Evidence map›Paper›PMID 39666270›Full record

ArticleEpilepsia2025

Discovering EEG biomarkers of Lennox-Gastaut syndrome through unsupervised time-frequency analysis.

Derek K Hu, Marco A Pinto-Orellana, Mandeep Rana, Linda Do, David J Adams, Shaun A Hussain, Daniel W Shrey, Beth A Lopour

Abstract read
In one paragraph

Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Derek K HuDepartment of Biomedical Engineering, University of California, Irvine, California, USA.ORCID https://orcid.org/0000-0003-4720-2622
Marco A Pinto-OrellanaDepartment of Biomedical Engineering, University of California, Irvine, California, USA.ORCID https://orcid.org/0000-0001-6495-1305
Mandeep RanaDivision of Neurology, Children's Hospital Orange County, Orange, California, USA.
Linda DoDivision of Neurology, Children's Hospital Orange County, Orange, California, USA.
David J AdamsDivision of Neurology, Children's Hospital Orange County, Orange, California, USA.
Shaun A HussainDivision of Pediatric Neurology, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-6947-8852
Daniel W ShreyDivision of Neurology, Children's Hospital Orange County, Orange, California, USA.ORCID https://orcid.org/0000-0002-3163-4773
Beth A LopourDepartment of Biomedical Engineering, University of California, Irvine, California, USA.ORCID https://orcid.org/0000-0003-4233-4802

Funding

John C. Hench FoundationLGS Foundation
6 · The paper itself

Abstract

objectiveThe discovery and validation of electroencephalography (EEG) biomarkers often rely on visual identification of waveforms. However, bias toward visually striking events restricts the search space for new biomarkers, and low interrater reliability can limit rigorous validation. We present a data-driven approach to biomarker discovery called scalp EEG Pattern Identification and Categorization (s-EPIC), which enables automated, unsupervised identification of EEG waveforms. S-EPIC is validated on Lennox-Gastaut syndrome (LGS), an epilepsy that is difficult to diagnose and assess due to its variable presentation and insidious evolution of symptoms.

methodsWe retrospectively collected 10-min scalp EEG clips during non-rapid eye movement (NREM) sleep from 20 subjects with LGS and 20 approximately age-matched healthy controls. For s-EPIC, EEG events of interest (EOIs) were detected in all subjects using time-frequency analysis. The 11 705 EOIs were characterized based on 11 features and were collectively grouped using both k-means clustering and feature categorization. To provide clinical context, 1350 EOIs were visually reviewed and classified by three epileptologists.

resultss-EPIC identified four clusters as candidate biomarkers of LGS, each having significantly more LGS EOIs than control EOIs. Two clusters contained EOIs resembling known LGS biomarkers such as interictal epileptiform discharges and generalized paroxysmal fast activity. The other two LGS-associated EEG clusters contained short bursts of power in beta and gamma frequency bands that were primarily unrecognized by epileptologists. This approach also uncovered significant differences in sleep spindles between LGS and control cohorts. SIGNIFICANCE: s-EPIC provides a quantitative approach to waveform identification that could be broadly applied to EEG from both healthy subjects and those with suspected pathology. s-EPIC can objectively identify and characterize relevant EEG waveforms without visual review or assumptions about the waveform's morphology and could therefore be a powerful tool for the discovery and refinement of EEG biomarkers.

Indexed as

ElectroencephalographyLennox Gastaut SyndromeAdolescentAdultBiomarkersChildChild, PreschoolFemaleHumansMaleRetrospective StudiesYoung AdultBiomarkersepilepsyepileptic encephalopathygeneralized paroxysmal fast activityinterictal epileptiform dischargemachine learningsleep spindle

Identifiers

PMID39666270
PMCPMC11827736

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.