Maria Centeno1,2, Tim M Tierney1, Suejen Perani1,3, Elhum A Shamshiri1, Kelly St Pier2, Charlotte Wilkinson2, Daniel Konn4, Serge Vulliemoz5, Frédéric Grouiller6, Louis Lemieux7, Ronit M Pressler8,9, Christopher A Clark1, J Helen Cross8,9, David W Carmichael1. 1. Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom. 2. Epilepsy Unit, Department of Neurophysiology, Great Ormond Street Hospital, London, United Kingdom. 3. Division of Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom. 4. Neurophysiology Department, University Hospital Southampton, Southampton, United Kingdom. 5. EEG and Epilepsy Unit, Department of Neurology, University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland. 6. Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland. 7. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, United Kingdom. 8. Neuroscience Medicine, Great Ormond Street Hospital for Children, London, United Kingdom. 9. Clinical Neuroscience, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Abstract
OBJECTIVE: Surgical treatment in epilepsy is effective if the epileptogenic zone (EZ) can be correctly localized and characterized. Here we use simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) data to derive EEG-fMRI and electrical source imaging (ESI) maps. Their yield and their individual and combined ability to (1) localize the EZ and (2) predict seizure outcome were then evaluated. METHODS: Fifty-three children with drug-resistant epilepsy underwent EEG-fMRI. Interictal discharges were mapped using both EEG-fMRI hemodynamic responses and ESI. A single localization was derived from each individual test (EEG-fMRI global maxima [GM]/ESI maximum) and from the combination of both maps (EEG-fMRI/ESI spatial intersection). To determine the localization accuracy and its predictive performance, the individual and combined test localizations were compared to the presumed EZ and to the postsurgical outcome. RESULTS: Fifty-two of 53 patients had significant maps: 47 of 53 for EEG-fMRI, 44 of 53 for ESI, and 34 of 53 for both. The EZ was well characterized in 29 patients; 26 had an EEG-fMRI GM localization that was correct in 11, 22 patients had ESI localization that was correct in 17, and 12 patients had combined EEG-fMRI and ESI that was correct in 11. Seizure outcome following resection was correctly predicted by EEG-fMRI GM in 8 of 20 patients, and by the ESI maximum in 13 of 16. The combined EEG-fMRI/ESI region entirely predicted outcome in 9 of 9 patients, including 3 with no lesion visible on MRI. INTERPRETATION: EEG-fMRI combined with ESI provides a simple unbiased localization that may predict surgery better than each individual test, including in MRI-negative patients. Ann Neurol 2017;82:278-287.
OBJECTIVE: Surgical treatment in epilepsy is effective if the epileptogenic zone (EZ) can be correctly localized and characterized. Here we use simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) data to derive EEG-fMRI and electrical source imaging (ESI) maps. Their yield and their individual and combined ability to (1) localize the EZ and (2) predict seizure outcome were then evaluated. METHODS: Fifty-three children with drug-resistant epilepsy underwent EEG-fMRI. Interictal discharges were mapped using both EEG-fMRI hemodynamic responses and ESI. A single localization was derived from each individual test (EEG-fMRI global maxima [GM]/ESI maximum) and from the combination of both maps (EEG-fMRI/ESI spatial intersection). To determine the localization accuracy and its predictive performance, the individual and combined test localizations were compared to the presumed EZ and to the postsurgical outcome. RESULTS: Fifty-two of 53 patients had significant maps: 47 of 53 for EEG-fMRI, 44 of 53 for ESI, and 34 of 53 for both. The EZ was well characterized in 29 patients; 26 had an EEG-fMRI GM localization that was correct in 11, 22 patients had ESI localization that was correct in 17, and 12 patients had combined EEG-fMRI and ESI that was correct in 11. Seizure outcome following resection was correctly predicted by EEG-fMRI GM in 8 of 20 patients, and by the ESI maximum in 13 of 16. The combined EEG-fMRI/ESI region entirely predicted outcome in 9 of 9 patients, including 3 with no lesion visible on MRI. INTERPRETATION: EEG-fMRI combined with ESI provides a simple unbiased localization that may predict surgery better than each individual test, including in MRI-negative patients. Ann Neurol 2017;82:278-287.
Authors: Andreas Koupparis; Nicolás von Ellenrieder; Hui Ming Khoo; Natalja Zazubovits; Dang Khoa Nguyen; Jeffery A Hall; Roy W R Dudley; Francois Dubeau; Jean Gotman Journal: Neurology Date: 2021-08-16 Impact factor: 11.800
Authors: Niraj K Sharma; Carlos Pedreira; Umair J Chaudhary; Maria Centeno; David W Carmichael; Tinonkorn Yadee; Teresa Murta; Beate Diehl; Louis Lemieux Journal: Neuroimage Date: 2018-10-10 Impact factor: 6.556
Authors: Marc J Casale; Lara V Marcuse; James J Young; Nathalie Jette; Fedor E Panov; H Allison Bender; Adam E Saad; Ravi S Ghotra; Saadi Ghatan; Anuradha Singh; Ji Yeoun Yoo; Madeline C Fields Journal: J Clin Neurophysiol Date: 2022-01-01 Impact factor: 2.590