OBJECTIVE: We comprehensively characterized a large pediatric cohort with focal cortical dysplasia (FCD) type 1 to expand the phenotypic spectrum and to identify predictors of postsurgical outcomes. METHODS: We included pediatric patients with histopathological diagnosis of isolated FCD type 1 and at least 1 year of postsurgical follow-up. We systematically reanalyzed clinical, electrophysiological, and radiological features. The results of this reanalysis served as independent variables for subsequent statistical analyses of outcome predictors. RESULTS: All children (N = 31) had drug-resistant epilepsy with varying impacts on neurodevelopment and cognition (presurgical intelligence quotient [IQ]/developmental quotient scores = 32-106). Low presurgical IQ was associated with abnormal slow background electroencephalographic (EEG) activity and disrupted sleep architecture. Scalp EEG showed predominantly multiregional and often bilateral epileptiform activity. Advanced epilepsy magnetic resonance imaging (MRI) protocols identified FCD-specific features in 74.2% of patients (23/31), 17 of whom were initially evaluated as MRI-negative. In six of eight MRI-negative cases, fluorodeoxyglucose-positron emission tomography (PET) and subtraction ictal single photon emission computed tomography coregistered to MRI helped localize the dysplastic cortex. Sixteen patients (51.6%) underwent invasive EEG. By the last follow-up (median = 5 years, interquartile range = 3.3-9 years), seizure freedom was achieved in 71% of patients (22/31), including seven of eight MRI-negative patients. Antiseizure medications were reduced in 21 patients, with complete withdrawal in six. Seizure outcome was predicted by a combination of the following descriptors: age at epilepsy onset, epilepsy duration, long-term invasive EEG, and specific MRI and PET findings. SIGNIFICANCE: This study highlights the broad phenotypic spectrum of FCD type 1, which spans far beyond the narrow descriptions of previous studies. The applied multilayered presurgical approach helped localize the epileptogenic zone in many previously nonlesional cases, resulting in improved postsurgical seizure outcomes, which are more favorable than previously reported for FCD type 1 patients.
- MeSH
- dítě MeSH
- elektroencefalografie * metody MeSH
- epilepsie MeSH
- fokální kortikální dysplazie MeSH
- kohortové studie MeSH
- kojenec MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- malformace mozkové kůry, skupina I * chirurgie komplikace diagnostické zobrazování MeSH
- malformace mozkové kůry chirurgie komplikace diagnostické zobrazování MeSH
- mladiství MeSH
- pozitronová emisní tomografie MeSH
- předškolní dítě MeSH
- refrakterní epilepsie * chirurgie diagnostické zobrazování patofyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Epilepsy surgery in the operculoinsular cortex is challenging due to the difficult delineation of the epileptogenic zone and the high risk of postoperative deficits. METHODS: Pre- and postsurgical data from 30 pediatric patients who underwent operculoinsular cortex surgery at the Motol Epilepsy Center Prague from 2010 to 2022 were analyzed. RESULTS: Focal cortical dysplasia (FCD; n = 15, 50%) was the predominant cause of epilepsy, followed by epilepsy-associated tumors (n = 5, 17%) and tuberous sclerosis complex (n = 2, 7%). In eight patients where FCD was the most likely etiology, the histology was negative. Seven patients (23%) displayed normal magnetic resonance imaging results. Seizures exhibited diverse semiology and propagation patterns (frontal, perisylvian, and temporal). The ictal and interictal electroencephalographic (EEG) findings were mostly extensive. Multimodal imaging and advanced postprocessing were frequently used. Stereo-EEG was used for localizing the epileptogenic zone and eloquent cortex in 23 patients (77%). Oblique electrodes were used as guides for better neurosurgeon orientation. The epileptogenic zone was in the dominant hemisphere in 16 patients. At the 2-year follow-up, 22 patients (73%) were completely seizure-free, and eight (27%) experienced a seizure frequency reduction of >50% (International League Against Epilepsy class 3 and 4). Fourteen patients (47%) underwent antiseizure medication tapering; treatment was completely withdrawn in two (7%). Nineteen patients (63%) remained seizure-free following the definitive outcome assessment (median = 6 years 5 months, range = 2 years to 13 years 5 months postsurgery). Six patients (20%) experienced corona radiata or basal ganglia ischemia; four (13%) improved to mild and one (3%) to moderate hemiparesis. Two patients (7%) operated on in the anterior insula along with frontotemporal resection experienced major complications: pontine ischemia and postoperative brain edema. SIGNIFICANCE: Epilepsy surgery in the operculoinsular cortex can lead to excellent patient outcomes. A comprehensive diagnostic approach is crucial for surgical success. Rehabilitation brings a great chance for significant recovery of postoperative deficits.
