Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 12 de 12
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Clin Neurophysiol ; 129(11): 2403-2410, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30278389

RESUMO

OBJECTIVE: To evaluate the accuracy of automated EEG source imaging (ESI) in localizing epileptogenic zone. METHODS: Long-term EEG, recorded with the standard 25-electrode array of the IFCN, from 41 consecutive patients with focal epilepsy who underwent resective surgery, were analyzed blinded to the surgical outcome. The automated analysis comprised spike-detection, clustering and source imaging at the half-rising time and at the peak of each spike-cluster, using individual head-models with six tissue-layers and a distributed source model (sLORETA). The fully automated approach presented ESI of the cluster with the highest number of spikes, at the half-rising time. In addition, a physician involved in the presurgical evaluation of the patients, evaluated the automated ESI results (up to four clusters per patient) in clinical context and selected the dominant cluster and the analysis time-point (semi-automated approach). The reference standard was location of the resected area and outcome one year after operation. RESULTS: Accuracy was 61% (95% CI: 45-76%) for the fully automated approach and 78% (95% CI: 62-89%) for the semi-automated approach. CONCLUSION: Automated ESI has an accuracy similar to previously reported neuroimaging methods. SIGNIFICANCE: Automated ESI will contribute to increased utilization of source imaging in the presurgical evaluation of patients with epilepsy.


Assuntos
Automação/métodos , Eletroencefalografia/métodos , Epilepsia/diagnóstico , Adolescente , Adulto , Automação/normas , Criança , Eletroencefalografia/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade
2.
Neuroimage Clin ; 16: 689-698, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29034162

RESUMO

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.


Assuntos
Encéfalo/fisiopatologia , Epilepsia Resistente a Medicamentos/complicações , Eletroencefalografia/métodos , Convulsões/diagnóstico , Adolescente , Adulto , Criança , Epilepsia Resistente a Medicamentos/cirurgia , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Convulsões/complicações , Convulsões/cirurgia , Processamento de Sinais Assistido por Computador , Adulto Jovem
3.
Front Neurosci ; 11: 156, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28428738

RESUMO

Presurgical evaluation of brain neural activity is commonly carried out in refractory epilepsy patients to delineate as accurately as possible the seizure onset zone (SOZ) before epilepsy surgery. In practice, any subjective interpretation of electroencephalographic (EEG) recordings is hindered mainly because of the highly stochastic behavior of the epileptic activity. We propose a new method for dynamic source connectivity analysis that aims to accurately localize the seizure onset zones by explicitly including temporal, spectral, and spatial information of the brain neural activity extracted from EEG recordings. In particular, we encode the source nonstationarities in three critical stages of processing: Inverse problem solution, estimation of the time courses extracted from the regions of interest, and connectivity assessment. With the aim to correctly encode all temporal dynamics of the seizure-related neural network, a directed functional connectivity measure is employed to quantify the information flow variations over the time window of interest. Obtained results on simulated and real EEG data confirm that the proposed approach improves the accuracy of SOZ localization.

4.
Acta Neurol Belg ; 117(2): 477-491, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28214927

RESUMO

Auditory phoneme discrimination (APD) is supported by both auditory and motor regions through a sensorimotor interface embedded in a fronto-temporo-parietal cortical network. However, the specific spatiotemporal organization of this network during APD with respect to different types of phonemic contrasts is still unclear. Here, we use source reconstruction, applied to event-related potentials in a group of 47 participants, to uncover a potential spatiotemporal differentiation in these brain regions during a passive and active APD task with respect to place of articulation (PoA), voicing and manner of articulation (MoA). Results demonstrate that in an early stage (50-110 ms), auditory, motor and sensorimotor regions elicit more activation during the passive and active APD task with MoA and active APD task with voicing compared to PoA. In a later stage (130-175 ms), the same auditory and motor regions elicit more activation during the APD task with PoA compared to MoA and voicing, yet only in the active condition, implying important timing differences. Degree of attention influences a frontal network during the APD task with PoA, whereas auditory regions are more affected during the APD task with MoA and voicing. Based on these findings, it can be carefully suggested that APD is supported by the integration of early activation of auditory-acoustic properties in superior temporal regions, more perpetuated for MoA and voicing, and later auditory-to-motor integration in sensorimotor areas, more perpetuated for PoA.


