Supporting Data doc 1.1MB

Assessing risk for relapse among children with infantile spasms using the BASED score

Objective: We sought to determine whether an association exists between Burden of Amplitudes and Epileptiform Discharges (BASED) score after ACTH treatment and relapse after initial response with ACTH. Methods: We retrospectively reviewed data from children with IS who achieved initial response after ACTH treatment. Subjects were assigned to the relapse group if relapse occurred within 12 months after ACTH treatment. General clinical data and EEG data after ACTH treatment were collected for all subjects. BASED was used to score EEG data collected within the last 2 days of ACTH treatment, and all features were analyzed by group comparisons. Cox proportional hazards models were fit to determine factors associated with relapse. Results: We identified a total of 64 children with IS. Of these, 37 (57.8%) experienced relapse; median time to relapse after ACTH treatment was 3 (1.5, 6) months. BASED score was significantly higher in the relapse group than in the non-relapse group(Table 1). Cox modeling demonstrated that BASED score was independently associated with relapse(Table 2 and Figure 1). Patients with BASED score > 3 showed a high rate (89.3%) of relapse(Figure 2). The relapse group had stronger, more stable EEG functional networks than the non-relapse group, correlations were noted between BASED score and functional connectivity(Figure 3 and 4). Conclusion: Children with IS whose BASED score is > 3 after initial response to ACTH carry a high risk of relapse within one year, and EEG abnormal functional connections maybe exist among them.
Keywords: infantile spasms, relapse, risk factors, BASED score, dynamic functional connectivity