: SEEG investigation.bioRxiv : the preprint server for biology · 2026Article
- Reduced cortical excitability is associated with head impact severity and cognitive symptoms in adolescent football players.iScience · 2026Article
- Ketamine alters the aperiodic EEG exponent in major depression: implications for cortical E/I balance and treatment prediction.Therapeutic advances in psychopharmacology · 2026Article
- A structured narrative review on VNS-treated drug-resistant epilepsy: EEG markers, neurochemical mechanisms, and future biomarker-driven computational directions.Frontiers in neuroscience · 2026Review
- Sleep in Lennox-Gastaut Syndrome: A Scoping Review.Children (Basel, Switzerland) · 2025Review
- Aperiodic Activity Reflects Pathologic Waveform Shapes in Focal Epilepsy.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025Article
- Collapse of interictal suppressive networks permits seizure spread.Brain : a journal of neurology · 2025Article
- Review
- Factors influencing seizure control of patients with convulsive epilepsy in rural areas of northwest China.Epilepsia open · 2025Article
- EEG Spectral Exponents and Visual Chirp Responses Mirror Anti-Seizure Medication Load in Refractory Focal Epilepsy.Annals of clinical and translational neurology · 2025Article
- Mechanistic insights into the interaction between epilepsy and sleep.Nature reviews. Neurology · 2025Review
- Can brain network analyses guide epilepsy surgery?Current opinion in neurology · 2025Review
- The hidden rhythms of epilepsy: exploring biological clocks and epileptic seizure dynamics.Acta epileptologica · 2025Review
- Long-Term Ambulatory Intracranial EEG.Stereotactic and functional neurosurgery · 2025Review
- Influence of mindfulness meditation on intracranial EEG parameters in epileptic and non-epileptic brain areas.Epilepsy & behavior : E&B · 2024Article
- Reduced Cortical Excitability is Associated with Cognitive Symptoms in Concussed Adolescent Football Players.medRxiv : the preprint server for health sciences · 2024Article
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesResponsive neurostimulation (RNS) is an established therapy for drug-resistant epilepsy that delivers direct electrical brain stimulation in response to detected epileptiform activity. However, despite an overall reduction in seizure frequency, clinical outcomes are variable, and few patients become seizure-free. The aim of this retrospective study was to evaluate aperiodic electrophysiological activity, associated with excitation/inhibition balance, as a novel electrographic biomarker of seizure reduction to aid early prognostication of the clinical response to RNS.
methodsWe identified patients with intractable mesial temporal lobe epilepsy who were implanted with the RNS System between 2015 and 2021 at the University of Utah. We parameterized the neural power spectra from intracranial RNS System recordings during the first 3 months following implantation into aperiodic and periodic components. We then correlated circadian changes in aperiodic and periodic parameters of baseline neural recordings with seizure reduction at the most recent follow-up.
resultsSeizure reduction was correlated significantly with a patient's average change in the day/night aperiodic exponent (r = .50, p = .016, n = 23 patients) and oscillatory alpha power (r = .45, p = .042, n = 23 patients) across patients for baseline neural recordings. The aperiodic exponent reached its maximum during nighttime hours (12 a.m. to 6 a.m.) for most responders (i.e., patients with at least a 50% reduction in seizures). SIGNIFICANCE: These findings suggest that circadian modulation of baseline broadband activity is a biomarker of response to RNS early during therapy. This marker has the potential to identify patients who are likely to respond to mesial temporal RNS. Furthermore, we propose that less day/night modulation of the aperiodic exponent may be related to dysfunction in excitation/inhibition balance and its interconnected role in epilepsy, sleep, and memory.
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