Assuntos
Estimulação Acústica/métodos , Córtex Auditivo/fisiologia , Percepção Auditiva/fisiologia , Potenciais Evocados Auditivos/fisiologia , Córtex Sensório-Motor/fisiologia , Adulto , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor/fisiologia , Percepção da Fala/fisiologia , Fatores de Tempo
5.
Epilepsia Open ; 2(3): 322-333, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-29588961

RESUMO

Objective: We investigated the performance of automatic spike detection and subsequent electroencephalogram (EEG) source imaging to localize the epileptogenic zone (EZ) from long-term EEG recorded during video-EEG monitoring. Methods: In 32 patients, spikes were automatically detected in the EEG and clustered according to their morphology. The two spike clusters with most single events in each patient were averaged and localized in the brain at the half-rising time and peak of the spike using EEG source imaging. On the basis of the distance from the sources to the resection and the known patient outcome after surgery, the performance of the automated EEG analysis to localize the EZ was quantified. Results: In 28 out of the 32 patients, the automatically detected spike clusters corresponded with the reported interictal findings. The median distance to the resection in patients with Engel class I outcome was 6.5 and 15 mm for spike cluster 1 and 27 and 26 mm for cluster 2, at the peak and the half-rising time of the spike, respectively. Spike occurrence (cluster 1 vs. cluster 2) and spike timing (peak vs. half-rising) significantly influenced the distance to the resection (p < 0.05). For patients with Engel class II, III, and IV outcomes, the median distance increased to 36 and 36 mm for cluster 1. Localizing spike cluster 1 at the peak resulted in a sensitivity of 70% and specificity of 100%, positive prediction value (PPV) of 100%, and negative predictive value (NPV) of 53%. Including the results of spike cluster 2 led to an increased sensitivity of 79% NPV of 55% and diagnostic OR of 11.4, while the specificity dropped to 75% and the PPV to 90%. Significance: We showed that automated analysis of long-term EEG recordings results in a high sensitivity and specificity to localize the epileptogenic focus.

6.
Int J Neural Syst ; 27(4): 1650048, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27712133

RESUMO

The mechanism of action of vagus nerve stimulation (VNS) is yet to be elucidated. To that end, the effects of VNS on the brain of epileptic patients were studied. Both when VNS was switched "On" and "Off", the brain activity of responders (R, seizure frequency reduction of over 50%) was compared to the brain activity of nonresponders (NR, seizure frequency reduction of less than 50%). Using EEG recordings, a significant increase in P300 amplitude for R and a significant decrease in P300 amplitude for NR were found. We found biomarkers for checking the efficacy of VNS with accuracy up to 94%. The results show that P300 features recorded in nonmidline electrodes are better P300 biomarkers for VNS efficacy than P300 features recorded in midline electrodes. Using source localization and connectivity analyses, the activity of the limbic system, insula and orbitofrontal cortex was found to be dependent on VNS switched "On" versus "Off" or patient group (R versus NR). The results suggest an important role for these areas in the mechanism of action of VNS, although a larger patient study should be done to confirm the findings.


Assuntos
Encéfalo/diagnóstico por imagem , Eletroencefalografia , Epilepsia/diagnóstico por imagem , Epilepsia/terapia , Estimulação do Nervo Vago , Estimulação Acústica , Encéfalo/fisiopatologia , Potenciais Evocados Auditivos , Humanos , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Processamento de Sinais Assistido por Computador , Resultado do Tratamento , Nervo Vago/fisiopatologia , Estimulação do Nervo Vago/métodos , Gravação em Vídeo
7.
Brain Topogr ; 30(2): 257-271, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27853892

