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1.
Hum Brain Mapp ; 45(10): e26720, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38994740

RESUMO

Electro/Magneto-EncephaloGraphy (EEG/MEG) source imaging (EMSI) of epileptic activity from deep generators is often challenging due to the higher sensitivity of EEG/MEG to superficial regions and to the spatial configuration of subcortical structures. We previously demonstrated the ability of the coherent Maximum Entropy on the Mean (cMEM) method to accurately localize the superficial cortical generators and their spatial extent. Here, we propose a depth-weighted adaptation of cMEM to localize deep generators more accurately. These methods were evaluated using realistic MEG/high-density EEG (HD-EEG) simulations of epileptic activity and actual MEG/HD-EEG recordings from patients with focal epilepsy. We incorporated depth-weighting within the MEM framework to compensate for its preference for superficial generators. We also included a mesh of both hippocampi, as an additional deep structure in the source model. We generated 5400 realistic simulations of interictal epileptic discharges for MEG and HD-EEG involving a wide range of spatial extents and signal-to-noise ratio (SNR) levels, before investigating EMSI on clinical HD-EEG in 16 patients and MEG in 14 patients. Clinical interictal epileptic discharges were marked by visual inspection. We applied three EMSI methods: cMEM, depth-weighted cMEM and depth-weighted minimum norm estimate (MNE). The ground truth was defined as the true simulated generator or as a drawn region based on clinical information available for patients. For deep sources, depth-weighted cMEM improved the localization when compared to cMEM and depth-weighted MNE, whereas depth-weighted cMEM did not deteriorate localization accuracy for superficial regions. For patients' data, we observed improvement in localization for deep sources, especially for the patients with mesial temporal epilepsy, for which cMEM failed to reconstruct the initial generator in the hippocampus. Depth weighting was more crucial for MEG (gradiometers) than for HD-EEG. Similar findings were found when considering depth weighting for the wavelet extension of MEM. In conclusion, depth-weighted cMEM improved the localization of deep sources without or with minimal deterioration of the localization of the superficial sources. This was demonstrated using extensive simulations with MEG and HD-EEG and clinical MEG and HD-EEG for epilepsy patients.


Assuntos
Eletroencefalografia , Entropia , Magnetoencefalografia , Humanos , Magnetoencefalografia/métodos , Eletroencefalografia/métodos , Adulto , Feminino , Masculino , Simulação por Computador , Adulto Jovem , Epilepsia/fisiopatologia , Epilepsia/diagnóstico por imagem , Pessoa de Meia-Idade , Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Hipocampo/diagnóstico por imagem , Hipocampo/fisiopatologia , Modelos Neurológicos
2.
Psychophysiology ; : e14624, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38873838

RESUMO

Previous studies have found electroencephalogram (EEG) amplitude and scalp topography differences between neurotypical and neurological/neurosurgical groups, being interpreted at the cognitive level. However, these comparisons are invariably accompanied by anatomical changes. Critical to EEG are the so-called volume currents, which are affected by the spatial distribution of the different tissues in the head. We investigated the effect of cerebrospinal fluid (CSF)-filled cavities on simulated EEG scalp data. We simulated EEG scalp potentials for known sources using different volume conduction models: a reference model (i.e., unlesioned brain) and models with realistic CSF-filled cavities gradually increasing in size. We used this approach for a single source close or far from the CSF-lesion cavity, and for a scenario with a distributed configuration of sources (i.e., a "cognitive event-related potential effect"). The magnitude and topography errors between the reference and lesion models were quantified. For the single-source simulation close to the lesion, the CSF-filled lesion modulated signal amplitude with more than 17% magnitude error and topography with more than 9% topographical error. Negligible modulation was found for the single source far from the lesion. For the multisource simulations of the cognitive effect, the CSF-filled lesion modulated signal amplitude with more than 6% magnitude error and topography with more than 16% topography error in a nonmonotonic fashion. In conclusion, the impact of a CSF-filled cavity cannot be neglected for scalp-level EEG data. Especially when group-level comparisons are made, any scalp-level attenuated, aberrant, or absent effects are difficult to interpret without considering the confounding effect of CSF.

