Ictal EEG Source Imaging With Supplemental Electrodes.

Autor:	Loube DK; Department of Neurology, Stanford University, Palo Alto, California, U.S.A., Tan YL; Department of Neurology, National Neuroscience Institute, SingHealth, Republic of Singapore., Yoshii-Contreras J; Division of Epilepsy, Department of Neurology, University of California San Diego, California, U.S.A; and., Kleen J; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, U.S.A., Rao VR; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, U.S.A., Chang EF; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, U.S.A., Knowlton RC; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, U.S.A.
Jazyk:	angličtina
Zdroj:	Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2024 Sep 01; Vol. 41 (6), pp. 507-514. Date of Electronic Publication: 2023 Oct 05.
DOI:	10.1097/WNP.0000000000001025
Abstrakt:	Introduction: Noninvasive brain imaging tests play a major role in guiding decision-making and the usage of invasive, costly intracranial electroencephalogram (ICEEG) in the presurgical epilepsy evaluation. This study prospectively examined the concordance in localization between ictal EEG source imaging (ESI) and ICEEG as a reference standard. Methods: Between August 2014 and April 2019, patients during video monitoring with scalp EEG were screened for those with intractable focal epilepsy believed to be amenable to surgical treatment. Additional 10-10 electrodes (total = 31-38 per patient, "31+") were placed over suspected regions of seizure onset in 104 patients. Of 42 patients requiring ICEEG, 30 (mean age 30, range 19-59) had sufficiently localized subsequent intracranial studies to allow comparison of localization between tests. ESI was performed using realistic forward boundary element models used in dipole and distributed source analyses. Results: At least partial sublobar concordance between ESI and ICEEG solutions was obtained in 97% of cases, with 73% achieving complete agreement. Median Euclidean distances between ESI and ICEEG solutions ranged from 25 to 30 mm (dipole) and 23 to 38 mm (distributed source). The latter was significantly more accurate with 31+ compared with 21 electrodes ( P < 0.01). A difference of ≤25 mm was present in two thirds of the cases. No significant difference was found between dipole and distributed source analyses. Conclusions: A practical method of ictal ESI (nonuniform placement of 31-38 electrodes) yields high accuracy for seizure localization in epilepsy surgery candidates. These results support routine clinical application of ESI in the presurgical evaluation. Competing Interests: None of the authors have any conflict of interest to disclose. (Copyright © 2023 by the American Clinical Neurophysiology Society.)
Databáze:	MEDLINE
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