RESUMO

Epilepsy surgery is the most efficient treatment option for patients with refractory epilepsy. Before surgery, it is of utmost importance to accurately delineate the seizure onset zone (SOZ). Non-invasive EEG is the most used neuroimaging technique to diagnose epilepsy, but it is hard to localize the SOZ from EEG due to its low spatial resolution and because epilepsy is a network disease, with several brain regions becoming active during a seizure. In this work, we propose and validate an approach based on EEG source imaging (ESI) combined with functional connectivity analysis to overcome these problems. We considered both simulations and real data of patients. Ictal epochs of 204-channel EEG and subsets down to 32 channels were analyzed. ESI was done using realistic head models and LORETA was used as inverse technique. The connectivity pattern between the reconstructed sources was calculated, and the source with the highest number of outgoing connections was selected as SOZ. We compared this algorithm with a more straightforward approach, i.e. selecting the source with the highest power after ESI as the SOZ. We found that functional connectivity analysis estimated the SOZ consistently closer to the simulated EZ/RZ than localization based on maximal power. Performance, however, decreased when 128 electrodes or less were used, especially in the realistic data. The results show the added value of functional connectivity analysis for SOZ localization, when the EEG is obtained with a high-density setup. Next to this, the method can potentially be used as objective tool in clinical settings.


Assuntos
Encéfalo/fisiopatologia , Epilepsias Parciais/fisiopatologia , Convulsões/fisiopatologia , Adulto , Algoritmos , Eletrodos , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroimagem
8.
Brain Topogr ; 29(4): 572-89, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26936594

RESUMO

We investigated the influence of different skull modeling approaches on EEG source imaging (ESI), using data of six patients with refractory temporal lobe epilepsy who later underwent successful epilepsy surgery. Four realistic head models with different skull compartments, based on finite difference methods, were constructed for each patient: (i) Three models had skulls with compact and spongy bone compartments as well as air-filled cavities, segmented from either computed tomography (CT), magnetic resonance imaging (MRI) or a CT-template and (ii) one model included a MRI-based skull with a single compact bone compartment. In all patients we performed ESI of single and averaged spikes marked in the clinical 27-channel EEG by the epileptologist. To analyze at which time point the dipole estimations were closer to the resected zone, ESI was performed at two time instants: the half-rising phase and peak of the spike. The estimated sources for each model were validated against the resected area, as indicated by the postoperative MRI. Our results showed that single spike analysis was highly influenced by the signal-to-noise ratio (SNR), yielding estimations with smaller distances to the resected volume at the peak of the spike. Although averaging reduced the SNR effects, it did not always result in dipole estimations lying closer to the resection. The proposed skull modeling approaches did not lead to significant differences in the localization of the irritative zone from clinical EEG data with low spatial sampling density. Furthermore, we showed that a simple skull model (MRI-based) resulted in similar accuracy in dipole estimation compared to more complex head models (based on CT- or CT-template). Therefore, all the considered head models can be used in the presurgical evaluation of patients with temporal lobe epilepsy to localize the irritative zone from low-density clinical EEG recordings.


Assuntos
Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Modelos Anatômicos , Crânio/diagnóstico por imagem , Adulto , Epilepsia do Lobo Temporal/cirurgia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Razão Sinal-Ruído , Tomografia Computadorizada por Raios X
9.
Neuroimage Clin ; 11: 252-263, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26958464

RESUMO

Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP) approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i) an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii) an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii) an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time epochs were in the same range as the LORETA and ECD techniques. We found distances smaller than 23 mm, with robust results for all the patients. For the finite difference models, we found that the distances to the resection border for the MSVP inversions of the full spike time epochs were generally smaller compared to the MSVP inversions of the time epochs before the spike peak. The results also suggest that the inversions using the finite difference models resulted in slightly smaller distances to the resection border compared to the spherical models. The results we obtained are promising because the MSVP approach allows to study the network of the estimated source-intensities and allows to characterize the spatial extent of the underlying sources.


Assuntos
Mapeamento Encefálico , Ondas Encefálicas/fisiologia , Epilepsia/fisiopatologia , Adolescente , Adulto , Eletroencefalografia , Epilepsia/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Modelos Teóricos , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
10.
Neuroimage ; 100: 715-24, 2014 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-25014435

