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Spatio-temporal spike dynamics predict surgical outcome in adult focal epilepsy
P. Klimes, L. Peter-Derex, J. Hall, F. Dubeau, B. Frauscher
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, práce podpořená grantem
Grantová podpora
PJT-175056
CIHR - Canada
- MeSH
- dospělí MeSH
- elektroencefalografie MeSH
- epilepsie parciální patofyziologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mapování mozku MeSH
- mladý dospělý MeSH
- modely neurologické MeSH
- mozek patofyziologie chirurgie MeSH
- mozkové vlny fyziologie MeSH
- neurochirurgické výkony MeSH
- prognóza MeSH
- refrakterní epilepsie patofyziologie chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: We hypothesized that spatio-temporal dynamics of interictal spikes reflect the extent and stability of epileptic sources and determine surgical outcome. METHODS: We studied 30 consecutive patients (14 good outcome). Spikes were detected in prolonged stereo-electroencephalography recordings. We quantified the spatio-temporal dynamics of spikes using the variance of the spike rate, line length and skewness of the spike distribution, and related these features to outcome. We built a logistic regression model, and compared its performance to traditional markers. RESULTS: Good outcome patients had more dominant and stable sources than poor outcome patients as expressed by a higher variance of spike rates, a lower variance of line length, and a lower variance of positive skewness (ps < 0.05). The outcome was correctly predicted in 80% of patients. This was better or non-inferior to predictions based on a focal lesion (p = 0.016), focal seizure-onset zone, or complete resection (ps > 0.05). In the five patients where traditional markers failed, spike distribution predicted the outcome correctly. The best results were achieved by 18-h periods or longer. CONCLUSIONS: Analysis of spike dynamics shows that surgery outcome depends on strong, single and stable sources. SIGNIFICANCE: Our quantitative method has the potential to be a reliable predictor of surgical outcome.
Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic
Lyon Neuroscience Research Center Lyon France
Montreal Neurological Hospital McGill University Montreal Quebec Canada
Citace poskytuje Crossref.org
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- $a OBJECTIVE: We hypothesized that spatio-temporal dynamics of interictal spikes reflect the extent and stability of epileptic sources and determine surgical outcome. METHODS: We studied 30 consecutive patients (14 good outcome). Spikes were detected in prolonged stereo-electroencephalography recordings. We quantified the spatio-temporal dynamics of spikes using the variance of the spike rate, line length and skewness of the spike distribution, and related these features to outcome. We built a logistic regression model, and compared its performance to traditional markers. RESULTS: Good outcome patients had more dominant and stable sources than poor outcome patients as expressed by a higher variance of spike rates, a lower variance of line length, and a lower variance of positive skewness (ps < 0.05). The outcome was correctly predicted in 80% of patients. This was better or non-inferior to predictions based on a focal lesion (p = 0.016), focal seizure-onset zone, or complete resection (ps > 0.05). In the five patients where traditional markers failed, spike distribution predicted the outcome correctly. The best results were achieved by 18-h periods or longer. CONCLUSIONS: Analysis of spike dynamics shows that surgery outcome depends on strong, single and stable sources. SIGNIFICANCE: Our quantitative method has the potential to be a reliable predictor of surgical outcome.
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