3.
J Neurosci Methods ; 409: 110193, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38871302

RESUMO

BACKGROUND: Scalp EEG is one of the main tools in the clinical evaluation of epilepsy. In some cases intracranial Interictal Epileptiform Discharges (IEDs) are not visible from the scalp. Recent studies have shown the feasibility of revealing them in the EEG if their timings are extracted from simultaneous intracranial recordings, but their potential for the localization of the epileptogenic zone is not yet well defined. NEW METHOD: We recorded simultaneous high-density EEG (HD-EEG) and stereo-electroencephalography (SEEG) during interictal periods in 8 patients affected by drug-resistant focal epilepsy. We identified IEDs in the SEEG and systematically analyzed the time-locked signals on the EEG by means of evoked potentials, topographical analysis and Electrical Source Imaging (ESI). The dataset has been standardized and is being publicly shared. RESULTS: Our results showed that IEDs that were not clearly visible at single-trials could be uncovered by averaging, in line with previous reports. They also showed that their topographical voltage distributions matched the position of the SEEG electrode where IEDs had been identified, and that ESI techniques can reconstruct it with an accuracy of ∼2 cm. Finally, the present dataset provides a reference to test the accuracy of different methods and parameters. COMPARISON WITH EXISTING METHODS: Our study is the first to systematically compare ESI methods on simultaneously recorded IEDs, and to share a public resource with in-vivo data for their evaluation. CONCLUSIONS: Simultaneous HD-EEG and SEEG recordings can unveil hidden IEDs whose origins can be reconstructed using topographical and ESI analyses, but results depend on the selected methods and parameters.

4.
Med Biol Eng Comput ; 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38771431

RESUMO

One of the most important needs in neuroimaging is brain dynamic source imaging with high spatial and temporal resolution. EEG source imaging estimates the underlying sources from EEG recordings, which provides enhanced spatial resolution with intrinsically high temporal resolution. To ensure identifiability in the underdetermined source reconstruction problem, constraints on EEG sources are essential. This paper introduces a novel method for estimating source activities based on spatio-temporal constraints and a dynamic source imaging algorithm. The method enhances time resolution by incorporating temporal evolution of neural activity into a regularization function. Additionally, two spatial regularization constraints based on L 1 and L 2 norms are applied in the transformed domain to address both focal and spread neural activities, achieved through spatial gradient and Laplacian transform. Performance evaluation, conducted quantitatively using synthetic datasets, discusses the influence of parameters such as source extent, number of sources, correlation level, and SNR level on temporal and spatial metrics. Results demonstrate that the proposed method provides superior spatial and temporal reconstructions compared to state-of-the-art inverse solutions including STRAPS, sLORETA, SBL, dSPM, and MxNE. This improvement is attributed to the simultaneous integration of transformed spatial and temporal constraints. When applied to a real auditory ERP dataset, our algorithm accurately reconstructs brain source time series and locations, effectively identifying the origins of auditory evoked potentials. In conclusion, our proposed method with spatio-temporal constraints outperforms the state-of-the-art algorithms in estimating source distribution and time courses.

5.
MethodsX ; 12: 102766, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38808097

RESUMO

Electroencephalogram (EEG) electrode digitization is crucial for accurate EEG source estimation, and several commercial systems are available for this purpose. The present study aimed to evaluate the digitizing accuracy of electromagnetic and optical systems. Additionally, we introduced a novel rotation method for the electromagnetic system and compared its accuracy with the conventional method of electromagnetic and optical systems. In the conventional method, the operator moves around a stationary participant to digitize, while the participant does not move their head or body. In contrast, in our proposed rotation method with an electromagnetic system, the operator rotates the participant sitting on a swivel chair to digitize in a consistent position. We showed high localization accuracy in both the optical and electromagnetic systems, with an average localization error of less than 3.6 mm. Comparisons of the digitization methods revealed that the electromagnetic system demonstrates superior digitizing accuracy compared to the optical system. Notably, the proposed rotational method is the most accurate among the three methods, which can be attributed to the consistent positioning of EEG electrode digitization within the electromagnetic field. Considering the affordability of the electromagnetic system, our findings provide valuable insights for researchers aiming for precise EEG source estimation.•The study compares the accuracy of electromagnetic and optical systems for EEG electrode digitization, introducing a novel rotation method for improved consistency and precision.•The electromagnetic system, especially with the proposed rotation method, achieves superior digitizing accuracy over the optical system.•Highlighting the cost-effectiveness and precision of the electromagnetic system with the rotation method, this research offers significant insights for achieving precise EEG source estimation.

