Visualization of the Spatiotemporal Propagation of Interictal Spikes in Temporal Lobe Epilepsy: A MEG Pilot Study.
Visualization of the Spatiotemporal Propagation of Interictal Spikes in Temporal Lobe Epilepsy: A MEG Pilot Study.
复制标题
颞叶癫痫发作间期尖峰时空传播的可视化：MEG 试点研究。
DOI：
10.1007/s10548-023-01017-z
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发表时间：
2024
期刊：
影响因子：
2.7
通讯作者：
Peled,Noam
中科院分区：
文献类型：
--
作者：
Zhou,DanielJ;Gumenyuk,Valentina;Taraschenko,Olga;Grobelny,BartoszT;Stufflebeam,StevenM;Peled,Noam
脑磁图（MEG）在临床上用于通过等效电流偶极子（ECD）方法定位癫痫患者离散脑区的发作间期棘波，但不能解释棘波活动的时间动态。最近的研究发现，发作间期棘波传播超出颞叶可能与更差的术后结局相关，但使用全脑数据（如MEG）的研究仍然有限。在这项试点研究中，我们开发了一种工具，可视化的时空动态发作间期MEG尖峰归一化为无尖峰睡眠活动，以评估其发病和传播模式的颞叶癫痫（TLE）患者。我们提取了发作间期源数据包含局灶性癫痫样活动在清醒和睡眠状态下，从7例患者的MEG ECD集群定位到颞叶和规范化的数据对无尖峰睡眠记录。我们计算了每个皮层标签随时间的归一化活动，确认了发作时的最大活动，并使用定制的多模态可视化工具将10 ms间隔内的活动映射到每个患者的大脑上。所有患者的活动发作出现在临床确定的致痫区附近。到10 ms时，4名患者的源活动仅限于颞叶内，3名患者的源活动扩散到颞外区域。使用这个工具，我们表明，可以实现非侵入性识别发作间期脑磁图棘波活动的发作和传播，这可能有助于进一步了解癫痫网络，并指导TLE患者的手术计划和干预。
Magnetoencephalography (MEG) is clinically used to localize interictal spikes in discrete brain areas of epilepsy patients through the equivalent current dipole (ECD) method, but does not account for the temporal dynamics of spike activity. Recent studies found that interictal spike propagation beyond the temporal lobe may be associated with worse postsurgical outcomes, but studies using whole-brain data such as in MEG remain limited. In this pilot study, we developed a tool that visualizes the spatiotemporal dynamics of interictal MEG spikes normalized to spike-free sleep activity to assess their onset and propagation patterns in patients with temporal lobe epilepsy (TLE). We extracted interictal source data containing focal epileptiform activity in awake and asleep states from seven patients whose MEG ECD clusters localized to the temporal lobe and normalized the data against spike-free sleep recordings. We calculated the normalized activity over time per cortical label, confirmed maximal activity at onset, and mapped the activity over a 10 ms interval onto each patient’s brain using a custom-built Multi-Modal Visualization Tool. The onset of activity in all patients appeared near the clinically determined epileptogenic zone. By 10 ms, four of the patients had propagated source activity restricted to within the temporal lobe, and three had propagated source activity spread to extratemporal regions. Using this tool, we show that noninvasively identifying the onset and propagation of interictal spike activity in MEG can be achieved, which may help provide further insight into epileptic networks and guide surgical planning and interventions in patients with TLE.