- MeSH
- dítě MeSH
- elektroencefalografie * MeSH
- epilepsie chirurgie diagnostické zobrazování MeSH
- kohortové studie MeSH
- kojenec MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- malformace mozkové kůry chirurgie komplikace diagnostické zobrazování MeSH
- mladiství MeSH
- mozková kůra diagnostické zobrazování chirurgie MeSH
- neurochirurgické výkony metody MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
UNLABELLED: Schizophrenia is a complex disorder characterized by altered brain functional connectivity, detectable during both task and resting state conditions using different neuroimaging methods. To this day, electroencephalography (EEG) studies have reported inconsistent results, showing both hyper- and hypo-connectivity with diverse topographical distributions. Interpretation of these findings is complicated by volume-conduction effects, where local brain activity fluctuations project simultaneously to distant scalp regions (zero-phase lag), inducing spurious inter-electrode correlations. AIM: In the present study, we explored the network dynamics of schizophrenia using a novel functional connectivity metric-corrected imaginary phase locking value (ciPLV)-which is insensitive to changes in amplitude as well as interactions at zero-phase lag. This method, which is less prone to volume conduction effects, provides a more reliable estimate of sensor-space functional network connectivity in schizophrenia. METHODS: We employed a cross-sectional design, utilizing resting state EEG recordings from two adult groups: individuals diagnosed with chronic schizophrenia (n = 30) and a control group of healthy participants (n = 30), all aged between 18 and 55 years old. RESULTS: Our observations revealed that schizophrenia is characterized by a prevalence of excess theta (4-8 Hz) power localized to centroparietal electrodes. This was accompanied by significant alterations in inter- and intra-hemispheric functional network connectivity patterns, mainly between frontotemporal regions within the theta band and frontoparietal regions within beta/gamma bands. CONCLUSIONS: Our findings suggest that patients with schizophrenia demonstrate long-range electrophysiological connectivity abnormalities that are independent of spectral power (i.e., volume conduction). Overall, distinct hemispheric differences were present in frontotemporo-parietal networks in theta and beta/gamma bands. While preliminary, these alterations could be promising new candidate biomarkers of chronic schizophrenia.
- MeSH
- chronická nemoc MeSH
- dospělí MeSH
- elektroencefalografie * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozek patofyziologie diagnostické zobrazování MeSH
- nervová síť patofyziologie diagnostické zobrazování MeSH
- odpočinek fyziologie MeSH
- průřezové studie MeSH
- schizofrenie * patofyziologie diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Electroencephalography (EEG) experiments typically generate vast amounts of data due to the high sampling rates and the use of multiple electrodes to capture brain activity. Consequently, storing and transmitting these large datasets is challenging, necessitating the creation of specialized compression techniques tailored to this data type. This study proposes one such method, which at its core uses an artificial neural network (specifically a convolutional autoencoder) to learn the latent representations of modelled EEG signals to perform lossy compression, which gets further improved with lossless corrections based on the user-defined threshold for the maximum tolerable amplitude loss, resulting in a flexible near-lossless compression scheme. To test the viability of our approach, a case study was performed on the 256-channel binocular rivalry dataset, which also describes mostly data-specific statistical analyses and preprocessing steps. Compression results, evaluation metrics, and comparisons with baseline general compression methods suggest that the proposed method can achieve substantial compression results and speed, making it one of the potential research topics for follow-up studies.
- MeSH
- dospělí MeSH
- elektroencefalografie * metody MeSH
- komprese dat * metody MeSH
- lidé MeSH
- neuronové sítě * MeSH
- počítačové zpracování signálu MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Diagnostic cortical stimulation (CS) in intracranial electroencephalography (iEEG) is an established epilepsy presurgical assessment tool to delineate relevant brain functions and elicit habitual epileptic seizures. Currently, no consensus exists as to whether CS should be routinely performed in pediatric patients. A significant challenge is their limited ability to cooperate during the procedure or to describe non-observable seizure semiology features. Our goal was to identify the spectrum of CS practices in Canada, for both eloquent cortex mapping and seizure stimulation. METHODS: An online survey, answered by all 8 Canadian pediatric epilepsy centers, enquired about implantation, stimulation methods, and use of standardized protocols. A systematic literature review extracted detailed stimulation parameters. RESULTS: Most of the institutions (n = 7/8) reported performing CS during presurgical evaluation. Four institutions indicated they perform stimulation in all implanted patients for the purpose of eloquent cortex mapping and seizure stimulation. The majority of physicians had their individual approach to CS. A largely variable approach to CS, mainly in the choice of stimulation parameters (i.e., train and pulse duration), was observed, with the highest variance concerning the purpose of seizure stimulation. The literature review highlighted an overall small sample size and minimal number of publications. Even though there is a rising trend towards stereotactic iEEG implantation, more data were available on subdural EEGs. CONCLUSION: This study shows individual and sparsely validated approach to CS in pediatric epilepsy. The literature review underscores the urgent need to harmonize pediatric intracranial EEG practices. More multicenter studies are needed to identify safe stimulation thresholds and allow implementation of evidence-based guidelines.
