C Cuello-Oderiz1, N von Ellenrieder2, R Sankhe3, A Olivier4, J Hall5, F Dubeau6, J Gotman7. 1. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: carolinacuellooderiz@gmail.com. 2. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: nicolas.vonellenrieder@mcgill.ca. 3. McGill University, 845 Sherbrooke St W, Montréal, QC H3A 0G4, Canada. Electronic address: rmsankhe@gmail.com. 4. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: andre.olivier@mcgill.ca. 5. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: jeff.hall@mcgill.ca. 6. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: francois.dubeau@mcgill.ca. 7. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada. Electronic address: jean.gotman@mcgill.ca.
Abstract
OBJECTIVES: There are different neurophysiological markers of the Epileptogenic Zone (EZ), but their sensitivity and specificity for the EZ is not known in Focal Cortical Dysplasia (FCD) patients. METHODS: We studied patients with FCD who underwent stereoelectroencephalography (SEEG) and surgery. We marked in the SEEG: (a) typical and atypical interictal epileptiform patterns, (b) ictal onset patterns, and (c) rates of ripples (80-250 Hz) and fast ripples (FRs) (>250 Hz). High frequency oscillations were marked automatically during one hour of deep sleep. Surgical outcome was defined as good (Engel I) or poor (Engel II-IV). We computed the sensitivity and, as a measure of specificity, the false positive rate to identify the EZ, and compared them across the different neurophysiological markers. RESULTS: We studied 21 patients, 19 with FCD II. Ictal and typical interictal pattern were the markers with highest sensitivity, while the atypical interictal pattern had the lowest. We found no significant difference in specificity among markers. However, there is a tendency that FRs had the lowest false positive rate. CONCLUSION: The typical interictal pattern has the highest sensitivity. The clinical use of FRs is limited by their low sensitivity. SIGNIFICANCE: We suggest to analyze the typical interictal pattern first. FRs should be analyzed in a second step. If, for instance, a focus with FRs and no typical interictal pattern is found, this area could be considered for resection.
OBJECTIVES: There are different neurophysiological markers of the Epileptogenic Zone (EZ), but their sensitivity and specificity for the EZ is not known in Focal Cortical Dysplasia (FCD) patients. METHODS: We studied patients with FCD who underwent stereoelectroencephalography (SEEG) and surgery. We marked in the SEEG: (a) typical and atypical interictal epileptiform patterns, (b) ictal onset patterns, and (c) rates of ripples (80-250 Hz) and fast ripples (FRs) (>250 Hz). High frequency oscillations were marked automatically during one hour of deep sleep. Surgical outcome was defined as good (Engel I) or poor (Engel II-IV). We computed the sensitivity and, as a measure of specificity, the false positive rate to identify the EZ, and compared them across the different neurophysiological markers. RESULTS: We studied 21 patients, 19 with FCD II. Ictal and typical interictal pattern were the markers with highest sensitivity, while the atypical interictal pattern had the lowest. We found no significant difference in specificity among markers. However, there is a tendency that FRs had the lowest false positive rate. CONCLUSION: The typical interictal pattern has the highest sensitivity. The clinical use of FRs is limited by their low sensitivity. SIGNIFICANCE: We suggest to analyze the typical interictal pattern first. FRs should be analyzed in a second step. If, for instance, a focus with FRs and no typical interictal pattern is found, this area could be considered for resection.
Authors: Vasileios Dimakopoulos; Jean Gotman; William Stacey; Nicolás von Ellenrieder; Julia Jacobs; Christos Papadelis; Jan Cimbalnik; Gregory Worrell; Michael R Sperling; Maike Zijlmans; Lucas Imbach; Birgit Frauscher; Johannes Sarnthein Journal: Brain Commun Date: 2022-06-09
Authors: Willemiek J E M Zweiphenning; Nicolás von Ellenrieder; François Dubeau; Laurence Martineau; Lorella Minotti; Jeffery A Hall; Stephan Chabardes; Roy Dudley; Philippe Kahane; Jean Gotman; Birgit Frauscher Journal: Epilepsia Date: 2021-12-16 Impact factor: 6.740
Authors: Jorge Gonzalez-Martinez; Sridevi V Sarma; Adam Li; Chester Huynh; Zachary Fitzgerald; Iahn Cajigas; Damian Brusko; Jonathan Jagid; Angel O Claudio; Andres M Kanner; Jennifer Hopp; Stephanie Chen; Jennifer Haagensen; Emily Johnson; William Anderson; Nathan Crone; Sara Inati; Kareem A Zaghloul; Juan Bulacio Journal: Nat Neurosci Date: 2021-08-05 Impact factor: 24.884