Spatio-temporal spike dynamics predict surgical outcome in adult focal epilepsy
Language English Country Netherlands Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
PJT-175056
CIHR - Canada
PubMed
34991017
DOI
10.1016/j.clinph.2021.10.023
PII: S1388-2457(21)00877-4
Knihovny.cz E-resources
- Keywords
- Intracranial EEG, Spike dynamics, Surgical outcomes,
- MeSH
- Adult MeSH
- Electroencephalography MeSH
- Epilepsies, Partial physiopathology surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Brain Mapping MeSH
- Young Adult MeSH
- Models, Neurological MeSH
- Brain physiopathology surgery MeSH
- Brain Waves physiology MeSH
- Neurosurgical Procedures MeSH
- Prognosis MeSH
- Drug Resistant Epilepsy physiopathology surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't 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.
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