Normative brain mapping of interictal intracranial EEG to localize epileptogenic tissue.
Normative brain mapping of interictal intracranial EEG to localize epileptogenic tissue.
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颅内内部脑外的规范性脑作图，以定位癫痫组织。
DOI：
10.1093/brain/awab380
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发表时间：
2022-04-29
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在包括癫痫在内的多种神经系统疾病中，识别异常的电信号活动对于定位致痫组织是很重要的。然而，在非癫痫发作(发作间歇期)期间，这种识别可能是具有挑战性的，特别是如果与可能的健康大脑动力学曲目相比，异常是微妙的。在这里，我们调查这种发作间期异常是否通过以特定位置的方式定量解释健康大脑动力学的范围而变得更加显著。为此，我们从234名参与者(21个 598电极接触者)发作间歇期的颅内记录中，根据相对频带功率构建了一个标准的脑动力学图。然后，我们将62名癫痫患者的发作间期记录与标准地图进行比较，以确定异常区域。我们提出，如果最异常的区域通过手术得以幸免，那么患者在手术后更有可能经历持续的癫痫发作。我们首先证实了标准图谱中跨大脑区域的频带功率的空间变化与文献中报道的健康变化是一致的。其次，在考虑正常变异的情况下，术后持续惊厥患者手术未被切除的区域比仅切除的区域异常更多(t=−3.6，P=0.0003)，证实了我们的假设。第三，我们发现这一效应区分了患者的预后(曲线下面积0.75P=0.0003)。标准化图谱在神经科学研究中是一种成熟的做法。我们的研究表明，该方法检测发作间期脑电异常是可行的，对癫痫病理组织的识别具有潜在的临床价值。最后，我们将我们的标准颅内地图公之于众，以方便未来对癫痫和其他疾病的研究。Taylor等人。根据200例癫痫患者发作间歇期和发作期外的颅内记录，构建一张标准的脑动力学图。然后，他们利用这一图谱在单独的患者队列中成功地识别致痫组织并预测手术结果。
The identification of abnormal electrographic activity is important in a wide range of neurological disorders, including epilepsy for localizing epileptogenic tissue. However, this identification may be challenging during non-seizure (interictal) periods, especially if abnormalities are subtle compared to the repertoire of possible healthy brain dynamics. Here, we investigate if such interictal abnormalities become more salient by quantitatively accounting for the range of healthy brain dynamics in a location-specific manner. To this end, we constructed a normative map of brain dynamics, in terms of relative band power, from interictal intracranial recordings from 234 participants (21 598 electrode contacts). We then compared interictal recordings from 62 patients with epilepsy to the normative map to identify abnormal regions. We proposed that if the most abnormal regions were spared by surgery, then patients would be more likely to experience continued seizures postoperatively. We first confirmed that the spatial variations of band power in the normative map across brain regions were consistent with healthy variations reported in the literature. Second, when accounting for the normative variations, regions that were spared by surgery were more abnormal than those resected only in patients with persistent postoperative seizures (t = −3.6, P = 0.0003), confirming our hypothesis. Third, we found that this effect discriminated patient outcomes (area under curve 0.75 P = 0.0003). Normative mapping is a well-established practice in neuroscientific research. Our study suggests that this approach is feasible to detect interictal abnormalities in intracranial EEG, and of potential clinical value to identify pathological tissue in epilepsy. Finally, we make our normative intracranial map publicly available to facilitate future investigations in epilepsy and beyond. Taylor et al. construct a normative map of brain dynamics from interictal intracranial recordings outside the seizure onset and initial propagation zones in >200 patients with epilepsy. They then leverage this map in a separate patient cohort to successfully identify epileptogenic tissue and predict surgical outcomes.
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14.5
作者：
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通讯作者：
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