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EEG source connectivity to localize the seizure onset zone in patients with drug resistant epilepsy.
Neuroimage Clin 2017; 16:689-698NC

Abstract

Electrical source imaging (ESI) from interictal scalp EEG is increasingly validated and used as a valuable tool in the presurgical evaluation of epilepsy as a reflection of the irritative zone. ESI of ictal scalp EEG to localize the seizure onset zone (SOZ) remains challenging. We investigated the value of an approach for ictal imaging using ESI and functional connectivity analysis (FC). Ictal scalp EEG from 111 seizures in 27 patients who had Engel class I outcome at least 1 year following resective surgery was analyzed. For every seizure, an artifact-free epoch close to the seizure onset was selected and ESI using LORETA was applied. In addition, the reconstructed sources underwent FC using the spectrum-weighted Adaptive Directed Transfer Function. This resulted in the estimation of the SOZ in two ways: (i) the source with maximal power after ESI, (ii) the source with the strongest outgoing connections after combined ESI and FC. Next, we calculated the distance between the estimated SOZ and the border of the resected zone (RZ) for both approaches and called this the localization error ((i) LEpow and (ii) LEconn respectively). By comparing LEpow and LEconn, we assessed the added value of FC. The source with maximal power after ESI was inside the RZ (LEpow = 0 mm) in 31% of the seizures and estimated within 10 mm from the border of the RZ (LEpow ≤ 10 mm) in 42%. Using ESI and FC, these numbers increased to 72% for LEconn = 0 mm and 94% for LEconn ≤ 10 mm. FC provided a significant added value to ESI alone (p < 0.001). ESI combined with subsequent FC is able to localize the SOZ in a non-invasive way with high accuracy. Therefore it could be a valuable tool in the presurgical evaluation of epilepsy.

Authors+Show Affiliations

Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University - imec, De Pintelaan 185, 9000 Ghent, Belgium.Epilog, Vlasgaardstraat 52, 9000 Ghent, Belgium.Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University - imec, De Pintelaan 185, 9000 Ghent, Belgium.Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University - imec, De Pintelaan 185, 9000 Ghent, Belgium. Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.EEG and Epilepsy Unit, Neurology Department, University Hospitals and Faculty of Medicine of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.Department of Neurosurgery, University Hospitals of Geneva and University of Geneva, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University - imec, De Pintelaan 185, 9000 Ghent, Belgium.EEG and Epilepsy Unit, Neurology Department, University Hospitals and Faculty of Medicine of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University - imec, De Pintelaan 185, 9000 Ghent, Belgium. Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29034162

Citation

Staljanssens, Willeke, et al. "EEG Source Connectivity to Localize the Seizure Onset Zone in Patients With Drug Resistant Epilepsy." NeuroImage. Clinical, vol. 16, 2017, pp. 689-698.
Staljanssens W, Strobbe G, Van Holen R, et al. EEG source connectivity to localize the seizure onset zone in patients with drug resistant epilepsy. Neuroimage Clin. 2017;16:689-698.
Staljanssens, W., Strobbe, G., Van Holen, R., Keereman, V., Gadeyne, S., Carrette, E., ... van Mierlo, P. (2017). EEG source connectivity to localize the seizure onset zone in patients with drug resistant epilepsy. NeuroImage. Clinical, 16, pp. 689-698. doi:10.1016/j.nicl.2017.09.011.
Staljanssens W, et al. EEG Source Connectivity to Localize the Seizure Onset Zone in Patients With Drug Resistant Epilepsy. Neuroimage Clin. 2017;16:689-698. PubMed PMID: 29034162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EEG source connectivity to localize the seizure onset zone in patients with drug resistant epilepsy. AU - Staljanssens,Willeke, AU - Strobbe,Gregor, AU - Van Holen,Roel, AU - Keereman,Vincent, AU - Gadeyne,Stefanie, AU - Carrette,Evelien, AU - Meurs,Alfred, AU - Pittau,Francesca, AU - Momjian,Shahan, AU - Seeck,Margitta, AU - Boon,Paul, AU - Vandenberghe,Stefaan, AU - Vulliemoz,Serge, AU - Vonck,Kristl, AU - van Mierlo,Pieter, Y1 - 2017/09/14/ PY - 2017/05/24/received PY - 2017/09/01/revised PY - 2017/09/12/accepted PY - 2017/10/17/entrez PY - 2017/10/17/pubmed PY - 2018/6/15/medline KW - Clinical EEG KW - EEG source imaging KW - Functional connectivity KW - Granger causality KW - Ictal imaging SP - 689 EP - 698 JF - NeuroImage. Clinical JO - Neuroimage Clin VL - 16 N2 - Electrical source imaging (ESI) from interictal scalp EEG is increasingly validated and used as a valuable tool in the presurgical evaluation of epilepsy as a reflection of the irritative zone. ESI of ictal scalp EEG to localize the seizure onset zone (SOZ) remains challenging. We investigated the value of an approach for ictal imaging using ESI and functional connectivity analysis (FC). Ictal scalp EEG from 111 seizures in 27 patients who had Engel class I outcome at least 1 year following resective surgery was analyzed. For every seizure, an artifact-free epoch close to the seizure onset was selected and ESI using LORETA was applied. In addition, the reconstructed sources underwent FC using the spectrum-weighted Adaptive Directed Transfer Function. This resulted in the estimation of the SOZ in two ways: (i) the source with maximal power after ESI, (ii) the source with the strongest outgoing connections after combined ESI and FC. Next, we calculated the distance between the estimated SOZ and the border of the resected zone (RZ) for both approaches and called this the localization error ((i) LEpow and (ii) LEconn respectively). By comparing LEpow and LEconn, we assessed the added value of FC. The source with maximal power after ESI was inside the RZ (LEpow = 0 mm) in 31% of the seizures and estimated within 10 mm from the border of the RZ (LEpow ≤ 10 mm) in 42%. Using ESI and FC, these numbers increased to 72% for LEconn = 0 mm and 94% for LEconn ≤ 10 mm. FC provided a significant added value to ESI alone (p < 0.001). ESI combined with subsequent FC is able to localize the SOZ in a non-invasive way with high accuracy. Therefore it could be a valuable tool in the presurgical evaluation of epilepsy. SN - 2213-1582 UR - https://www.unboundmedicine.com/medline/citation/29034162/EEG_source_connectivity_to_localize_the_seizure_onset_zone_in_patients_with_drug_resistant_epilepsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1582(17)30225-5 DB - PRIME DP - Unbound Medicine ER -