6.
Brain Inform ; 11(1): 11, 2024 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-38703311

RESUMO

The hand motor activity can be identified and converted into commands for controlling machines through a brain-computer interface (BCI) system. Electroencephalography (EEG) based BCI systems employ electrodes to measure the electrical brain activity projected at the scalp and discern patterns. However, the volume conduction problem attenuates the electric potential from the brain to the scalp and introduces spatial mixing to the signals. EEG source imaging (ESI) techniques can be applied to alleviate these issues and enhance the spatial segregation of information. Despite this potential solution, the use of ESI has not been extensively applied in BCI systems, largely due to accuracy concerns over reconstruction accuracy when using low-density EEG (ldEEG), which is commonly used in BCIs. To overcome these accuracy issues in low channel counts, recent studies have proposed reducing the number of EEG channels based on optimized channel selection. This work presents an evaluation of the spatial and temporal accuracy of ESI when applying optimized channel selection towards ldEEG number of channels. For this, a simulation study of source activity related to hand movement has been performed using as a starting point an EEG system with 339 channels. The results obtained after optimization show that the activity in the concerned areas can be retrieved with a spatial accuracy of 3.99, 10.69, and 14.29 mm (localization error) when using 32, 16, and 8 channel counts respectively. In addition, the use of optimally selected electrodes has been validated in a motor imagery classification task, obtaining a higher classification performance when using 16 optimally selected channels than 32 typical electrode distributions under 10-10 system, and obtaining higher classification performance when combining ESI methods with the optimal selected channels.

7.
Eur J Neurosci ; 60(1): 3772-3794, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38726801

RESUMO

Beside the well-documented involvement of secondary somatosensory area, the cortical network underlying late somatosensory evoked potentials (P60/N60 and P100/N100) is still unknown. Electroencephalogram and magnetoencephalogram source imaging were performed to further investigate the origin of the brain cortical areas involved in late somatosensory evoked potentials, using sensory inputs of different strengths and by testing the correlation between cortical sources. Simultaneous high-density electroencephalograms and magnetoencephalograms were performed in 19 participants, and electrical stimulation was applied to the median nerve (wrist level) at intensity between 1.5 and 9 times the perceptual threshold. Source imaging was undertaken to map the stimulus-induced brain cortical activity according to each individual brain magnetic resonance imaging, during three windows of analysis covering early and late somatosensory evoked potentials. Results for P60/N60 and P100/N100 were compared with those for P20/N20 (early response). According to literature, maximal activity during P20/N20 was found in central sulcus contralateral to stimulation site. During P60/N60 and P100/N100, activity was observed in contralateral primary sensorimotor area, secondary somatosensory area (on both hemispheres) and premotor and multisensory associative cortices. Late responses exhibited similar characteristics but different from P20/N20, and no significant correlation was found between early and late generated activities. Specific clusters of cortical activities were activated with specific input/output relationships underlying early and late somatosensory evoked potentials. Cortical networks, partly common to and distinct from early somatosensory responses, contribute to late responses, all participating in the complex somatosensory brain processing.


Assuntos
Eletroencefalografia , Potenciais Somatossensoriais Evocados , Magnetoencefalografia , Córtex Somatossensorial , Humanos , Potenciais Somatossensoriais Evocados/fisiologia , Magnetoencefalografia/métodos , Masculino , Feminino , Adulto , Eletroencefalografia/métodos , Córtex Somatossensorial/fisiologia , Córtex Somatossensorial/diagnóstico por imagem , Nervo Mediano/fisiologia , Adulto Jovem , Estimulação Elétrica/métodos , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos
8.
Hum Brain Mapp ; 45(5): e26638, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38520365

RESUMO

Connectome spectrum electromagnetic tomography (CSET) combines diffusion MRI-derived structural connectivity data with well-established graph signal processing tools to solve the M/EEG inverse problem. Using simulated EEG signals from fMRI responses, and two EEG datasets on visual-evoked potentials, we provide evidence supporting that (i) CSET captures realistic neurophysiological patterns with better accuracy than state-of-the-art methods, (ii) CSET can reconstruct brain responses more accurately and with more robustness to intrinsic noise in the EEG signal. These results demonstrate that CSET offers high spatio-temporal accuracy, enabling neuroscientists to extend their research beyond the current limitations of low sampling frequency in functional MRI and the poor spatial resolution of M/EEG.


