Noninvasive cortical imaging of epileptiform activities from interictal spikes in pediatric patients
Open accessAbstract
Improved non-invasive localization of the epileptogenic foci prior to epilepsy surgery would improve surgical outcome in patients with partial seizure disorders. A critical component for the identification of the epileptogenic brain is the analysis of electrophysiological data obtained during ictal activity from prolonged intracranial recordings. The development of a noninvasive means to identify the seizure onset zone (SOZ) would thus play an important role in treating patients with intractable epilepsy. In the present study, we have investigated non-invasive imaging of epileptiform activity in patients with medically intractable epilepsy by means of a cortical potential imaging (CPI) technique. Eight pediatric patients (1M/7F, ages 4-14 years) with intractable partial epilepsy were studied. Each patient had multiple (6 to 14) interictal spikes (IIS) subjected to the CPI analysis. Realistic geometry boundary element head models were built using each individual's MRI in order to maximize the imaging precision. CPI analysis was performed on the IISs, and extrema in the estimated CPI images were compared with SOZs as determined from the ictal electrocorticogram (ECoG) recordings, as well as the resected areas in the patients and surgical outcomes. The distances between the maximum cortical activities of the IISs reflected by the estimated cortical potential distributions and the SOZs were determined to quantitatively evaluate the performance of the CPI in localizing the epileptogenic zone. Ictal ECoG recordings revealed that six patients exhibited a single epileptogenic focus while two patients had multiple foci. In each patient, the CPI results revealed an area of activity overlapping with the SOZs as identified by ictal ECoG. The distance from the extreme of the CPI images at the peak of IIS to the nearest intracranial electrode associated with the onset of the ictal activity was evaluated for each patient and the averaged distance was 4.6mm. In the group of patients studied, the CPI imaged epileptogenic foci were within the resected areas. According to the follow-up of the eight patients included, two were seizure free and six had substantial reduction in seizure frequency. These promising results demonstrate the potential for noninvasive localization of the epileptogenic focus from interictal scalp EEG recordings. Confirmation of our results may have a significant impact on the process of presurgical planning in pediatric patients with intractable epilepsy by dramatically reducing or potentially eliminating the use of intracranial recording.
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Electrophysiological source imaging has been widely used in epilepsy source localization, including inter-ictal discharges.
“ESI has been widely used in epilepsy source localization, including inter-ictal discharges (76–81).”
From Electrophysiological source imaging: A noninvasive window to brain dynamics (2018) · cites this paper as [77]
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- Authors
- Lai, Y., Zhang, X., van Drongelen, W., Korhman, M., Hecox, K., Ni, Y., & He, B.
- Affiliations
- University of Minnesota (US)
- University of Chicago (US)
- University of Illinois Chicago (US)
- Corresponding author
- He, Bin
- ORCID
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 54
- Issue
- 1
- Pages
- 244-252
- ISSN
- 1053-8119 (ISSN-L)
- PMC
- PMC3033450
- OpenAlex
- W1991554320
- Cited by
- 22
- References
- 51
- Citations by year
- 2020: 3 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 4 · 2013: 1 · 2012: 4
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (RO1 EB007920, RO1 EB006433, RO1 EB00178)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural dynamics and brain function
- Keywords
- interictal spikes, epileptogenic zone localization, seizure onset zone, pediatric epilepsy, drug-resistant epilepsy, presurgical planning, electrocorticography, boundary element method, scalp EEG, epilepsy surgery, focal epilepsy
- MeSH terms
- Adolescent, Cerebral Cortex, Child, Child, Preschool, Electroencephalography, Epilepsies, Partial, Female, Frontal Lobe, Humans, Male, Models, Neurological, Parietal Lobe, Scalp, Skull, Temporal Lobe, Anterior Temporal Lobectomy
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