- MeSH
- dítě MeSH
- elektroencefalografie metody MeSH
- elektrokortikografie metody MeSH
- epilepsie chirurgie patofyziologie diagnóza MeSH
- lidé MeSH
- mapování mozku * metody MeSH
- mozková kůra patofyziologie MeSH
- pediatrie metody MeSH
- průzkumy a dotazníky MeSH
- záchvaty * patofyziologie diagnóza MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
- Geografické názvy
- Kanada MeSH
OBJECTIVE: The aim of this work was to study the differences at the whole-brain level between self-paced and cued movement processing in Parkinson's disease (PD). METHODS: High density electroencephalogram (HD-EEG) was recorded during the performance of self-paced movements (Bereitschaftspotential - BP) and visually cued movements (VMT) in PD patients (n = 38) and in a group of healthy controls (HC, n = 23). Oscillatory changes in the alpha, beta, and gamma frequencies were evaluated and correlated to the clinical scales- MDS-UPDRS and Freezing of Gait Questionnaire (FOGQ). RESULTS: The main difference in the alpha range was an activation in the basal ganglia area during VMT performance as compared to BP performance; this activation was present only in HC. The most important finding was observed in the high beta range: a higher activation of the right postcentral area during BP performance in PD subjects as compared to HC, correlating to the severity of FOG. Moreover, PD patients had lower gamma activation of the right frontal areas. CONCLUSION: A simplification of motor circuits and a hyperactivation of the right somatosensory cortex were observed in PD subjects. SIGNIFICANCE: Future studies should be focused on this area to confirm or disprove its role in FOG.
- MeSH
- elektroencefalografie * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- Parkinsonova nemoc * patofyziologie MeSH
- podněty MeSH
- pohyb fyziologie MeSH
- senioři MeSH
- somatosenzorické korové centrum * patofyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
RATIONALE: Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. METHODS: DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. RESULTS: A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p = 0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p = 0.006, DKEFS T2, p = 0.001, DKEFS T3, p = 0.002, DKEFS T4, p = 0.001; GPT dominant, p = 0.05, GPT non-dominant, p = 0.003). CONCLUSION: Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.
- MeSH
- deprese psychologie diagnóza etiologie MeSH
- dospělí MeSH
- elektroencefalografie MeSH
- konverzní poruchy psychologie diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- neuropsychologické testy MeSH
- posttraumatická stresová porucha psychologie diagnóza MeSH
- psychomotorický výkon fyziologie MeSH
- psychosomatické poruchy diagnóza psychologie MeSH
- retrospektivní studie MeSH
- řízení motorových vozidel * psychologie MeSH
- úzkost psychologie etiologie diagnóza MeSH
- záchvaty * psychologie diagnóza 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
The aim of this work was to study the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on the subnetwork of subcortical and cortical motor regions and on the whole brain connectivity using the functional connectivity analysis in Parkinson's disease (PD). The high-density source space EEG was acquired and analyzed in 43 PD subjects in DBS on and DBS off stimulation states (off medication) during a cognitive-motor task. Increased high gamma band (50-100 Hz) connectivity within subcortical regions and between subcortical and cortical motor regions was significantly associated with the Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III improvement after DBS. Whole brain neural correlates of cognitive performance were also detected in the high gamma (50-100 Hz) band. A whole brain multifrequency connectivity profile was found to classify optimal and suboptimal responders to DBS with a positive predictive value of 0.77, negative predictive value of 0.55, specificity of 0.73, and sensitivity of 0.60. Specific connectivity patterns related to PD, motor symptoms improvement after DBS, and therapy responsiveness predictive connectivity profiles were uncovered.
- MeSH
- elektroencefalografie metody MeSH
- hluboká mozková stimulace * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozek patofyziologie diagnostické zobrazování MeSH
- nucleus subthalamicus * patofyziologie MeSH
- Parkinsonova nemoc * terapie patofyziologie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- centrální nervový systém anatomie a histologie fyziologie MeSH
- disekce MeSH
- elektroencefalografie MeSH
- lidé MeSH
- mozek * anatomie a histologie chirurgie fyziologie patologie MeSH
- neurozobrazování metody MeSH
- poruchy vědomí MeSH
- teoretické modely MeSH
- vědomí fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- elektroencefalografie MeSH
- kognice fyziologie MeSH
- kognitivní věda metody MeSH
- lidé MeSH
- mozek fyziologie MeSH
- neurony fyziologie MeSH
- percepce fyziologie MeSH
- reflex fyziologie MeSH
- stadia spánku MeSH
- vědomí * fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH