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Journal of Neuro-Oncology

Erschienen in:

17.06.2022 | Research

Early EEG hyperexcitability is associated with decreased survival in newly diagnosed IDH-wildtype glioma

verfasst von: Steven Tobochnik, Emily Lapinskas, Jayne Vogelzang, Keith L. Ligon, Jong Woo Lee

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2022

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Abstract

Purpose

The relationship between peritumoral neuronal activity, early onset clinical seizures, and glioma survival outcomes remains poorly understood. Hyperexcitability on continuous EEG in the peri-operative period was studied as a prognostic biomarker in patients with newly diagnosed IDH-wildtype diffuse glioma.

Methods

A retrospective observational cohort study was performed including adults with newly diagnosed diffuse glioma, absence of IDH1/2 mutations, and continuous EEG monitoring prior to chemoradiation and within 1 month of initial resection. EEG hyperexcitability was defined by the presence of lateralized periodic discharges and/or electrographic seizures. The primary outcome of overall survival was estimated using the Kaplan–Meier method and compared between groups using multivariate Cox proportional hazards model.

Results

There were 424 patients without continuous EEG and 32 with continuous EEG, of whom lateralized periodic discharges and/or electrographic seizures were seen in 17 (53%). Peri-operative EEG hyperexcitability was associated with decreased overall survival in multivariate analysis (median 12.5 [95% CI 6.2–25.6] months with hyperexcitability versus median 19.9 [95% CI 8.9–53.5] months without hyperexcitability, p = 0.043). Compared to patients without continuous EEG, overall survival was decreased in patients with hyperexcitability (p < 0.0001) and similar in patients without hyperexcitability (p = 0.193). Patients with and without hyperexcitability had similar rates of exposure to anti-seizure medication at baseline, and in long-term follow-up had no difference in number of medications required for seizure control.

Conclusions

These findings indicate the potential prognostic value of a clinical EEG biomarker of glioma aggressiveness prior to the initiation of chemoradiation.

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Titel: Early EEG hyperexcitability is associated with decreased survival in newly diagnosed IDH-wildtype glioma
verfasst von: Steven Tobochnik
Emily Lapinskas
Jayne Vogelzang
Keith L. Ligon
Jong Woo Lee
Publikationsdatum: 17.06.2022
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 1/2022
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-022-04059-8

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Early EEG hyperexcitability is associated with decreased survival in newly diagnosed IDH-wildtype glioma