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Ictal gamma-band interactions localize ictogenic nodes of the epileptic network in focal cortical dysplasia

R. Janca, A. Jahodova, J. Hlinka, P. Jezdik, L. Svobodova, M. Kudr, A. Kalina, P. Marusic, P. Krsek, P. Jiruska

. 2021 ; 132 (8) : 1927-1936. [pub] 20210526

Language English Country Netherlands

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc22003983

OBJECTIVE: Epilepsy surgery fails in > 30% of patients with focal cortical dysplasia (FCD). The seizure persistence after surgery can be attributed to the inability to precisely localize the tissue with an endogenous potential to generate seizures. In this study, we aimed to identify the critical components of the epileptic network that were actively involved in seizure genesis. METHODS: The directed transfer function was applied to intracranial EEG recordings and the effective connectivity was determined with a high temporal and frequency resolution. Pre-ictal network properties were compared with ictal epochs to identify regions actively generating ictal activity and discriminate them from the areas of propagation. RESULTS: Analysis of 276 seizures from 30 patients revealed the existence of a seizure-related network reconfiguration in the gamma-band (25-170 Hz; p < 0.005) - ictogenic nodes. Unlike seizure onset zone, resecting the majority of ictogenic nodes correlated with favorable outcomes (p < 0.012). CONCLUSION: The prerequisite to successful epilepsy surgery is the accurate identification of brain areas from which seizures arise. We show that in FCD-related epilepsy, gamma-band network markers can reliably identify and distinguish ictogenic areas in macroelectrode recordings, improve intracranial EEG interpretation and better delineate the epileptogenic zone. SIGNIFICANCE: Ictogenic nodes localize the critical parts of the epileptogenic tissue and increase the diagnostic yield of intracranial evaluation.

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$a Janca, Radek $u Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic; Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address: jancarad@fel.cvut.cz
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$a Ictal gamma-band interactions localize ictogenic nodes of the epileptic network in focal cortical dysplasia / $c R. Janca, A. Jahodova, J. Hlinka, P. Jezdik, L. Svobodova, M. Kudr, A. Kalina, P. Marusic, P. Krsek, P. Jiruska
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$a OBJECTIVE: Epilepsy surgery fails in > 30% of patients with focal cortical dysplasia (FCD). The seizure persistence after surgery can be attributed to the inability to precisely localize the tissue with an endogenous potential to generate seizures. In this study, we aimed to identify the critical components of the epileptic network that were actively involved in seizure genesis. METHODS: The directed transfer function was applied to intracranial EEG recordings and the effective connectivity was determined with a high temporal and frequency resolution. Pre-ictal network properties were compared with ictal epochs to identify regions actively generating ictal activity and discriminate them from the areas of propagation. RESULTS: Analysis of 276 seizures from 30 patients revealed the existence of a seizure-related network reconfiguration in the gamma-band (25-170 Hz; p < 0.005) - ictogenic nodes. Unlike seizure onset zone, resecting the majority of ictogenic nodes correlated with favorable outcomes (p < 0.012). CONCLUSION: The prerequisite to successful epilepsy surgery is the accurate identification of brain areas from which seizures arise. We show that in FCD-related epilepsy, gamma-band network markers can reliably identify and distinguish ictogenic areas in macroelectrode recordings, improve intracranial EEG interpretation and better delineate the epileptogenic zone. SIGNIFICANCE: Ictogenic nodes localize the critical parts of the epileptogenic tissue and increase the diagnostic yield of intracranial evaluation.
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$a Jahodova, Alena $u Department of Paediatric Neurology, Full Member of the ERN EpiCAR, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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$a Hlinka, Jaroslav $u Department of Complex Systems, Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic
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$a Jezdik, Petr $u Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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$a Svobodova, Lenka $u Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic; Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
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$a Kudr, Martin $u Department of Paediatric Neurology, Full Member of the ERN EpiCAR, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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$a Kalina, Adam $u Department of Neurology, Full Member of the ERN EpiCAR, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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$a Marusic, Petr $u Department of Neurology, Full Member of the ERN EpiCAR, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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$a Krsek, Pavel $u Department of Paediatric Neurology, Full Member of the ERN EpiCAR, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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$a Jiruska, Premysl $u Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Developmental Epileptology, Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic. Electronic address: jiruskapremysl@gmail.com
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