Network analysis for epilepsy surgery

项目摘要 准确定位难治性局灶性癫痫患者的癫痫发作区域对于 使用组织切除、激光消融和脑切除等干预措施进行成功的神经外科治疗 刺激.然而，目前的本地化方法有严重的缺点，因为它们是时间- 消耗量大、费用高、质量差，而且不一定导致缉获控制。为了克服这一障碍，我们 我建议验证一种新的和强大的方法，称为脑发作间期网络映射-BINMAP-通过 大脑发作间期（背景）活动的一小段将被用来首先建立频率 特定频带的功能连接图，然后该图将用于准确地描绘癫痫发作 局灶性癫痫的发病区域。这里的目的是在不同的患者中验证BINMAP方法。 局灶性癫痫的类型和局灶性新皮质癫痫的啮齿动物模型。核心假设是， BINMAP将比当前的方法更有效、更准确地描绘癫痫发作区域， 降低癫痫手术的费用和患者的不适，改善癫痫手术的结果。第一个目标 本研究旨在优化和验证BINMAP在120例新皮层和内侧颞叶患者中的应用 癫痫该方法将在发作间期颅内脑电图（icEEG）上进行， 头皮EEG，在长达2周的连续住院监测期间的多个时间点采样 程序.第二个目标是使用两种已建立的局灶性新皮质癫痫啮齿动物模型， 了解损伤后癫痫的生物标志物和 BINMAP检测到功能连接。为此，将在大脑中创建离散的致癫痫病变 大鼠的新皮层，随后通过BINMAP监测癫痫发生过程。该研究具有创新性， 两个原因第首先，它使用了短暂的发作间期icEEG片段，与在几个小时内获得的癫痫发作记录相比， 天的连续长期监测，以描绘癫痫患者的发作区域。第二、 目的是了解局灶性新皮层功能连接发展的机制， 在癫痫发生过程中的癫痫。这项研究的预期结果将有助于阐明网络 伴随癫痫发生的变化，改变了临床医生定位癫痫发作区域的方式， 用发作间期的icEEG分析取代昂贵且耗时的icEEG记录。如果成功，这 该项目将具有很高的转化影响，因为它将大大降低成本，并增加 癫痫发作区域定位的准确性，从而降低医疗费用并增加治疗的成功率。 癫痫手术

PROJECT SUMMARY Accurate localization of the seizure onset area in patients with medically refractory focal epilepsies is crucial for successful neurosurgical treatment using interventions such as tissue resection, laser ablation and brain stimulation. However, current localization approaches have serious shortcomings because they are time- consuming, expensive, qualitative and do not necessarily lead to seizure control. To overcome this hurdle, we propose to validate a novel and powerful approach, termed brain interictal network mapping – BINMAP – by which a brief segment of the brain’s interictal (background) activity will be used to first establish a frequency band-specific functional connectivity map and then this map will be used to accurately delineate the seizure onset area in focal epilepsies. The objective here is to validate the BINMAP approach in patients with different types of focal epilepsies and rodent models of focal neocortical epilepsy. The central hypothesis is that BINMAP will delineate the seizure onset area more effectively and accurately than current approaches and reduce the cost and patient discomfort and improve the outcome of epilepsy surgery. The first aim of the project is to optimize and validate BINMAP in 120 patients with neocortical and mesial temporal lobe epilepsies. The method will be conducted on the interictal intracranial electroencephalogram (icEEG) and scalp EEG, sampled at multiple time points during continuous, up to 2-week long, inpatient monitoring procedures. The second aim will be to use two established rodent models of focal neocortical epilepsy, to understand the mechanisms underlying the development of both a biomarker for post-lesion epilepsy and the functional connectivity detected by BINMAP. To this end, discrete epileptogenic lesions will be created in the neocortex of rats, followed by BINMAP monitoring of the epileptogenic process. The research is innovative for two reasons. First, it uses a brief segment of interictal icEEG, versus seizure recordings obtained over several days of continuous long-term monitoring, to delineate the seizure onset area in patients with epilepsy. Second, it aims to understand the mechanism underlying the development of functional connectivity in focal neocortical epilepsies during epileptogenesis. The expected outcome of this study will both help elucidate the network changes which accompany epileptogenesis and transform the way clinicians locate the seizure onset area by replacing expensive and time-consuming icEEG recordings with analysis of interictal icEEG. If successful, this project will have a high translational impact because it will dramatically reduce the cost and increase the accuracy of seizure onset area localization, thereby lowering health expenses and increasing the success of epilepsy surgery.