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Voets NL, Bartsch AJ, Plaha P. Functional MRI applications for intra-axial brain tumours: uses and nuances in surgical practise. Br J Neurosurg 2023; 37:1544-1559. [PMID: 36148501 DOI: 10.1080/02688697.2022.2123893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/07/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Functional MRI (fMRI) has well-established uses to inform risks and plan maximally safe approaches in neurosurgery. In the field of brain tumour surgery, however, fMRI is currently in a state of clinical equipoise due to debate around both its sensitivity and specificity. MATERIALS AND METHODS In this review, we summarise the role and our experience of fMRI in neurosurgery for gliomas and metastases. We discuss nuances in the conduct and interpretation of fMRI that, based on our practise, most directly impact fMRI's usefulness in the neurosurgical setting. RESULTS Illustrated examples in which fMRI in our hands directly influences the neurosurgical treatment of brain tumours include evaluating the probability and nature of functional risks, especially for language functions. These presurgical risk assessments, in turn, help to predict the resectability of tumours, select or deselect patients for awake surgery, indicate the need for neurophysiological monitoring and guide the optimal use of intra-operative stimulation mapping. A further emerging application of fMRI is in measuring functional adaptation of functional networks after (partial) surgery, of potential use in the timing of further surgery. CONCLUSIONS In appropriately selected patients with a clearly defined surgical question, fMRI offers a valuable complementary tool in the pre-surgical evaluation of brain tumours. However, there is a great need for standards in the administration and analysis of fMRI as much as in the techniques that it is commonly evaluated against. Surprisingly little data exists that evaluates the accuracy of fMRI not just against complementary methods, but in terms of its ultimate clinical aim of minimising post-surgical morbidity.
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Affiliation(s)
- Natalie L Voets
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- GenesisCare Ltd, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Andreas J Bartsch
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Puneet Plaha
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Neurosurgery, University of Oxford, Oxford, UK
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2
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Shurtleff HA, Poliakov A, Barry D, Wright JN, Warner MH, Novotny EJ, Marashly A, Buckley R, Goldstein HE, Hauptman JS, Ojemann JG, Shaw DWW. A clinically applicable functional MRI memory paradigm for use with pediatric patients. Epilepsy Behav 2022; 126:108461. [PMID: 34896785 DOI: 10.1016/j.yebeh.2021.108461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Clinically employable functional MRI (fMRI) memory paradigms are not yet established for pediatric patient epilepsy surgery workups. Seeking to establish such a paradigm, we evaluated the effectiveness of memory fMRI tasks we developed by quantifying individual activation in a clinical pediatric setting, analyzing patterns of activation relative to the side of temporal lobe (TL) pathology, and comparing fMRI and Wada test results. METHODS We retrospectively identified 72 patients aged 6.7-20.9 years with pathology (seizure focus and/or tumor) limited to the TL who had attempted memory and language fMRI tasks over a 9-year period as part of presurgical workups. Memory fMRI tasks required visualization of autobiographical memories in a block design alternating with covert counting. Language fMRI protocols involved verb and sentence generation. Scans were both qualitatively interpreted and quantitatively assessed for blood oxygenation level dependent (BOLD) signal change using region of interest (ROI) masks. We calculated the percentage of successfully scanned individual cases, compared 2 memory task activation masks in cases with left versus right TL pathology, and compared fMRI with Wada tests when available. Patients who had viable fMRI and Wada tests had generally concordant results. RESULTS Of the 72 cases, 60 (83%), aged 7.6-20.9 years, successfully performed the memory fMRI tasks and 12 (17%) failed. Eleven of 12 unsuccessful scans were due to motion and/or inability to perform the tasks, and the success of a twelfth was indeterminate due to orthodontic metal artifact. Seven of the successful 60 cases had distorted anatomy that precluded employing predetermined masks for quantitative analysis. Successful fMRI memory studies showed bilateral mesial temporal activation and quantitatively demonstrated: (1) left activation (L-ACT) less than right activation (R-ACT) in cases with left temporal lobe (L-TL) pathology, (2) nonsignificant R-ACT less than L-ACT in cases with right temporal lobe (R-TL) pathology, and (3) lower L-ACT plus R-ACT activation for cases with L-TL versus R-TL pathology. Patients who had viable fMRI and Wada tests had generally concordant results. SIGNIFICANCE This study demonstrates evidence of an fMRI memory task paradigm that elicits reliable activation at the individual level and can generally be accomplished in clinically involved pediatric patients. This autobiographical memory paradigm showed activation in mesial TL structures, and cases with left compared to right TL pathology showed differences in activation consistent with extant literature in TL epilepsy. Further studies will be required to assess outcome prediction.
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Affiliation(s)
- Hillary A Shurtleff
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States.
| | | | - Dwight Barry
- Clinical Analytics, Seattle Children's Hospital, United States
| | - Jason N Wright
- Radiology, Seattle Children's Hospital, United States; Department of Radiology, University of Washington School of Medicine, United States
| | - Molly H Warner
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States
| | - Edward J Novotny
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Neurology, Seattle Children's Hospital, United States; Department of Neurology, University of Washington School of Medicine, United States
| | - Ahmad Marashly
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Neurology, Seattle Children's Hospital, United States; Department of Neurology, University of Washington School of Medicine, United States
| | - Robert Buckley
- Department of Neurological Surgery, University of Washington School of Medicine, United States
| | - Hannah E Goldstein
- Neurosciences Institute, Seattle Children's Hospital, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Jason S Hauptman
- Neurosciences Institute, Seattle Children's Hospital, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Jeffrey G Ojemann
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Dennis W W Shaw
- Radiology, Seattle Children's Hospital, United States; Department of Radiology, University of Washington School of Medicine, United States
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3
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Han Y, Tong X, Wang X, Teng F, Deng Q, Zhou J, Guan Y, Yan Z, Chen L, Luan G, Wang M. A concordance study determining language dominance between navigated transcranial magnetic stimulation and the Wada test in patients with drug-resistant epilepsy. Epilepsy Behav 2021; 117:107711. [PMID: 33636527 DOI: 10.1016/j.yebeh.2020.107711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It remains unclear whether transcranial magnetic stimulation (TMS) can replace the Wada test to determine language hemisphere dominance (HD). Using the Wada test as the gold standard, this study aimed to investigate the accuracy of navigated TMS (nTMS) in determining language HD. METHODS This study enrolled nine right-handed patients with drug-resistant epilepsy. We hypothesized that application of nTMS to language-related areas of the language-dominant hemisphere would induce positive manifestation of language dysfunction (LD). To test our hypothesis, the patients were instructed to perform a visual object-naming task while nTMS was applied to the anterior (e.g., Broca's area) and posterior (e.g., Wernicke's area) regions, which are closely related to language processing. The Wada test result was used as the gold standard, and the diagnostic value of nTMS was assessed using the Kappa consistency test. RESULTS The nTMS-induced LD positive rate for the bilateral anterior language areas (85.7%) was higher than that for the posterior language areas (57.1%). There was high consistency between nTMS stimulation of the left anterior and posterior language areas and the Wada test results for determining language HD. In contrast, the consistency of stimulation of the right anterior and posterior transfer sites was moderate (Kappa value = 0.545, P = 0.171) and low, respectively. For the latter, no statistical calculation was performed because stimulation of the right posterior speech area was negative in all patients compared with the Wada test results. CONCLUSIONS Our findings revealed that using nTMS to stimulate language-related left anterior and posterior areas could predict language HD with high accuracy. When the stimulation performance of these areas is positive, nTMS and the Wada test are equally accurate. Observing only negative performance may indicate that language HD has been transferred to the right side.
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Affiliation(s)
- Yixian Han
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xuezhi Tong
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xiongfei Wang
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Fei Teng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Qinqin Deng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Jian Zhou
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Yuguang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Zhaofen Yan
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Lingling Chen
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Guoming Luan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China; Beijing Key Laboratory of Epilepsy, Beijing 100093, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100093, China.
| | - Mengyang Wang
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China.
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Schiller K, Choudhri AF, Jones T, Holder C, Wheless JW, Narayana S. Concordance Between Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging (MRI) Derived Localization of Language in a Clinical Cohort. J Child Neurol 2020; 35:363-379. [PMID: 32122221 DOI: 10.1177/0883073820901415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)-derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI-derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI-derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters.
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Affiliation(s)
- Katherine Schiller
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Asim F Choudhri
- Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tamekia Jones
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Christen Holder
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - James W Wheless
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - Shalini Narayana
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Neurobiology and Anatomy, University of Tennessee Health Science Center, Memphis, TN, USA
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5
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Baumgartner C, Koren JP, Britto-Arias M, Zoche L, Pirker S. Presurgical epilepsy evaluation and epilepsy surgery. F1000Res 2019; 8. [PMID: 31700611 PMCID: PMC6820825 DOI: 10.12688/f1000research.17714.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2019] [Indexed: 12/21/2022] Open
Abstract
With a prevalence of 0.8 to 1.2%, epilepsy represents one of the most frequent chronic neurological disorders; 30 to 40% of patients suffer from drug-resistant epilepsy (that is, seizures cannot be controlled adequately with antiepileptic drugs). Epilepsy surgery represents a valuable treatment option for 10 to 50% of these patients. Epilepsy surgery aims to control seizures by resection of the epileptogenic tissue while avoiding neuropsychological and other neurological deficits by sparing essential brain areas. The most common histopathological findings in epilepsy surgery specimens are hippocampal sclerosis in adults and focal cortical dysplasia in children. Whereas presurgical evaluations and surgeries in patients with mesial temporal sclerosis and benign tumors recently decreased in most centers, non-lesional patients, patients requiring intracranial recordings, and neocortical resections increased. Recent developments in neurophysiological techniques (high-density electroencephalography [EEG], magnetoencephalography, electrical and magnetic source imaging, EEG-functional magnetic resonance imaging [EEG-fMRI], and recording of pathological high-frequency oscillations), structural magnetic resonance imaging (MRI) (ultra-high-field imaging at 7 Tesla, novel imaging acquisition protocols, and advanced image analysis [post-processing] techniques), functional imaging (positron emission tomography and single-photon emission computed tomography co-registered to MRI), and fMRI significantly improved non-invasive presurgical evaluation and have opened the option of epilepsy surgery to patients previously not considered surgical candidates. Technical improvements of resective surgery techniques facilitate successful and safe operations in highly delicate brain areas like the perisylvian area in operculoinsular epilepsy. Novel less-invasive surgical techniques include stereotactic radiosurgery, MR-guided laser interstitial thermal therapy, and stereotactic intracerebral EEG-guided radiofrequency thermocoagulation.
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Affiliation(s)
- Christoph Baumgartner
- Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.,Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Johannes P Koren
- Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.,Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Martha Britto-Arias
- Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.,Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Lea Zoche
- Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.,Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Susanne Pirker
- Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.,Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
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Hari R, Baillet S, Barnes G, Burgess R, Forss N, Gross J, Hämäläinen M, Jensen O, Kakigi R, Mauguière F, Nakasato N, Puce A, Romani GL, Schnitzler A, Taulu S. IFCN-endorsed practical guidelines for clinical magnetoencephalography (MEG). Clin Neurophysiol 2018; 129:1720-1747. [PMID: 29724661 PMCID: PMC6045462 DOI: 10.1016/j.clinph.2018.03.042] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/18/2018] [Accepted: 03/24/2018] [Indexed: 12/22/2022]
Abstract
Magnetoencephalography (MEG) records weak magnetic fields outside the human head and thereby provides millisecond-accurate information about neuronal currents supporting human brain function. MEG and electroencephalography (EEG) are closely related complementary methods and should be interpreted together whenever possible. This manuscript covers the basic physical and physiological principles of MEG and discusses the main aspects of state-of-the-art MEG data analysis. We provide guidelines for best practices of patient preparation, stimulus presentation, MEG data collection and analysis, as well as for MEG interpretation in routine clinical examinations. In 2017, about 200 whole-scalp MEG devices were in operation worldwide, many of them located in clinical environments. Yet, the established clinical indications for MEG examinations remain few, mainly restricted to the diagnostics of epilepsy and to preoperative functional evaluation of neurosurgical patients. We are confident that the extensive ongoing basic MEG research indicates potential for the evaluation of neurological and psychiatric syndromes, developmental disorders, and the integrity of cortical brain networks after stroke. Basic and clinical research is, thus, paving way for new clinical applications to be identified by an increasing number of practitioners of MEG.
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Affiliation(s)
- Riitta Hari
- Department of Art, Aalto University, Helsinki, Finland.
| | - Sylvain Baillet
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Gareth Barnes
- Wellcome Centre for Human Neuroimaging, University College of London, London, UK
| | - Richard Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nina Forss
- Clinical Neuroscience, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Joachim Gross
- Centre for Cognitive Neuroimaging, University of Glasgow, Glasgow, UK; Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Germany
| | - Matti Hämäläinen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA; NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ole Jensen
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Ryusuke Kakigi
- Department of Integrative Physiology, National Institute of Physiological Sciences, Okazaki, Japan
| | - François Mauguière
- Department of Functional Neurology and Epileptology, Neurological Hospital & University of Lyon, Lyon, France
| | | | - Aina Puce
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Gian-Luca Romani
- Department of Neuroscience, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Samu Taulu
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA; Department of Physics, University of Washington, Seattle, WA, USA
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7
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Kemp S, Prendergast G, Karapanagiotidis T, Baker G, Kelly TP, Patankar T, Keller SS. Concordance between the Wada test and neuroimaging lateralization: Influence of imaging modality (fMRI and MEG) and patient experience. Epilepsy Behav 2018; 78:155-160. [PMID: 29245083 DOI: 10.1016/j.yebeh.2017.09.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/26/2017] [Accepted: 09/28/2017] [Indexed: 11/24/2022]
Abstract
The Wada test remains the traditional test for lateralizing language and memory function prior to epilepsy surgery. Functional imaging, particularly functional MRI (fMRI), has made progress in the language domain, but less so in the memory domain. Magnetoencephalography (MEG) has received less research attention, but shows promise, particularly for language lateralization. We recruited a consecutive sample of 19 patients with epilepsy who had completed presurgical work-up, including the Wada test, and compared fMRI (memory) and MEG (language and memory) with Wada test results. The main research question was the concordance between Wada and these two imaging techniques as preepilepsy surgery investigations. We were also interested in the acceptability of the three techniques to patients. Concordance rates (N=16) were nonsignificant (Cohen's Kappa) between fMRI and Wada test (memory) and between MEG and Wada test (memory and language). The Wada test was a well-established protocol used at several epilepsy surgery centers in the UK. Patients generally found the Wada test an odd, but not aversive procedure. Sixteen (84%) patients who were scanned reported some level of obtundation in MEG. We present these discordant findings in support of the position that functional imaging and the Wada test are distinctive procedures, with little in the way of overlapping mechanisms, and that patient's experience should be taken into account when procedures are selected and offered to them.
