Effective connectivity analysis of iEEG and accurate localization of the epileptogenic focus at the onset of operculo-insular seizures
Effective connectivity analysis of iEEG and accurate localization of the epileptogenic focus at the onset of operculo-insular seizures
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DOI：
10.1016/j.eplepsyres.2019.02.006
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发表时间：
2019-05-01
影响因子：
2.2
通讯作者：
Sawan, Mohamad
中科院分区：
文献类型：
--
作者：
Assi, Elie Bou;Rihana, Sandy;Sawan, Mohamad
岛叶癫痫的识别有时可能具有挑战性，因为岛叶癫痫发作可以通过与周围皮质的广泛连接迅速蔓延到整个大脑皮层。频谱加权自适应定向传递函数是一种基于多变量因果关系的有效连通性度量，它被应用于脑电记录以识别癫痫发作活动的产生。使用基于替代数据检验的非参数检验来验证因果关系的统计学意义。从计算的转移矩阵中提取癫痫活动的流出和流入。分析了7名患者的21次癫痫发作的记录数据，其中5名患者在岛叶周围切除术后癫痫发作消失。7例S电发作后的有效连通性分析证实，5例患者发作性癫痫起源于岛外，术后癫痫预后良好，并通过脑电触点采集切除区域。在2例术后癫痫预后不佳的患者中，发现了不同或更多的癫痫灶。研究结果强调了基于定量方法准确定位岛叶周围癫痫灶的可行性。
Recognition of insular epilepsy may sometimes be challenging due to the rapid speed at which insular seizures can spread throughout the cortex via extensive connections to surrounding cortices. The spectrum weighted adaptive directed transfer function, a multivariate causality-based effective connectivity measure, was applied to intracranial electroencephalography recordings to identify generators of seizure activity. A non-parametric test based on surrogate data testing was used to validate statistical significance of causal relations. Outflow and inflow of seizure activity were extracted from the computed transfer matrix. Recorded data of 21 seizures from seven patients were analyzed including five who were rendered seizure-free after operculo-insular resection. Effective connectivity analysis of 7 s following electrical onset confirmed an operculo-insular seizure origin in 5 patients with a good post-operative seizure outcome, and for whom the resected region was sampled by intracranial electroencephalography contacts. Different or additional seizure foci were identified in 2 patients with a bad post-operative seizure outcome. Findings highlight the feasibility of accurate operculo-insular seizure foci localization based on quantitative approaches.