An Electroencephalography Profile of Paroxysmal Kinesigenic Dyskinesia

Background: Paroxysmal kinesigenic dyskinesia (PKD) associates with disturbance of neural circuit and network activities, while its neurophysiological characteristics have not been fully elucidated.Methods: This study utilized the high-density electroencephalogram (hd-EEG) signals to detect abnormal brain activity of PKD and provide a neural biomarker for its clinical diagnosis and monitoring of PKD progression. We recorded hd-EEG from two independent datasets (96 PKD patients and 98 health controls in dataset 1, and 31 PKD patients in dataset 2) in eye-open and eye-closed paradigms, which was then source-localized for measuring the oscillatory activities and function connectivity (FC) patterns of cortical and subcortical regions. Results: The abnormal elevation of theta oscillation represented the most remarkable physiological feature for PKD, involving the cerebellum, subcortical, limbic network (LN), somatomotor network (SMN), and default mode network (DMN); these changes returned to healthy control level in remission patients. Another remarkable feature of PKD was the decreased high-gamma FCs in the non-remission patients, mainly including DMN, dorsal attention network (DAN), SMN, and ventral attention network (VAN). Subtype analyses reported that increased theta oscillations might be related to the emotional trigger type of PKD, while the decreased high-gamma FCs were related to the motor symptoms of PKD. Finally, we established connectome-based predictive modelling (CPM) and successfully identified the remission state in PKD patients in dataset 1 (AUC of ROC = 0.995) and dataset 2 (AUC of the ROC=0.735). Interpretation: Our findings establish a clinically relevant electroencephalography profile of PKD and indicate that hd-EEG can provide robust neural biomarkers to evaluate the prognosis of PKD. Funding: Outstanding Academic Leaders of Shanghai (23XD1402500), Training program for research physicians of innovative translational ability (SHDC2022CRD037), and National Natural Science Foundation of China (No. 81870889).Declaration of Interest: The authors report no competing interests.Ethical Approval: All participants or their guardians signed written informed consent, and ethics approval was granted by the research ethics boards of the Shanghai Sixth People’s Hospital (Approval No: 2021-219).