Ictal EEG source imaging and connectivity to localize the seizure onset zone in extratemporal lobe epilepsy.

Seizure : the Journal of the British Epilepsy Association
Simone VespaRiëm El Tahry

Abstract

To evaluate the yield of Functional Connectivity (FC) in addition to low-density ictal Electrical Source Imaging (ESI) in extratemporal lobe epilepsy (ETLE), using an automated algorithm for analysis. Long-term EEG monitoring of consecutive ETLE patients who underwent surgery was reviewed by epileptologists, and seizure onsets characterized by rhythmical activity were identified. A spectrogram-based algorithm was developed to select objectively the parameters of ESI analysis. Two methods for SOZ localization were compared: i) ESI power, based on LORETA exclusively; ii) ESI + FC, including a Granger causality-based connectivity analysis. Results were determined at a sublobar level. The resection zone, in relation to 1-year follow-up surgical outcome, was considered as reference standard for diagnostic accuracy analyses. Ninety-four seizures from 24 patients were analyzed. At seizure-level, ESI power showed 36 % sensitivity and 72 % specificity (accuracy: 45 %). ESI + FC significantly improved the accuracy, with 52 % sensitivity and 84 % specificity (accuracy: 61 %, p = 0.04). Results of ESI + FC were equally valuable in patients with lateralized or bilateral/generalized visual interpretation of ictal EEG. In a patient level sub-...Continue Reading

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Citations

Feb 21, 2021·Seizure : the Journal of the British Epilepsy Association·Ricardo Lutzky SauteJoao Pereira Leite
May 12, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Amir G BaroumandSándor Beniczky
May 26, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Lorenzo RicciChristos Papadelis

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