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Zanello M, Garnier E, Carron R, Jegou A, Lagarde S, Makhalova J, Medina S, Bénar CG, Bartolomei F, Pizzo F. Stereo-EEG-based ictal functional connectivity in patients with periventricular nodular heterotopia-related epilepsy. Epilepsia 2024; 65:e47-e54. [PMID: 38345420 DOI: 10.1111/epi.17891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 04/16/2024]
Abstract
Nodular heterotopia (NH)-related drug-resistant epilepsy is challenging due to the deep location of the NH and the complexity of the underlying epileptogenic network. Using ictal stereo-electroencephalography (SEEG) and functional connectivity (FC) analyses in 14 patients with NH-related drug-resistant epilepsy, we aimed to determine the leading structure during seizures. For this purpose, we compared node IN and OUT strength between bipolar channels inside the heterotopia and inside gray matter, at the group level and at the individual level. At seizure onset, the channels within NH belonging to the epileptogenic and/or propagation network showed higher node OUT-strength than the channels within the gray matter (p = .03), with higher node OUT-strength than node IN-strength (p = .03). These results are in favor of a "leading" role of NH during seizure onset when involved in the epileptogenic- or propagation-zone network (50% of patients). However, when looking at the individual level, no significant difference between NH and gray matter was found, except for one patient (in two of three seizures). This result confirms the heterogeneity and the complexity of the epileptogenic network organization in NH and the need for SEEG exploration to characterize more precisely patient-specific epileptogenic network organization.
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Affiliation(s)
- Marc Zanello
- Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, IMA-BRAIN, Université Paris Cité, Paris, France
| | - Elodie Garnier
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Romain Carron
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Stereotactic and Functional Neurosurgery, Marseille, France
| | - Aude Jegou
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Stanislas Lagarde
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Julia Makhalova
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
- APHM La Timone, CEMEREM, Marseille, France
| | - Samuel Medina
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Christian-G Bénar
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Fabrice Bartolomei
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Francesca Pizzo
- INSERM, INS, Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
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