Prospective observational study: Fast ripple localization delineates the epileptogenic zone
| Autor: | Jimmy C. Nguyen, Shaun A. Hussain, Joyce H. Matsumoto, Danilo Bernardo, Kristina K. Murata, Raman Sankar, Noriko Salamon, Lekha M. Rao, Aria Fallah, Hiroki Nariai, Jason T. Lerner, Rajsekar R. Rajaraman, Joyce Y. Wu, David Elashoff |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty animal structures Adolescent 050105 experimental psychology Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Neuroimaging Seizures Physiology (medical) Humans Medicine 0501 psychology and cognitive sciences Ictal Epilepsy surgery Prospective Studies Child Electrocorticography Slow-wave sleep Brain Mapping medicine.diagnostic_test business.industry 05 social sciences Brain medicine.disease Epileptogenic zone Sensory Systems Neurology Child Preschool Female Observational study Epilepsies Partial Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Clinical Neurophysiology. 130:2144-2152 |
| ISSN: | 1388-2457 |
| DOI: | 10.1016/j.clinph.2019.08.026 |
| Popis: | To investigate spatial correlation between interictal HFOs and neuroimaging abnormalities, and to determine if complete removal of prospectively identified interictal HFOs correlates with post-surgical seizure-freedom.Interictal fast ripples (FRs: 250-500 Hz) in 19 consecutive children with pharmacoresistant focal epilepsy who underwent extra-operative electrocorticography (ECoG) recording were prospectively analyzed. The interictal FRs were sampled at 2000 Hz and were visually identified during 10 min of slow wave sleep. Interictal FRs, MRI and FDG-PET were delineated on patient-specific reconstructed three-dimensional brain MRI.Interictal FRs were observed in all patients except one. Thirteen out of 18 patients (72%) exhibited FRs beyond the extent of neuroimaging abnormalities. Fifteen of 19 children underwent resective surgery, and survival analysis with log-rank test demonstrated that complete resection of cortical sites showing interictal FRs correlated with longer post-operative seizure-freedom (p 0.01). Complete resection of seizure onset zones (SOZ) also correlated with longer post-operative seizure-freedom (p = 0.01), yet complete resection of neuroimaging abnormalities did not (p = 0.43).Prospective visual analysis of interictal FRs was feasible, and it seemed to accurately localize epileptogenic zones.Topological extent of epileptogenic region may exceed what is discernible by multimodal neuroimaging. |
| Databáze: | OpenAIRE |
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