Ictal gamma-band interactions localize ictogenic nodes of the epileptic network in focal cortical dysplasia
Language English Country Netherlands Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
34157635
DOI
10.1016/j.clinph.2021.04.016
PII: S1388-2457(21)00577-0
Knihovny.cz E-resources
- Keywords
- Effective connectivity, Epilepsy, Intracranial EEG, Networks, Outcome, Seizure onset zone,
- MeSH
- Child MeSH
- Adult MeSH
- Gamma Rhythm physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Malformations of Cortical Development diagnostic imaging physiopathology surgery MeSH
- Adolescent MeSH
- Young Adult MeSH
- Cerebral Cortex diagnostic imaging physiopathology surgery MeSH
- Follow-Up Studies MeSH
- Nerve Net diagnostic imaging physiopathology surgery MeSH
- Drug Resistant Epilepsy diagnostic imaging physiopathology surgery MeSH
- Retrospective Studies MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
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.
References provided by Crossref.org
Epilepsy surgery in children with operculoinsular epilepsy: Results of a large unicentric cohort