Assuntos
Conectoma , Humanos , Conectoma/métodos , Eletroencefalografia/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Imageamento por Ressonância Magnética/métodos , Fenômenos Eletromagnéticos
9.
Brain Inform ; 11(1): 8, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38472438

RESUMO

EEG/MEG source imaging (ESI) aims to find the underlying brain sources to explain the observed EEG or MEG measurement. Multiple classical approaches have been proposed to solve the ESI problem based on different neurophysiological assumptions. To support clinical decision-making, it is important to estimate not only the exact location of the source signal but also the extended source activation regions. Existing methods may render over-diffuse or sparse solutions, which limit the source extent estimation accuracy. In this work, we leverage the graph structures defined in the 3D mesh of the brain and the spatial graph Fourier transform (GFT) to decompose the spatial graph structure into sub-spaces of low-, medium-, and high-frequency basis. We propose to use the low-frequency basis of spatial graph filters to approximate the extended areas of brain activation and embed the GFT into the classical ESI methods. We validated the classical source localization methods with the corresponding improved version using GFT in both synthetic data and real data. We found the proposed method can effectively reconstruct focal source patterns and significantly improve the performance compared to the classical algorithms.

10.
Epilepsia ; 65(4): 944-960, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38318986

RESUMO

OBJECTIVE: To deconstruct the epileptogenic networks of patients with drug-resistant epilepsy (DRE) using source functional connectivity (FC) analysis; unveil the FC biomarkers of the epileptogenic zone (EZ); and develop machine learning (ML) models to estimate the EZ using brief interictal electroencephalography (EEG) data. METHODS: We analyzed scalp EEG from 50 patients with DRE who had surgery. We reconstructed the activity (electrical source imaging [ESI]) of virtual sensors (VSs) across the whole cortex and computed FC separately for epileptiform and non-epileptiform EEG epochs (with or without spikes). In patients with good outcome (Engel 1a), four cortical regions were defined: EZ (resection) and three non-epileptogenic zones (NEZs) in the same and opposite hemispheres. Region-specific FC features in six frequency bands and three spatial ranges (long, short, inner) were compared between regions (Wilcoxon sign-rank). We developed ML classifiers to identify the VSs in the EZ using VS-specific FC features. Cross-validation was performed using good outcome data. Performance was compared with poor outcomes and interictal spike localization. RESULTS: FC differed between EZ and NEZs (p < .05) during non-epileptiform and epileptiform epochs, showing higher FC in the EZ than its homotopic contralateral NEZ. During epileptiform epochs, the NEZ in the epileptogenic hemisphere showed higher FC than its contralateral NEZ. In good outcome patients, the ML classifiers reached 75% accuracy to the resection (91% sensitivity; 74% specificity; distance from EZ: 38 mm) using epileptiform epochs (gamma and beta frequency bands) and 62% accuracy using broadband non-epileptiform epochs, both outperforming spike localization (accuracy = 47%; p < .05; distance from EZ: 57 mm). Lower performance was seen in poor outcomes. SIGNIFICANCE: We present an FC approach to extract EZ biomarkers from brief EEG data. Increased FC in various frequencies characterized the EZ during epileptiform and non-epileptiform epochs. FC-based ML models identified the resection better in good than poor outcome patients, demonstrating their potential for presurgical use in pediatric DRE.


Assuntos
Epilepsia Resistente a Medicamentos , Eletroencefalografia , Humanos , Criança , Eletroencefalografia/métodos , Epilepsia Resistente a Medicamentos/cirurgia , Imageamento por Ressonância Magnética , Biomarcadores
11.
Epilepsia ; 65(4): 961-973, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38306118

RESUMO

OBJECTIVE: Genetic generalized epilepsy (GGE) accounts for approximately 20% of adult epilepsy cases and is considered a disorder of large brain networks, involving both hemispheres. Most studies have not shown any difference in functional whole-brain network topology when compared to healthy controls. Our objective was to examine whether this preserved global network topology could hide local reorganizations that balance out at the global network level. METHODS: We recorded high-density electroencephalograms from 20 patients and 20 controls, and reconstructed the activity of 118 regions. We computed functional connectivity in windows free of interictal epileptiform discharges in broad, delta, theta, alpha, and beta frequency bands, characterized the network topology, and used the Hub Disruption Index (HDI) to quantify the topological reorganization. We examined the generalizability of our results by reproducing a 25-electrode clinical system. RESULTS: Our study did not reveal any significant change in whole-brain network topology among GGE patients. However, the HDI was significantly different between patients and controls in all frequency bands except alpha (p < .01, false discovery rate [FDR] corrected, d < -1), and accompanied by an increase in connectivity in the prefrontal regions and default mode network. This reorganization suggests that regions that are important in transferring the information in controls were less so in patients. Inversely, the crucial regions in patients are less so in controls. These findings were also found in delta and theta frequency bands when using 25 electrodes (p < .001, FDR corrected, d < -1). SIGNIFICANCE: In GGE patients, the overall network topology is similar to that of healthy controls but presents a balanced local topological reorganization. This reorganization causes the prefrontal areas and default mode network to be more integrated and segregated, which may explain executive impairment associated with GGE. Additionally, the reorganization distinguishes patients from controls even when using 25 electrodes, suggesting its potential use as a diagnostic tool.