RESUMO

We revisit the multiple sparse priors (MSP) algorithm implemented in the statistical parametric mapping software (SPM) for distributed EEG source reconstruction (Friston et al., 2008). In the present implementation, multiple cortical patches are introduced as source priors based on a dipole source space restricted to a cortical surface mesh. In this note, we present a technique to construct volumetric cortical regions to introduce as source priors by restricting the dipole source space to a segmented gray matter layer and using a region growing approach. This extension allows to reconstruct brain structures besides the cortical surface and facilitates the use of more realistic volumetric head models including more layers, such as cerebrospinal fluid (CSF), compared to the standard 3-layered scalp-skull-brain head models. We illustrated the technique with ERP data and anatomical MR images in 12 subjects. Based on the segmented gray matter for each of the subjects, cortical regions were created and introduced as source priors for MSP-inversion assuming two types of head models. The standard 3-layered scalp-skull-brain head models and extended 4-layered head models including CSF. We compared these models with the current implementation by assessing the free energy corresponding with each of the reconstructions using Bayesian model selection for group studies. Strong evidence was found in favor of the volumetric MSP approach compared to the MSP approach based on cortical patches for both types of head models. Overall, the strongest evidence was found in favor of the volumetric MSP reconstructions based on the extended head models including CSF. These results were verified by comparing the reconstructed activity. The use of volumetric cortical regions as source priors is a useful complement to the present implementation as it allows to introduce more complex head models and volumetric source priors in future studies.


Assuntos
Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Eletroencefalografia/métodos , Adulto , Potenciais Evocados/fisiologia , Humanos , Imagem por Ressonância Magnética , Processamento de Sinais Assistido por Computador
11.
Neuroimage ; 93 Pt 1: 11-22, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24582919

RESUMO

Several EEG source reconstruction techniques have been proposed to identify the generating neuronal sources of electrical activity measured on the scalp. The solution of these techniques depends directly on the accuracy of the forward model that is inverted. Recently, a parametric empirical Bayesian (PEB) framework for distributed source reconstruction in EEG/MEG was introduced and implemented in the Statistical Parametric Mapping (SPM) software. The framework allows us to compare different forward modeling approaches, using real data, instead of using more traditional simulated data from an assumed true forward model. In the absence of a subject specific MR image, a 3-layered boundary element method (BEM) template head model is currently used including a scalp, skull and brain compartment. In this study, we introduced volumetric template head models based on the finite difference method (FDM). We constructed a FDM head model equivalent to the BEM model and an extended FDM model including CSF. These models were compared within the context of three different types of source priors related to the type of inversion used in the PEB framework: independent and identically distributed (IID) sources, equivalent to classical minimum norm approaches, coherence (COH) priors similar to methods such as LORETA, and multiple sparse priors (MSP). The resulting models were compared based on ERP data of 20 subjects using Bayesian model selection for group studies. The reconstructed activity was also compared with the findings of previous studies using functional magnetic resonance imaging. We found very strong evidence in favor of the extended FDM head model with CSF and assuming MSP. These results suggest that the use of realistic volumetric forward models can improve PEB EEG source reconstruction.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia/métodos , Modelos Neurológicos , Teorema de Bayes , Humanos
12.
Brain Topogr ; 27(1): 95-111, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24002699

RESUMO

Electroencephalographic source localization (ESL) relies on an accurate model representing the human head for the computation of the forward solution. In this head model, the skull is of utmost importance due to its complex geometry and low conductivity compared to the other tissues inside the head. We investigated the influence of using different skull modeling approaches on ESL. These approaches, consisting in skull conductivity and geometry modeling simplifications, make use of X-ray computed tomography (CT) and magnetic resonance (MR) images to generate seven different head models. A head model with an accurately segmented skull from CT images, including spongy and compact bone compartments as well as some air-filled cavities, was used as the reference model. EEG simulations were performed for a configuration of 32 and 128 electrodes, and for both noiseless and noisy data. The results show that skull geometry simplifications have a larger effect on ESL than those of the conductivity modeling. This suggests that accurate skull modeling is important in order to achieve reliable results for ESL that are useful in a clinical environment. We recommend the following guidelines to be taken into account for skull modeling in the generation of subject-specific head models: (i) If CT images are available, i.e., if the geometry of the skull and its different tissue types can be accurately segmented, the conductivity should be modeled as isotropic heterogeneous. The spongy bone might be segmented as an erosion of the compact bone; (ii) when only MR images are available, the skull base should be represented as accurately as possible and the conductivity can be modeled as isotropic heterogeneous, segmenting the spongy bone directly from the MR image; (iii) a large number of EEG electrodes should be used to obtain high spatial sampling, which reduces the localization errors at realistic noise levels.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia , Crânio/anatomia & histologia , Humanos , Imagem por Ressonância Magnética , Modelos Neurológicos , Tomografia Computadorizada por Raios X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA