Network analysis for epilepsy surgery

项目总结 对药物难治性局灶性癫痫患者的癫痫发作区域的准确定位对 使用组织切除、激光消融和脑等干预措施成功地进行神经外科治疗 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、昂贵、定性，并不一定会导致癫痫控制。为了克服这一障碍，我们 提出了一种新的、功能强大的方法，称为大脑发作间网络映射-BINMAP-by 大脑发作间期(背景)活动的哪一小段将被用来首先建立频率 特定波段的功能连接图，然后这张图将被用来准确地描绘癫痫 局灶性癫痫的发病区域。这里的目标是验证BINMAP方法在不同疾病患者中的有效性 局灶性癫痫的类型和局灶性新皮质癫痫的啮齿动物模型。中心假设是 BINMAP将比目前的方法更有效和准确地描绘癫痫发作起始区和 减少成本和患者的不适，改善癫痫手术的结果。的第一个目标是 项目是优化和验证120名患有新皮质和内侧颞叶的患者的BINMAP 癫痫。该方法将对发作期的颅内脑电(IcEEG)和 头皮脑电，在住院患者连续监测期间在多个时间点采样，最长可达2周 程序。第二个目标是使用两个已建立的局灶性新皮质癫痫的啮齿动物模型，以 了解皮损后癫痫的生物标记物和 BINMAP检测到功能连接。为此，将在 BINMAP监测大鼠新皮质致痫过程。这项研究在以下方面具有创新性 有两个原因。首先，它使用了发作间歇期的一小段icEEG，而不是在几个月内获得的癫痫记录 持续长期监测天数，圈定癫痫患者发作区。第二, 它旨在了解局灶性新皮质功能连通性发展的机制 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该网络 伴随癫痫发生的变化和临床医生定位癫痫发作区域的方式的改变 用发作间期icEEG分析取代昂贵且耗时的icEEG记录。如果成功，这将是 项目将产生很高的翻译影响，因为它将显著降低成本并增加 准确定位癫痫起病区域，从而降低医疗费用，提高治疗成功率 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.