Electric Source Imaging on Intracranial EEG Localizes Spatiotemporal Propagation of Interictal Spikes in Children with Epilepsy.
Electric Source Imaging on Intracranial EEG Localizes Spatiotemporal Propagation of Interictal Spikes in Children with Epilepsy.
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DOI：
10.1109/embc46164.2021.9630246
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发表时间：
2021-11
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通讯作者：
Papadelis C
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作者：
Matarrese MAG;Loppini A;Jahromi S;Tamilia E;Fabbri L;Madsen JR;Pearl PL;Filippi S;Papadelis C
发作间期癫痫样放电（IED）是敏感但非特异性的癫痫生物标志物，可以在接受手术的耐药性癫痫（DRE）患者中描绘致癫痫区（EZ）。颅内脑电图 (icEEG) 研究表明，简易爆炸装置会及时在大脑的大片区域传播。这种传播的开始被认为是比传播区域更具体的癫痫生物标志物。然而，icEEG 有限的空间分辨率无法高精度地识别这种活动的开始。在这里，我们提出了一种新方法，通过在 icEEG 上使用电源成像（ESI）来绘制 IED 的时空传播（并识别其发作），从而绕过 icEEG 的空间限制。我们在 8 名患有 DRE 的儿童的 icEEG 记录上验证了我们的方法，这些儿童接受了手术并取得了良好的结果（恩格尔评分 = 1）。在每个 icEEG 通道上，我们检测了简易爆炸装置并使用自动算法识别了传播起始点。我们使用时间滑动窗口方法通过动态统计参数映射 (dSPM) 来定位 IED 的传播。我们定义了两个大脑区域：ESI 起始区和 ESI 扩散区。我们估计了这些区域与切除体积的重叠（以百分比表示），这是 EZ 的黄金标准。我们还估计了这些区域距切除和临床定义的癫痫发作区（SOZ）的平均距离。我们观察了所有患者中简易爆炸装置在多个通道 (98 [85-102]) 中的时空传播，平均持续时间为 155 毫秒 [96-186 毫秒]。与扩散相比，ESI 起始区域与切除的重叠更高（73.3 % [ 47.4-100 %]、36.5 % [20.3-59.9 %]，p = 0.008）。与 ESI 扩散区相比，ESI 起始点距切除的距离较短（4.3 mm [3.4-5.5 mm]、7.4 mm [6.0-20.6 mm]，p = 0.008），并且距 SOZ 的距离也观察到相同的趋势（11.9 mm [7.2-15.1 mm]、20.6 mm [15.4-27.2 mm]，p = 0.02）。这些发现表明，我们的方法可以绘制简易爆炸装置的时空传播图并描绘其发作，这是 DRE 儿童 EZ 的可靠且焦点的生物标志物。对 DRE 儿童的 icEEG 记录进行 ESI 可以定位尖峰传播现象并帮助描绘 EZ。
Interictal epileptiform discharges (IEDs) serve as sensitive but not specific biomarkers of epilepsy that can delineate the epileptogenic zone (EZ) in patients with drug resistant epilepsy (DRE) undergoing surgery. Intracranial EEG (icEEG) studies have shown that IEDs propagate in time across large areas of the brain. The onset of this propagation is regarded as a more specific biomarker of epilepsy than areas of spread. Yet, the limited spatial resolution of icEEG does not allow to identify the onset of this activity with high precision. Here, we propose a new method of mapping the spatiotemporal propagation of IEDs (and identify its onset) by using Electrical Source Imaging (ESI) on icEEG bypassing the spatial limitations of icEEG. We validated our method on icEEG recordings from 8 children with DRE who underwent surgery with good outcome (Engel score = 1). On each icEEG channel, we detected IEDs and identified the propagation onset using an automated algorithm. We localized the propagation of IEDs with dynamic Statistical Parametric Mapping (dSPM) using a time-sliding window approach. We defined two brain regions: the ESI-onset and ESI-spread zone. We estimated the overlap of these regions with resection volume (in percentage), which served as the gold-standard of the EZ. We also estimated the mean distance of these regions from resection and clinically defined seizure onset zone (SOZ). We observed spatiotemporal propagation of IEDs in all patients across several channels (98 [85-102]) with a mean duration of 155 ms [96-186 ms]. A higher overlap with resection was seen for the ESI-onset zone compared to spread (73.3 % [ 47.4-100 %], 36.5 % [20.3-59.9 %], p = 0.008). The distance of the ESI-onset from resection was shorter compared to the ESI-spread zone (4.3 mm [3.4-5.5 mm], 7.4 mm [6.0-20.6 mm], p = 0.008) and the same trend was observed for the distance from the SOZ (11.9 mm [7.2-15.1 mm], 20.6 mm [15.4-27.2 mm], p = 0.02). These findings show that our method can map the spatiotemporal propagation of IEDs and delineate its onset, which is a reliable and focal biomarker of the EZ in children with DRE. ESI on icEEG recordings of children with DRE can localize the spikes propagation phenomenon and help in the delineation of the EZ.