Prognostic value of the 5-SENSE Score to predict focality of the seizure-onset zone as assessed by stereoelectroencephalography: a prospective international multicentre validation study.
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2024-01
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Abstract
Introduction
Epilepsy surgery is the only curative treatment for patients with drug-resistant focal epilepsy. Stereoelectroencephalography (SEEG) is the gold standard to delineate the seizure-onset zone (SOZ). However, up to 40% of patients are subsequently not operated as no focal non-eloquent SOZ can be identified. The 5-SENSE Score is a 5-point score to predict whether a focal SOZ is likely to be identified by SEEG. This study aims to validate the 5-SENSE Score, improve score performance by incorporating auxiliary diagnostic methods and evaluate its concordance with expert decisions.Methods and analysis
Non-interventional, observational, multicentre, prospective study including 200 patients with drug-resistant epilepsy aged ≥15 years undergoing SEEG for identification of a focal SOZ and 200 controls at 22 epilepsy surgery centres worldwide. The primary objective is to assess the diagnostic accuracy and generalisability of the 5-SENSE in predicting focality in SEEG in a prospective cohort. Secondary objectives are to optimise score performance by incorporating auxiliary diagnostic methods and to analyse concordance of the 5-SENSE Score with the expert decisions made in the multidisciplinary team discussion.Ethics and dissemination
Prospective multicentre validation of the 5-SENSE score may lead to its implementation into clinical practice to assist clinicians in the difficult decision of whether to proceed with implantation. This study will be conducted in accordance with the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (2014). We plan to publish the study results in a peer-reviewed full-length original article and present its findings at scientific conferences.Trial registration number
NCT06138808.Type
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Astner-Rohracher, Alexandra, Alyssa Ho, John Archer, Fabrice Bartolomei, Milan Brazdil, Melita Cacic Hribljan, James Castellano, Irena Dolezalova, et al. (2024). Prognostic value of the 5-SENSE Score to predict focality of the seizure-onset zone as assessed by stereoelectroencephalography: a prospective international multicentre validation study. BMJ neurology open, 6(2). p. e000765. 10.1136/bmjno-2024-000765 Retrieved from https://hdl.handle.net/10161/33036.
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Prachi T. Parikh
Birgit Frauscher
Dr. Birgit Frauscher is a clinician scientist whose career is dedicated to improve diagnosis and prognosis of people with epilepsy by developing new methods based on advanced electroencephalography techniques to better localize the epileptic focus in order to improve epilepsy treatment outcomes and ultimately achieve the best possible quality of life. She is currently holding the position of Director of the Duke Comprehensive Epilepsy Center and holds a secondary appointment with the Department of Biomedical Engineering at the Duke Pratt School of Engineering.
Her academic journey started at the Medical University of Innsbruck in Austria, where she accomplished her medical training, residency in neurology, and subspecialty training in electroencephalography, epilepsy and sleep medicine. Early in her career during Medical School she became fascinated by the technique of electroencephalography and how it allows to draw important conclusions on brain function. After completion of her clinical training in 2008, she underwent subsequent research training resulting in the successful completion of her habilitation degree in 2011. To specialize on intracranial EEG and signal analysis, she spent a visiting professorship at the Montreal Neurological Institute and Hospital, McGill University in Canada between 2013 – 2015. Subsequently, she served at the Montreal Neurological Institute and Hospital as an Attending Epileptologist and later as Group Leader of Epilepsy and Professor of Neurology.
Her research interests include i) the development of novel seizure-independent EEG markers for the epileptogenic zone in order to achieve a more accurate diagnosis of epilepsy, ii) the investigation of the important interactions between sleep and epilepsy, and iii) the use of the unique possibility of invasive intracranial EEG for studying brain physiology during wakefulness and sleep in order to better delineate normal from abnormal intracranial EEG activity.
Dr. Frauscher’s publication record holds over 170 peer-reviewed papers dedicated to epilepsy and sleep with a H-index of 62. Her scholarly endeavors have earned her several prestigious awards, including Clinician-Scientist awards of the FRSQ (2018-2023), the Michael Prize of the International League against Epilepsy (2019) and the Ernst Niedermeyer Prize from the Austrian Epilepsy Society (2015). Dr. Frauscher's dedication to pushing the boundaries of epilepsy and sleep research highlights her standing in the field and her significant contributions to advancing clinical knowledge.
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