Effect of epilepsy magnetic source imaging on intracranial electrode placement.
Effect of epilepsy magnetic source imaging on intracranial electrode placement.
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DOI：
10.1002/ana.21660
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发表时间：
2009-06
影响因子：
11.2
通讯作者：
Kuzniecky, Ruben
中科院分区：
文献类型：
--
作者：
Knowlton, Robert C.;Razdan, Shantanu N.;Limdi, Nita;Elgavish, Rotem A.;Killen, Jeff;Blount, Jeffrey;Burneo, Jorge G.;Hoef, Lawrence Ver;Paige, Lebron;Faught, Edward;Kankirawatana, Pongkiat;Bartolucci, Al;Riley, Kristen;Kuzniecky, Ruben
长期植入电极的颅内脑电图（ICEEG）是一种昂贵的侵入性诊断程序，对于接受癫痫手术评估的大部分患者来说仍然是必要的。本研究旨在评价磁源成像（MSI）（一种基于脑磁图源定位的非侵入性测试）是否可以通过影响电极放置来补充ICEEG，以改善癫痫发作区的采样。在298例连续癫痫手术候选者中（2001-2006年），160例基于癫痫监测和MRI结果定位不足而前瞻性入组。在呈现MSI结果之前，决定是否继续ICEEG，如果是，在哪里放置电极，以便对假设的癫痫发作区进行采样。然后提供MSI结果，允许对原始计划进行更改。MSI显示77例ICEEG病例中有18例（23%）额外电极覆盖。在39%（95% CI：16.4，61.4）癫痫发作ICEEG模式涉及额外的电极指示MSI。62例患者根据ICEEG记录的癫痫发作进行手术切除。对于整个手术人群（n=62），高度局部MSI与无复发结局（平均=3.4年，最小> 1年）显著相关。MSI棘波定位增加了当患者接受ICEEG进行术前癫痫评估时对癫痫发作区进行采样的机会。这种效果的临床影响-提高ICEEG的诊断率-应考虑在手术候选人，没有令人满意的癫痫定位从癫痫症状学，EEG和MRI的指示。
Intracranial electroencephalography (ICEEG) with chronically implanted electrodes is a costly invasive diagnostic procedure that remains necessary for a large proportion of patients who undergo evaluation for epilepsy surgery. This study was designed to evaluate whether magnetic source imaging (MSI), a non-invasive test based on magnetoencephalography source localization, can supplement ICEEG by affecting electrode placement to improve sampling of the seizure onset zone(s). Of 298 consecutive epilepsy surgery candidates (between 2001-2006) 160 cases were prospectively enrolled on the basis of insufficient localization from seizure monitoring and MRI results. Prior to presenting MSI results, decisions were made as to whether to proceed with ICEEG, and if so, where to place electrodes such that the hypothetical seizure onset zone would be sampled. MSI results were then provided with allowance of changes to the original plan. MSI indicated additional electrode coverage in 18 of 77 (23%) ICEEG cases. In 39% percent (95% CI: 16.4, 61.4) seizure onset ICEEG patterns involved the additional electrodes indicated by MSI. Sixty-two patients underwent surgical resection based on ICEEG recording of seizures. Highly localized MSI was significantly associated with seizure-free outcome (mean=3.4 years, minimum > 1 year) for the entire surgical population (n=62). MSI spike localization increases the chance that the seizure onset zone is sampled when patients undergo ICEEG for presurgical epilepsy evaluations. The clinical impact of this effect–-improving diagnostic yield of ICEEG–-should be considered in surgery candidates that do not have satisfactory indication of epilepsy localization from seizure semiology, EEG, and MRI.
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影响因子：
4.8
作者：
Bauman, JA;Feoli, E;Weiner, HL
通讯作者：
Weiner, HL
影响因子：
11.2
作者：
Knowlton, Robert C.;Elgavish, Rotem A.;Kuzniecky, Ruben
通讯作者：
Kuzniecky, Ruben
影响因子：
9.9
作者：
Sutherling, W. W.;Mamelak, A. N.;Lopez, N.
通讯作者：
Lopez, N.
影响因子：
11.2
作者：
Knowlton, RC;Laxer, KD;Rowley, HA
通讯作者：
Rowley, HA
影响因子：
4.1
作者：
Mamelak, AN;Lopez, N;Sutherling, WW
通讯作者：
Sutherling, WW