ArticleActa epileptologica2026
Efficacy of oxcarbazepine in treating focal epilepsy based on resting-state EEG functional connectivity and power spectral analyses.
Article in Acta epileptologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObjective electroencephalography (EEG)-based biomarkers are needed to assess oxcarbazepine (OXC) response in patients with focal epilepsy. This study aimed to identify resting-state EEG biomarkers associated with oxcarbazepine efficacy in focal epilepsy using power spectral and functional connectivity analyses.
methodsIn this retrospective cohort study, 27 drug-naïve patients with focal epilepsy underwent resting-state EEG before treatment and approximately 1 year after initiating OXC monotherapy. Nineteen 10-20 system electrodes were recorded at 256/512 Hz, and preprocessed (resampling, detrending, 50 Hz notch, 0.5-70 Hz band-pass, independent component analysis [ICA] artifact removal). Relative power spectral density (rPSD) was estimated via Welch's method (5 s windows, 50% overlap). Functional connectivity (FC) was quantified by amplitude envelope correlation with correction (AEC-C) within canonical bands, yielding 19×19 matrices. Group comparisons used nonparametric tests with Benjamini-Hochberg false discovery rate (FDR) correction for rPSD and network-based statistic (NBS) for FC (5,000 permutations; initial thresholds t = 2.787, P < 0.01, and t = 3.725, P < 0.001). Clinical outcomes were classified as seizure-free (SF) or not seizure-free (NSF) at 6-24 months after OXC initiation.
resultsBaseline clinical characteristics did not differ between groups. At the on-treatment follow-up EEG, the NSF group exhibited significantly higher θ-band rPSD at multiple frontal-central electrodes (Fp1, Fp2, F3, F4, C3, C4, F7, F8, Fz, Cz) after FDR correction. FC analysis showed stronger δ-band connectivity in the NSF group across frontal-central nodes at P < 0.01; under the stricter threshold (P < 0.001), a robust edge between P3 and F7 remained significantly stronger in the NSF group. No significant between-group differences were observed in other frequency bands after correction.
conclusionsThese findings suggest that the response to oxcarbazepine in focal epilepsy is linked to differential regulation of slow-frequency brain networks. Persistent low-frequency synchronization reflects ongoing network instability and reduced treatment efficacy, whereas attenuation of pathological slow-wave activity indicates effective network stabilization. These band-limited spectral and network features are promising EEG features associated with treatment response to OXC.
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