Assuntos
Epilepsia Generalizada , Epilepsia , Adulto , Humanos , Rede Nervosa/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Eletroencefalografia/métodos , Mapeamento Encefálico , Epilepsia Generalizada/genética , Imageamento por Ressonância Magnética/métodos
12.
Epilepsia ; 65(3): 651-663, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38258618

RESUMO

OBJECTIVE: We aimed to assess the ability of semiautomated electric source imaging (ESI) from long-term video-electroencephalographic (EEG) monitoring (LTM) to determine the epileptogenicity of temporopolar encephaloceles (TEs) in patients with temporal lobe epilepsy. METHODS: We conducted a retrospective study involving 32 temporal lobe epilepsy patients with TEs as potentially epileptogenic lesions in structural magnetic resonance imaging scans. Findings were validated through invasive intracerebral stereo-EEG in six of 32 patients and postsurgical outcome after tailored resection of the TE in 17 of 32 patients. LTM (mean duration = 6 days) was performed using the 10/20 system with additional T1/T2 for all patients and sphenoidal electrodes in 23 of 32 patients. Semiautomated detection and clustering of interictal epileptiform discharges (IEDs) were carried out to create IED types. ESI was performed on the averages of the two most frequent IED types per patient, utilizing individual head models, and two independent inverse methods (sLORETA [standardized low-resolution brain electromagnetic tomography], MUSIC [multiple signal classification]). ESI maxima concordance and propagation in spatial relation to TEs were quantified for sources with good signal quality (signal-to-noise ratio > 2, explained signal > 60%). RESULTS: ESI maxima correctly colocalized with a TE in 20 of 32 patients (62.5%) either at the onset or half-rising flank of at least one IED type per patient. ESI maxima showed propagation from the temporal pole to other temporal or extratemporal regions in 14 of 32 patients (44%), confirming propagation originating in the area of the TE. The findings from both inverse methods validated each other in 14 of 20 patients (70%), and sphenoidal electrodes exhibited the highest signal amplitudes in 17 of 23 patients (74%). The concordance of ESI with the TE predicted a seizure-free postsurgical outcome (Engel I vs. >I) with a diagnostic odds ratio of 2.1. SIGNIFICANCE: Semiautomated ESI from LTM often successfully identifies the epileptogenicity of TEs and the IED onset zone within the area of the TEs. Additionally, it shows potential predictive power for postsurgical outcomes in these patients.


Assuntos
Epilepsia do Lobo Temporal , Humanos , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/cirurgia , Eletroencefalografia/métodos , Encefalocele/complicações , Encefalocele/diagnóstico por imagem , Estudos Retrospectivos , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/cirurgia , Imageamento por Ressonância Magnética
13.
Brain Topogr ; 37(3): 447-460, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37615798

RESUMO

The aim of this study was to provide preliminary evidence on temporal dynamics of resting-state brain networks in youth with anorexia nervosa (AN) using electroencephalography (EEG). Resting-state EEG data were collected in 18 young women with AN and 18 healthy controls (HC). Between-group differences in brain networks were assessed using microstates analyses. Five microstates were identified across all subjects (A, B, C, D, E). Using a single set of maps representative of the whole dataset, group differences were identified for microstates A, C, and E. A common-for-all template revealed a relatively high degree of consistency in results for reduced time coverage of microstate C, but also an increased presence of microstate class E. AN and HC had different microstate transition probabilities, largely involving microstate A. Using LORETA, for microstate D, we found that those with AN had augmented activations in the left frontal inferior operculum, left insula, and bilateral paracentral lobule, compared with HC. For microstate E, AN had augmented activations in the para-hippocampal gyrus, caudate, pallidum, cerebellum, and cerebellar vermis. Our findings suggest altered microstates in young women with AN associated with integration of sensory and bodily signals, monitoring of internal/external mental states, and self-referential processes. Future research should examine how EEG-derived microstates could be applied to develop diagnostic and prognostic models of AN.


