Complementary structural and functional abnormalities to localise epileptogenic tissue.
Complementary structural and functional abnormalities to localise epileptogenic tissue.
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DOI：
10.1016/j.ebiom.2023.104848
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发表时间：
2023-11
期刊：
影响因子：
11.1
通讯作者：
中科院分区：
文献类型：
--
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在研究癫痫手术的适用性时，患有药物难治性局灶性癫痫的人可能会植入颅内EEG（iEEG）电极以定位癫痫发作。可以采集弥散加权磁共振成像（dMRI）以识别关键的白色物质束，以避免手术。在这里，我们调查是否结构连接异常，推断从dMRI，可用于与功能性iEEG异常，以帮助定位的致痫区（EZ），改善癫痫的手术结果。我们回顾性研究了43例（42%为女性）在iEEG后接受手术的癫痫患者的数据。25例患者（58%）在1年时未发生致残性癫痫发作（ILAE 1或2）。发作间期iEEG功能和dMRI结构连接异常通过与正常标测图和健康对照进行比较进行量化。我们探讨了切除最大畸形是否与改善手术结果有关，在两种方式中单独和同时进行。此外，我们还通过患者案例研究提出了连接异常如何影响手术前iEEG电极的放置。最大连通性切除术和iEEG异常的患者无癫痫发作的可能性高15倍（p = 0.008）。这两种模式分别区分患者手术结果组，当同时使用时，决策树正确分离了43例患者中的36例（84%）。我们的研究结果表明，连接和iEEG异常可能定位致痫组织，这两种方式可以提供手术前评估的补充信息。本研究由、资助。
When investigating suitability for epilepsy surgery, people with drug-refractory focal epilepsy may have intracranial EEG (iEEG) electrodes implanted to localise seizure onset. Diffusion-weighted magnetic resonance imaging (dMRI) may be acquired to identify key white matter tracts for surgical avoidance. Here, we investigate whether structural connectivity abnormalities, inferred from dMRI, may be used in conjunction with functional iEEG abnormalities to aid localisation of the epileptogenic zone (EZ), improving surgical outcomes in epilepsy. We retrospectively investigated data from 43 patients (42% female) with epilepsy who had surgery following iEEG. Twenty-five patients (58%) were free from disabling seizures (ILAE 1 or 2) at one year. Interictal iEEG functional, and dMRI structural connectivity abnormalities were quantified by comparison to a normative map and healthy controls. We explored whether the resection of maximal abnormalities related to improved surgical outcomes, in both modalities individually and concurrently. Additionally, we suggest how connectivity abnormalities may inform the placement of iEEG electrodes pre-surgically using a patient case study. Seizure freedom was 15 times more likely in patients with resection of maximal connectivity and iEEG abnormalities (p = 0.008). Both modalities separately distinguished patient surgical outcome groups and when used simultaneously, a decision tree correctly separated 36 of 43 (84%) patients. Our results suggest that both connectivity and iEEG abnormalities may localise epileptogenic tissue, and that these two modalities may provide complementary information in pre-surgical evaluations. This research was funded by , in Cloud Computing for Big Data, , , and .
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DOI：
10.1016/s1474-4422(15)00383-x
发表时间：
2016-04
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Duncan JS;Winston GP;Koepp MJ;Ourselin S
通讯作者：
Ourselin S
影响因子：
14.5
作者：
Frauscher, Birgit;von Ellenrieder, Nicolas;Gotman, Jean
通讯作者：
Gotman, Jean
影响因子：
14.5
作者：
Hatton, Sean N.;Huynh, Khoa H.;McDonald, Carrie R.
通讯作者：
McDonald, Carrie R.
影响因子：
3.4
作者：
通讯作者：
--
影响因子：
5.6
作者：
Bell ML;Rao S;So EL;Trenerry M;Kazemi N;Stead SM;Cascino G;Marsh R;Meyer FB;Watson RE;Giannini C;Worrell GA
通讯作者：
Worrell GA