Abstract
PURPOSE: To investigate the association of EEG-assessed Phase Lag Index (PLI) with cognitive dysfunction and seizure occurrence in pediatric patients with epilepsy. METHODS: A retrospective cohort study enrolled 117 children with epilepsy aged 4 to 16 years. Participants were categorized into Normal PLI (n=53) and Abnormal PLI (n=64) groups based on EEG-assessed PLI values. EEG signals were collected using 87-channel Natus Brain Monitor amplifier, and PLI and coherence were calculated for various brain regions. Cognitive function and seizure occurrence were assessed using standardized tests and clinical parameters. Statistical analyses, including t-tests, Spearman correlation analysis, and logistic regression, were conducted to evaluate the associations between EEG-assessed PLI, cognitive dysfunction, and seizure occurrence. RESULTS: The Abnormal PLI group exhibited significantly higher PLI measurements across various brain regions compared to the Normal PLI group (P < 0.001 for all comparisons). Distinct EEG pattern alterations, especially in PLI and various frequency bands, were observed in the Abnormal PLI group. This group also displayed significant cognitive impairments across all cognitive measures (P < 0.001 for all comparisons) and experienced markedly higher seizure frequency, longer average seizure duration, and greater seizure severity compared to the Normal PLI group (P < 0.001 for all comparisons). Correlation and logistic regression analyses supported the robust relationships between PLI, cognitive dysfunction, and seizure parameters (P < 0.001 for all). CONCLUSION: EEG-assessed PLI shows promise as a valuable tool for assessing cognitive dysfunction and predicting seizure occurrence in children with epilepsy. The study's findings contribute to the understanding of the neuropathophysiology of epilepsy in children and offer implications for prognostic assessment and therapeutic intervention in this vulnerable patient population. The results emphasize the potential clinical utility of EEG-derived biomarkers in the evaluation and management of epilepsy in pediatric patients, suggesting avenues for personalized treatment strategies to optimize cognitive outcomes and seizure management in this population.