Assuntos
Anorexia Nervosa , Adolescente , Humanos , Feminino , Eletroencefalografia , Encéfalo , Mapeamento Encefálico/métodos , Cerebelo
14.
Brain Topogr ; 37(1): 88-101, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37737957

RESUMO

INTRODUCTION: Literature lacks studies investigating the cortical generation of sleep spindles in drug-resistant epilepsy (DRE) and how they evolve after resection of the epileptogenic zone (EZ). Here, we examined sleep EEGs of children with focal DRE who became seizure-free after focal epilepsy surgery, and aimed to investigate the changes in the spindle generation before and after the surgery using low-density scalp EEG and electrical source imaging (ESI). METHODS: We analyzed N2-sleep EEGs from 19 children with DRE before and after surgery. We identified slow (8-12 Hz) and fast spindles (13-16 Hz), computed their spectral features and cortical generators through ESI and computed their distance from the EZ and irritative zone (IZ). We performed two-way ANOVA testing the effect of spindle type (slow vs. fast) and surgical phase (pre-surgery vs. post-surgery) on each feature. RESULTS: Power, frequency and cortical activation of slow spindles increased after surgery (p < 0.005), while this was not seen for fast spindles. Before surgery, the cortical generators of slow spindles were closer to the EZ (57.3 vs. 66.2 mm, p = 0.007) and IZ (41.3 vs. 55.5 mm, p = 0.02) than fast spindle generators. CONCLUSIONS: Our data indicate alterations in the EEG slow spindles after resective epilepsy surgery. Fast spindle generation on the contrary did not change after surgery. Although the study is limited by its retrospective nature, lack of healthy controls, and reduced cortical spatial sampling, our findings suggest a spatial relationship between the slow spindles and the epileptogenic generators.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsias Parciais , Epilepsia , Criança , Humanos , Estudos Retrospectivos , Epilepsia/diagnóstico por imagem , Epilepsia/cirurgia , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/cirurgia , Sono/fisiologia , Eletroencefalografia/métodos
15.
J Neurosurg ; 140(3): 880-891, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37877975

RESUMO

OBJECTIVE: The objective of this study was to ascertain specific patterns of electrical source imaging (ESI) that are associated with a good surgical outcome (no seizure recurrence) using 256-channel high-density (HD) electroencephalography (EEG) in patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) who underwent temporal lobectomy. METHODS: Adult patients (age ≥ 18 years) were prospectively recruited from September 2016 to May 2020 at the authors' center. All patients underwent phase I presurgical evaluation and were subsequently advised to proceed with surgery based on consensus from a multidisciplinary epilepsy conference, without knowing HD-ESI results. All recruited patients were followed for at least 12 months after surgery. The outcome of interest was a status of no seizure recurrence, which was assessed at the end of the study. The association between ESI patterns and outcome was assessed using the chi-square or Fisher exact test. Associated p values as well as odds ratios and 95% CIs were reported. The diagnostic performance of the significant pattern associated with the outcome was also evaluated. RESULTS: Fifty-eight patients with known predictors for either good or worse surgical outcomes were recruited. The mean postoperative follow-up period was 33.34 (SD 13.88) months. Forty-seven patients had sufficient interictal epileptiform discharges for HD-ESI analysis. Thirteen of these 47 patients experienced seizure recurrence. The most common source localizations were at Brodmann area (BA) 20 (inferior temporal area) and BA 21 (middle temporal area). A specific ESI pattern of BA 21 without extratemporal sources was significantly associated with no seizure recurrence (p = 0.047). This pattern had a high positive predictive value of 100% and false-positive rate of 0% associated with no seizure recurrence following the surgery. CONCLUSIONS: A specific ESI pattern that was highly associated with no seizure recurrence following surgery was demonstrated by a 256-channel HD-EEG. If this pattern can be reproducibly proven in further studies, some TLE-HS patients may be able to proceed with surgery without further investigations.


Assuntos
Epilepsia do Lobo Temporal , Hemisferectomia , Esclerose Hipocampal , Adulto , Humanos , Adolescente , Diagnóstico por Imagem , Craniotomia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/cirurgia , Convulsões
16.
Neuroimage ; 285: 120490, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38103624

