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Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy.
World Neurosurg 2016; 88:576-585WN

Abstract

BACKGROUND

Electroencephalography source imaging (ESI) is a promising tool for localizing the cortical sources of both ictal and interictal epileptic activities. Many studies have shown the clinical usefulness of interictal ESI, but very few have investigated the utility of ictal ESI. The aim of this article is to examine the clinical usefulness of ictal ESI for epileptic focus localization in patients with refractory focal epilepsy, especially extratemporal lobe epilepsy.

METHODS

Both ictal and interictal ESI were performed by the use of patient-specific realistic forward models and 3 different linear distributed inverse models. Lateralization as well as concordance between ESI-estimated focuses and single-photon emission computed tomography (SPECT) focuses were assessed.

RESULTS

All the ESI focuses (both ictal and interictal) were found lateralized to the same hemisphere as ictal SPECT focuses. Lateralization results also were in agreement with the lesion sides as visualized on magnetic resonance imaging. Ictal ESI results, obtained from the best-performing inverse model, were fully concordant with the same cortical lobe as SPECT focuses, whereas the corresponding concordance rate is 87.50% in case of interictal ESI.

CONCLUSIONS

Our findings show that ictal ESI gives fully lateralized and highly concordant results with ictal SPECT and may provide a cost-effective substitute for ictal SPECT.

Authors+Show Affiliations

Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Department of Computer Science & Engineering, Chittagong University of Engineering & Technology, Chittagong, Bangladesh.Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: fatimah@um.edu.my.Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26548833

Citation

Habib, Mohammad Ashfak, et al. "Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy." World Neurosurgery, vol. 88, 2016, pp. 576-585.
Habib MA, Ibrahim F, Mohktar MS, et al. Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy. World Neurosurg. 2016;88:576-585.
Habib, M. A., Ibrahim, F., Mohktar, M. S., Kamaruzzaman, S. B., Rahmat, K., & Lim, K. S. (2016). Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy. World Neurosurgery, 88, pp. 576-585. doi:10.1016/j.wneu.2015.10.096.
Habib MA, et al. Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy. World Neurosurg. 2016;88:576-585. PubMed PMID: 26548833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ictal EEG Source Imaging for Presurgical Evaluation of Refractory Focal Epilepsy. AU - Habib,Mohammad Ashfak, AU - Ibrahim,Fatimah, AU - Mohktar,Mas S, AU - Kamaruzzaman,Shahrul Bahyah, AU - Rahmat,Kartini, AU - Lim,Kheng Seang, Y1 - 2015/11/05/ PY - 2015/06/15/received PY - 2015/10/25/revised PY - 2015/10/26/accepted PY - 2015/11/10/entrez PY - 2015/11/10/pubmed PY - 2016/8/25/medline KW - Epilepsy KW - Ictal EEG KW - Interictal EEG KW - Source imaging KW - Source localization SP - 576 EP - 585 JF - World neurosurgery JO - World Neurosurg VL - 88 N2 - BACKGROUND: Electroencephalography source imaging (ESI) is a promising tool for localizing the cortical sources of both ictal and interictal epileptic activities. Many studies have shown the clinical usefulness of interictal ESI, but very few have investigated the utility of ictal ESI. The aim of this article is to examine the clinical usefulness of ictal ESI for epileptic focus localization in patients with refractory focal epilepsy, especially extratemporal lobe epilepsy. METHODS: Both ictal and interictal ESI were performed by the use of patient-specific realistic forward models and 3 different linear distributed inverse models. Lateralization as well as concordance between ESI-estimated focuses and single-photon emission computed tomography (SPECT) focuses were assessed. RESULTS: All the ESI focuses (both ictal and interictal) were found lateralized to the same hemisphere as ictal SPECT focuses. Lateralization results also were in agreement with the lesion sides as visualized on magnetic resonance imaging. Ictal ESI results, obtained from the best-performing inverse model, were fully concordant with the same cortical lobe as SPECT focuses, whereas the corresponding concordance rate is 87.50% in case of interictal ESI. CONCLUSIONS: Our findings show that ictal ESI gives fully lateralized and highly concordant results with ictal SPECT and may provide a cost-effective substitute for ictal SPECT. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/26548833/Ictal_EEG_Source_Imaging_for_Presurgical_Evaluation_of_Refractory_Focal_Epilepsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(15)01514-4 DB - PRIME DP - Unbound Medicine ER -