- MeSH
- diferenciální diagnóza MeSH
- lidé MeSH
- lissencefalie diagnostické zobrazování genetika MeSH
- malformace mozkové kůry * diagnostické zobrazování genetika klasifikace MeSH
- megalencefalie diagnostické zobrazování etiologie MeSH
- novorozenec MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- přehledy MeSH
Vývoj kortexu se děje postupně pomocí migrace jednotlivých neuronálních populací tak, že se vytváří laminace nejprve nejhlubší vrstvy, poté postupně migrují neurony přes ni a tvoří u neokortexu postupně jeho šest vrstev. Migrační poruchy vývoje kortexu zahrnují fokální, laminární a subkortikální formu kortikální heterotopie, lyssencefalii a mezi poruchy migrace a vrstvení kortexu patří i polymikrogyrie. Přehledová práce podává přehled o morfologii kortexu a jednotlivých typech migračních poruch a obrazu v magnetické rezonanci.
Development of the neocortex is the action of the successive migration of the individual neuronal populations in pattern, that the deepest lamina is created at first, the others are developer one by one migrating through the previously formed, all six laminae are developed at the end of migration. Migration disorders are covered cortical heterotopias (nodular, laminar, subcortical), lissencephaly and also polymicrogyria. The article gives the review of the cortical morphology and individual migration disorders and their magnetic resonance imaging.
- MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- malformace mozkové kůry * diagnostické zobrazování klasifikace patologie MeSH
- mozková kůra anatomie a histologie diagnostické zobrazování růst a vývoj MeSH
- neokortex anatomie a histologie MeSH
- polymikrogyrie diagnostické zobrazování klasifikace patologie MeSH
- šedá hmota * abnormality anatomie a histologie růst a vývoj MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
OBJECTIVE: Focal cortical dysplasia (FCD) is the most common malformation causing refractory focal epilepsy. Surgical removal of the entire dysplastic cortex is crucial for achieving a seizure-free outcome. Precise presurgical distinctions between FCD types by neuroimaging are difficult, mainly in patients with normal magnetic resonance imaging findings. However, the FCD type is important for planning the extent of surgical approach and counselling. METHODS: This study included patients with focal drug-resistant epilepsy and definite histopathological FCD type I or II diagnoses who underwent intracranial electroencephalography (iEEG). We detected interictal epileptiform discharges (IEDs) and their recruitment into repetitive discharges (RDs) to compare electrophysiological patterns characterizing FCD types. RESULTS: Patients with FCD type II had a significantly higher IED rate (p < 0.005), a shorter inter-discharge interval within RD episodes (p < 0.003), sleep influence on decreased RD periodicity (p < 0.036), and longer RD episode duration (p < 0.003) than patients with type I. A Bayesian classifier stratified FCD types with 82% accuracy. CONCLUSION: Temporal characteristics of IEDs and RDs reflect the histological findings of FCD subtypes and can differentiate FCD types I and II. SIGNIFICANCE: Presurgical prediction of FCD type can help to plan a more tailored surgical approach in patients with normal magnetic resonance findings.
- MeSH
- Bayesova věta MeSH
- elektroencefalografie škodlivé účinky MeSH
- elektrokortikografie škodlivé účinky MeSH
- epilepsie * chirurgie MeSH
- fokální kortikální dysplazie * MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- malformace mozkové kůry * diagnostické zobrazování chirurgie komplikace MeSH
- refrakterní epilepsie * diagnostické zobrazování chirurgie etiologie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Patients with tuberous sclerosis complex (TSC) present with drug-resistant epilepsy in about 60% of cases, and evaluation for epilepsy surgery may be warranted. Correct delineation of the epileptogenic zone (EZ) among multiple dysplastic lesions on MRI represents a challenging step in pre-surgical evaluation. METHODS: Two experienced neuroradiologists evaluated pre- and post-surgical MRIs of 28 epilepsy surgery patients with TSC, assessing characteristics of tubers, cysts, calcifications, and focal cortical dysplasia (FCD)-resembling lesions. Utilizing multiple metrics, we compared MRI features of the EZ-defined as the resected area in TSC patients who achieved seizure-freedom 2 years after epilepsy surgery-with features of other brain areas. Using combinatorial analysis, we identified combinations of dysplastic features that are most frequently observed in the epileptogenic zone in TSC patients. RESULTS: All TSC-associated dysplastic features were more frequently observed in the EZ than in other brain areas (increased cortical thickness, gray-white matter blurring, transmantle sign, calcifications, and tubers; Kendal's tau 0.35, 0.25, 0.27, 0.26, and 0.23, respectively; P value <.001 in all). No single feature could reliably and independently indicate the EZ in all patients. Conversely, the EZ was indicated by the presence of the combination of three of the following features: tubers, transmantle sign, increased cortical thickness, calcifications, and the largest FCD-affected area. Out of these, the largest FCD-affected area emerged as the most reliable indicator of the EZ, combined either with calcifications or tubers. SIGNIFICANCE: The epileptogenic zone in TSC patients harbors multiple dysplastic features, consistent with focal cortical dysplasia. A specific combination of these features can indicate the EZ and aid in pre-surgical MRI evaluation in epilepsy surgery candidates with TSC.
- MeSH
- dítě MeSH
- epilepsie * komplikace etiologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- malformace mozkové kůry * komplikace diagnostické zobrazování patologie MeSH
- mozek patologie MeSH
- tuberózní skleróza * komplikace diagnostické zobrazování MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem 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.
- MeSH
- dítě MeSH
- dospělí MeSH
- gama rytmus EEG fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- malformace mozkové kůry diagnostické zobrazování patofyziologie chirurgie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozková kůra diagnostické zobrazování patofyziologie chirurgie MeSH
- následné studie MeSH
- nervová síť diagnostické zobrazování patofyziologie chirurgie MeSH
- refrakterní epilepsie diagnostické zobrazování patofyziologie chirurgie MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Focal cortical dysplasias (FCDs) are a range of malformations of cortical development each with specific histopathological features. Conventional radiological assessment of standard structural MRI is useful for the localization of lesions but is unable to accurately predict the histopathological features. Quantitative MRI offers the possibility to probe tissue biophysical properties in vivo and may bridge the gap between radiological assessment and ex-vivo histology. This review will cover histological, genetic and radiological features of FCD following the ILAE classification and will explain how quantitative voxel- and surface-based techniques can characterise these features. We will provide an overview of the quantitative MRI measures available, their link with biophysical properties and finally the potential application of quantitative MRI to the problem of FCD subtyping. Future research linking quantitative MRI to FCD histological properties should improve clinical protocols, allow better characterisation of lesions in vivo and tailored surgical planning to the individual.
- MeSH
- fenotyp * MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody využití MeSH
- malformace mozkové kůry diagnostické zobrazování genetika patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