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Affiliation(s)
- Steven Kemp
- Department of Clinical and Health Psychology, St James's University Hospital, Leeds, UK.
| | | | | | - Gus Baker
- University of Liverpool, UK/The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | | | - Simon S Keller
- University of Liverpool, UK/The Walton Centre NHS Foundation Trust, Liverpool, UK; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
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8
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van Vliet EA, Dedeurwaerdere S, Cole AJ, Friedman A, Koepp MJ, Potschka H, Immonen R, Pitkänen A, Federico P. WONOEP appraisal: Imaging biomarkers in epilepsy. Epilepsia 2016; 58:315-330. [PMID: 27883181 DOI: 10.1111/epi.13621] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 01/04/2023]
Abstract
Neuroimaging offers a wide range of opportunities to obtain information about neuronal activity, brain inflammation, blood-brain barrier alterations, and various molecular alterations during epileptogenesis or for the prediction of pharmacoresponsiveness as well as postoperative outcome. Imaging biomarkers were examined during the XIII Workshop on Neurobiology of Epilepsy (XIII WONOEP) organized in 2015 by the Neurobiology Commission of the International League Against Epilepsy (ILAE). Here we present an extended summary of the discussed issues and provide an overview of the current state of knowledge regarding the biomarker potential of different neuroimaging approaches for epilepsy.
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Affiliation(s)
- Erwin A van Vliet
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Andrew J Cole
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Alon Friedman
- Department of Brain and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilian-University, Munich, Germany
| | - Riikka Immonen
- Department of Neurobiology, A I Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Asla Pitkänen
- Department of Neurobiology, A I Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Paolo Federico
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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9
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Duncan JS, Winston GP, Koepp MJ, Ourselin S. Brain imaging in the assessment for epilepsy surgery. Lancet Neurol 2016; 15:420-33. [PMID: 26925532 DOI: 10.1016/s1474-4422(15)00383-x] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/22/2015] [Accepted: 12/02/2015] [Indexed: 01/14/2023]
Abstract
Brain imaging has a crucial role in the presurgical assessment of patients with epilepsy. Structural imaging reveals most cerebral lesions underlying focal epilepsy. Advances in MRI acquisitions including diffusion-weighted imaging, post-acquisition image processing techniques, and quantification of imaging data are increasing the accuracy of lesion detection. Functional MRI can be used to identify areas of the cortex that are essential for language, motor function, and memory, and tractography can reveal white matter tracts that are vital for these functions, thus reducing the risk of epilepsy surgery causing new morbidities. PET, SPECT, simultaneous EEG and functional MRI, and electrical and magnetic source imaging can be used to infer the localisation of epileptic foci and assist in the design of intracranial EEG recording strategies. Progress in semi-automated methods to register imaging data into a common space is enabling the creation of multimodal three-dimensional patient-specific datasets. These techniques show promise for the demonstration of the complex relations between normal and abnormal structural and functional data and could be used to direct precise intracranial navigation and surgery for individual patients.
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Affiliation(s)
- John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; National Hospital for Neurology and Neurosurgery, London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Gerrards Cross, UK.
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; National Hospital for Neurology and Neurosurgery, London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Gerrards Cross, UK
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; National Hospital for Neurology and Neurosurgery, London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Gerrards Cross, UK
| | - Sebastien Ourselin
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK; National Hospital for Neurology and Neurosurgery, London, UK
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10
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Beimer NJ, Buchtel HA, Glynn SM. One center's experience with complications during the Wada test. Epilepsia 2015; 56:e110-3. [DOI: 10.1111/epi.13046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nicholas J. Beimer
- Department of Neurology; University of Michigan; Ann Arbor Michigan U.S.A
| | - Henry A. Buchtel
- Department of Psychiatry; University of Michigan; Ann Arbor Michigan U.S.A
- Neuropsychology Section; VA Ann Arbor; Ann Arbor Michigan U.S.A
| | - Simon M. Glynn
- Department of Neurology; University of Michigan; Ann Arbor Michigan U.S.A
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