RESUMO

Identifying the location, the spatial extent and the electrical activity of distributed brain sources in the context of epilepsy through ElectroEncephaloGraphy (EEG) recordings is a challenging task because of the highly ill-posed nature of the underlying Electrophysiological Source Imaging (ESI) problem. To guarantee a unique solution, most existing ESI methods pay more attention to solve this inverse problem by imposing physiological constraints. This paper proposes an efficient ESI approach based on simulation-driven deep learning. Epileptic High-resolution 256-channels scalp EEG (Hr-EEG) signals are simulated in a realistic manner to train the proposed patient-specific model. More particularly, a computational neural mass model developed in our team is used to generate the temporal dynamics of the activity of each dipole while the forward problem is solved using a patient-specific three-shell realistic head model and the boundary element method. A Temporal Convolutional Network (TCN) is considered in the proposed model to capture local spatial patterns. To enable the model to observe the EEG signals from different scale levels, the multi-scale strategy is leveraged to capture the overall features and fine-grain features by adjusting the convolutional kernel size. Then, the Long Short-Term Memory (LSTM) is used to extract temporal dependencies among the computed spatial features. The performance of the proposed method is evaluated through three different scenarios of realistic synthetic interictal Hr-EEG data as well as on real interictal Hr-EEG data acquired in three patients with drug-resistant partial epilepsy, during their presurgical evaluation. A performance comparison study is also conducted with two other deep learning-based methods and four classical ESI techniques. The proposed model achieved a Dipole Localization Error (DLE) of 1.39 and Normalized Hamming Distance (NHD) of 0.28 in the case of one patch with SNR of 10 dB. In the case of two uncorrelated patches with an SNR of 10 dB, obtained DLE and NHD were respectively 1.50 and 0.28. Even in the more challenging scenario of two correlated patches with an SNR of 10 dB, the proposed approach still achieved a DLE of 3.74 and an NHD of 0.43. The results obtained on simulated data demonstrate that the proposed method outperforms the existing methods for different signal-to-noise and source configurations. The good behavior of the proposed method is also confirmed on real interictal EEG data. The robustness with respect to noise makes it a promising and alternative tool to localize epileptic brain areas and to reconstruct their electrical activities from EEG signals.


Assuntos
Aprendizado Profundo , Epilepsia Resistente a Medicamentos , Epilepsia , Humanos , Encéfalo/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Eletroencefalografia/métodos , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Mapeamento Encefálico/métodos
17.
J Neural Eng ; 20(6)2023 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-38055968

RESUMO

Objective.Electroencephalography source imaging (ESI) is a valuable tool in clinical evaluation for epilepsy patients but is underutilized in part due to sensitivity to anatomical modeling errors. Accurate localization of scalp electrodes is instrumental to ESI, but existing localization devices are expensive and not portable. As a result, electrode localization challenges further impede access to ESI, particularly in inpatient and intensive care settings.Approach.To address this challenge, we present a portable and affordable electrode digitization method using the 3D scanning feature in modern iPhone models. This technique combines iPhone scanning with semi-automated image processing using point-cloud electrode selection (PC-ES), a custom MATLAB desktop application. We compare iPhone electrode localization to state-of-the-art photogrammetry technology in a human study with over 6000 electrodes labeled using each method. We also characterize the performance of PC-ES with respect to head location and examine the relative impact of different algorithm parameters.Main Results.The median electrode position variation across reviewers was 1.50 mm for PC-ES scanning and 0.53 mm for photogrammetry, and the average median distance between PC-ES and photogrammetry electrodes was 3.4 mm. These metrics demonstrate comparable performance of iPhone/PC-ES scanning to currently available technology and sufficient accuracy for ESI.Significance.Low cost, portable electrode localization using iPhone scanning removes barriers to ESI in inpatient, outpatient, and remote care settings. While PC-ES has current limitations in user bias and processing time, we anticipate these will improve with software automation techniques as well as future developments in iPhone 3D scanning technology.


Assuntos
Eletroencefalografia , Epilepsia , Humanos , Eletroencefalografia/métodos , Eletrodos , Couro Cabeludo , Software , Imageamento por Ressonância Magnética/métodos
18.
Seizure ; 113: 41-47, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37976800

RESUMO

PURPOSE: Study assessed the role of MSI in predicting the post-operative seizure outcome. METHODS: This retrospective study included patients who underwent MEG and epilepsy surgery and had a minimum 6 months of postoperative follow-up. Concordance of MEG cluster with post-surgical resection cavity was classified as follows Class I) Concordant and region-specific, Class II) Concordant and region non-specific, Class III) Concordant lateralization only and Class IV) Discordant lateralization. The relationship between MSI concordance and post-operative seizure outcome was assessed. RESULTS: A total of 183 patients (M: F = 109:74) were included. The mean age at onset of seizures: 8.0 ± 6.4 years. The dipoles were frequent in 123(67.2 %). The primary cluster orientation was regular in 59 (32.2 %) and mixed in 124 (67.8 %) patients. Concordance between MEG and resection cavity: Class I - 124 (67.8 %), class II- 30 (16.4 %), class III- 23 (12.6 %), and class IV- 6 (3.3 %). The post-surgically mean duration of follow-up was 19.52 ± 11.27 months. At 6-month follow-up period, 144 (78.7 %) patients had complete seizure freedom out of which 106 (73.6 %) had class I concordance. Concordance of MEG with resection cavity was associated with a good outcome at 6 months (p = 0.001), 1 year (p = 0.001), 2 years (p = 0.0005) and 5 years (p = 0.04). MEG cluster characteristics had no association with seizure outcome except the strength of the cluster and outcome at 3 years (p = 0.02) follow-up. CONCLUSION: The study supports that the complete resection of the MEG cluster had high chance of seizure-freedom and can be used as a complementary noninvasive presurgical evaluation tool.


Assuntos
Eletroencefalografia , Magnetoencefalografia , Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Estudos Retrospectivos , Resultado do Tratamento , Convulsões/diagnóstico , Convulsões/cirurgia , Imageamento por Ressonância Magnética
19.
Int J Neurosci ; : 1-13, 2023 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-37824719

RESUMO

OBJECTIVES: This study aimed to localise the eloquent cortex and measure evoked field (EF) parameters using magnetoencephalography in patients with epilepsy and tumours near the eloquent cortex. METHODS: A total of 41 patients (26 with drug-refractory epilepsy and 15 with tumours), with a mean age of 33 years, were recruited. Visual evoked field (VEF), auditory evoked field (AEF), sensory evoked field (SSEF), and motor-evoked field (MEF) latencies, amplitudes, and localisation were compared with those of a control population. Subgroup analyses were performed based on lobar involvement. Evoked Field parameters on the affected side were compared with those on the opposite side. The effect of distance from the lesion on nearby and distant evoked fields was evaluated. RESULTS: AEF and VEF amplitudes and latencies were reduced bilaterally (p < 0.05). Amplitude in the ipsilateral SSEF was reduced by 29.27% and 2.16% in the AEF group compared to the contralateral side (p = 0.02). In patients with temporal lobe lesions, the SSEF amplitude was reduced bilaterally (p < 0.02), and latency was prolonged compared with controls. The MEF amplitude was reduced and latency was prolonged in patients with frontal lobe lesions (p = 0.01). EF displacement was 32%, 57%, 21%, and 16% for AEF, MEF, VEF, and SSEF respectively. Patients in the epilepsy group had distant EF abnormalities. CONCLUSIONS: EF amplitude was reduced and latency was prolonged in the involved hemisphere. Distant EF amplitudes were more affected than latencies in epilepsy. Amplitude and distance from the lesion had negative correlation for all EF. EF changes indicated eloquent cortical displacement which may not be apparent on MRI.

20.
Clin Neurophysiol ; 156: 4-13, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37832322

RESUMO

OBJECTIVE: To determine the effect of inverse methods and timepoints of interictal epileptic discharges (IEDs) used for high-density electric source imaging (hd-ESI) in pharmacoresistant focal epilepsies. METHODS: We retrospectively evaluated the hd-ESI and [18F]fluorodeoxyglucose positron emission tomography (18FDG-PET) of 21 operated patients with pharmacoresistant focal epilepsy (Engel I). Volumetric hd-ESI was performed with three different inverse methods such as the inverse solution linearly constrained minimum variance (LCMV, a beamformer method), standardized low resolution electromagnetic tomography (sLORETA) and weighted minimum-norm estimation (wMNE) and at different IED phases. Hd-ESI accuracy was determined by volumetric overlap and distance between hd-ESI source maximum, as well as 18FDG-PET hypometabolic region relative to the resection zone (RZ). RESULTS: In our cohort, the shortest distances and greatest volumetric overlaps to the RZ were found in the half-rise and peak-phase for all inverse methods. The distance to the RZ was not different between the centroid of the clinical hypothesis-based cluster and the source maximum in peak-phase. However, the distance of the hypothesis-based cluster was significantly shorter compared to the cluster selected by the smallest p-value. CONCLUSIONS: Hd-ESI provides the greatest accuracy in determining the RZ at the IED half-rise and peak-phase for all applied inverse methods, whereby sLORETA and LCMV were equally accurate. SIGNIFICANCE: Our results offer guidance in selecting inverse methods and IED phases for hd-ESI, compare the performance of hd-ESI and 18FDG-PET and encourage future studies in investigating the relationship between interictal ESI and 18FDG-PET hypometabolism.


Assuntos
Epilepsias Parciais , Epilepsia , Humanos , Eletroencefalografia/métodos , Imageamento por Ressonância Magnética/métodos , Estudos Retrospectivos , Fluordesoxiglucose F18 , Epilepsia/cirurgia
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