Mapping Interictal activity in epilepsy using a hidden Markov model: A magnetoencephalography study.

Autor: Seedat ZA; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.; Young Epilepsy, St Pier's Lane, Lingfield, RH7 6PW, UK., Rier L; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK., Gascoyne LE; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK., Cook H; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK., Woolrich MW; Oxford Centre for Human Brain Activity, University Department of Psychiatry, Warneford Hospital, Oxford, UK., Quinn AJ; Oxford Centre for Human Brain Activity, University Department of Psychiatry, Warneford Hospital, Oxford, UK., Roberts TPL; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Furlong PL; Aston Brain Centre, Aston University, Birmingham, UK., Armstrong C; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Pediatric Epilepsy Program, Division of Child Neurology, CHOP, Philadelphia, Pennsylvania, USA., St Pier K; Young Epilepsy, St Pier's Lane, Lingfield, RH7 6PW, UK., Mullinger KJ; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.; Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK., Marsh ED; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Pediatric Epilepsy Program, Division of Child Neurology, CHOP, Philadelphia, Pennsylvania, USA.; Departments of Neurology and Paediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Brookes MJ; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK., Gaetz W; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Human brain mapping [Hum Brain Mapp] 2023 Jan; Vol. 44 (1), pp. 66-81. Date of Electronic Publication: 2022 Oct 19.
DOI: 10.1002/hbm.26118
Abstrakt: Epilepsy is a highly heterogeneous neurological disorder with variable etiology, manifestation, and response to treatment. It is imperative that new models of epileptiform brain activity account for this variability, to identify individual needs and allow clinicians to curate personalized care. Here, we use a hidden Markov model (HMM) to create a unique statistical model of interictal brain activity for 10 pediatric patients. We use magnetoencephalography (MEG) data acquired as part of standard clinical care for patients at the Children's Hospital of Philadelphia. These data are routinely analyzed using excess kurtosis mapping (EKM); however, as cases become more complex (extreme multifocal and/or polymorphic activity), they become harder to interpret with EKM. We assessed the performance of the HMM against EKM for three patient groups, with increasingly complicated presentation. The difference in localization of epileptogenic foci for the two methods was 7 ± 2 mm (mean ± SD over all 10 patients); and 94% ± 13% of EKM temporal markers were matched by an HMM state visit. The HMM localizes epileptogenic areas (in agreement with EKM) and provides additional information about the relationship between those areas. A key advantage over current methods is that the HMM is a data-driven model, so the output is tuned to each individual. Finally, the model output is intuitive, allowing a user (clinician) to review the result and manually select the HMM epileptiform state, offering multiple advantages over previous methods and allowing for broader implementation of MEG epileptiform analysis in surgical decision-making for patients with intractable epilepsy.
(© 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: