1
|
Okamura A, Hashizume A, Kagawa K, Seyama G, Yoshino A, Yamawaki S, Horie N, Iida K. Magnetoencephalographic detection of synchronized epileptic activity between the hippocampus and insular cortex. Epilepsy Behav Rep 2024; 26:100669. [PMID: 38699062 PMCID: PMC11063376 DOI: 10.1016/j.ebr.2024.100669] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/05/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024] Open
Abstract
Most magnetoencephalographic signals are derived from synchronized activity in the brain surface cortex. By contrast, the contribution of synchronized activity in the deep brain to magnetoencephalography (MEG) has remained unclear. We compared stereotactic electroencephalography (sEEG) with simultaneous MEG findings in a patient with temporal lobe epilepsy to determine the conditions under which MEG could also detect sEEG findings. The synchrony and similarity of the waves were evaluated using visual inspection and wavelet coherence. A 45-year-old woman with intractable temporal lobe epilepsy underwent sEEG and MEG simultaneously to determine the laterality and precise location of the epileptic focus. When spike-and-waves were seen in the right hippocampal head alone, no distinct spike-and-waves were observed visually in the right temporal MEG. The seizure then spread to the right insula on sEEG with a rhythmic theta frequency while synchronous activity was observed in the right temporal MEG channels. When polyspikes appeared in the right hippocampus, the right temporal MEG showed electrical activity with relatively high similarity to that of the right hippocampal head and insular cortex but less similarity to that of the right lateral temporal lobe cortex. MEG might detect epileptic activity synchronized between the hippocampus and insular cortex.
Collapse
Affiliation(s)
- Akitake Okamura
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Hashizume
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kota Kagawa
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Go Seyama
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Center for Brain, Mind and KANSEI Science Research, Hiroshima University, Hiroshima, Japan
| | - Shigeto Yamawaki
- Center for Brain, Mind and KANSEI Science Research, Hiroshima University, Hiroshima, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koji Iida
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
2
|
Mikutta CA, Knight RT, Sammler D, Müller TJ, Koenig T. Electrocorticographic Activation Patterns of Electroencephalographic Microstates. Brain Topogr 2024; 37:287-295. [PMID: 36939988 PMCID: PMC10884069 DOI: 10.1007/s10548-023-00952-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/27/2022] [Accepted: 02/26/2023] [Indexed: 03/21/2023]
Abstract
Electroencephalography (EEG) microstates are short successive periods of stable scalp field potentials representing spontaneous activation of brain resting-state networks. EEG microstates are assumed to mediate local activity patterns. To test this hypothesis, we correlated momentary global EEG microstate dynamics with the local temporo-spectral evolution of electrocorticography (ECoG) and stereotactic EEG (SEEG) depth electrode recordings. We hypothesized that these correlations involve the gamma band. We also hypothesized that the anatomical locations of these correlations would converge with those of previous studies using either combined functional magnetic resonance imaging (fMRI)-EEG or EEG source localization. We analyzed resting-state data (5 min) of simultaneous noninvasive scalp EEG and invasive ECoG and SEEG recordings of two participants. Data were recorded during the presurgical evaluation of pharmacoresistant epilepsy using subdural and intracranial electrodes. After standard preprocessing, we fitted a set of normative microstate template maps to the scalp EEG data. Using covariance mapping with EEG microstate timelines and ECoG/SEEG temporo-spectral evolutions as inputs, we identified systematic changes in the activation of ECoG/SEEG local field potentials in different frequency bands (theta, alpha, beta, and high-gamma) based on the presence of particular microstate classes. We found significant covariation of ECoG/SEEG spectral amplitudes with microstate timelines in all four frequency bands (p = 0.001, permutation test). The covariance patterns of the ECoG/SEEG electrodes during the different microstates of both participants were similar. To our knowledge, this is the first study to demonstrate distinct activation/deactivation patterns of frequency-domain ECoG local field potentials associated with simultaneous EEG microstates.
Collapse
Affiliation(s)
- Christian A Mikutta
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Private Clinic Meiringen, Meiringen, Switzerland
- Interdisciplinary Biosciences Doctoral Training Partnership, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Robert T Knight
- Helen Wills Neuroscience Institute, University of California-Berkeley, 132 Barker Hall, 94720, Berkeley, CA, USA
| | - Daniela Sammler
- Research Group Neurocognition of Music and Language, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Thomas J Müller
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Private Clinic Meiringen, Meiringen, Switzerland
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| |
Collapse
|
3
|
Jedynak M, Boyer A, Mercier M, Chanteloup-Forêt B, Bhattacharjee M, Kahane P, David O. SEEG electrode shaft affects amplitude and latency of potentials evoked with single pulse electrical stimulation. J Neurosci Methods 2024; 403:110035. [PMID: 38128785 DOI: 10.1016/j.jneumeth.2023.110035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Long and thin shaft electrodes are implanted intracerebrally for stereoelectroencephalography (SEEG) in patients with pharmacoresistant focal epilepsies. Two adjacent contacts of one of such electrodes can deliver a train of single pulse electrical stimulations (SPES), and evoked potentials (EPs) are recorded on other contacts. In this study we assess if stimulating and recording on the same shaft, as opposed to different shafts, has an impact on common EP features. NEW METHOD We leverage the large volume of SEEG data gathered in the F-TRACT database and analyze data from nearly one thousand SEEG implantations in order to verify whether stimulation and recording from the same shaft influence the EP pattern. RESULTS We found that when the stimulated and the recording contacts were located on the same shaft, the mean and median amplitudes of an EP are greater, and its mean and median latencies are smaller than when the contacts were located on different shafts. This effect is small (Cohen's d ∼ 0.1), but robust (p-value < 10-3) across the SEEG database. COMPARISON WITH EXISTING METHOD(S) Our study is the first one to address this question. Due to the choice of commonly used EP features, our method is congruent with other studies. CONCLUSIONS The magnitude of the reported effect does not obligate all standard analyses to correct for it, unless they aim at high precision. The source of the effect is not clear. Manufacturers of SEEG electrodes could examine it and potentially minimize the effect in their future products.
Collapse
Affiliation(s)
- Maciej Jedynak
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Anthony Boyer
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Manuel Mercier
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | | | - Manik Bhattacharjee
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France; Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Philippe Kahane
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Neurology Department, CHU Grenoble Alpes, Grenoble, France
| | - Olivier David
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| |
Collapse
|
4
|
Mutoh M, Maesawa S, Nakatsubo D, Ishizaki T, Tanei T, Torii J, Ito Y, Hashida M, Saito R. Boltless nylon-suture technique for stereotactic electroencephalography as a safe, effective alternative when the anchor bolt is inappropriate. Acta Neurochir (Wien) 2024; 166:18. [PMID: 38231293 DOI: 10.1007/s00701-024-05889-3] [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: 09/01/2023] [Accepted: 11/23/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND The use of anchor bolts to secure electrodes to the skull can be difficult in some clinical situations. Herein, we present the boltless technique to secure electrodes to the scalp using nylon sutures to overcome the problems associated with anchor bolts. We investigated the safety, accuracy errors, and patient-related and operative factors affecting errors in the boltless technique. METHODS This single-institution retrospective series analyzed 103 electrodes placed in 12 patients. The target-point localization error (TPLE), entry-point localization error (EPLE), radial error (RE), and depth error (DE) of the electrodes were calculated. RESULTS The median of the mean operative time per electrode was 9.3 min. The median TPLE, EPLE, RE, and absolute DE value were 4.1 mm, 1.6 mm, 2.7 mm, and 1.9 mm, respectively. Positive correlations were observed between the preoperative scalp thickness, mean operative time per electrode, EPLE, RE, and the absolute value of DE versus TPLE (r = .228, p = .02; r = .678, p = .015; r = .228, p = .02; r = .445, p < .01; r = .630, p < .01, respectively), and electrode approach angle versus EPLE (r = .213, p = .031). Multivariate analysis revealed that the absolute value of DE had the strongest influence on the TPLE, followed by RE and preoperative scalp thickness, respectively (β = .938, .544, .060, respectively, p < .001). No complications related to SEEG insertion and monitoring were encountered. CONCLUSION The boltless technique using our unique planning and technical method is a safe, effective, and low-cost alternative in cases where anchor bolts are contraindicated.
Collapse
Affiliation(s)
- Manabu Mutoh
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Satoshi Maesawa
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan.
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan.
| | - Daisuke Nakatsubo
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
- Focused Ultrasound Therapy Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Tomotaka Ishizaki
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Takafumi Tanei
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Jun Torii
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Yoshiki Ito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Miki Hashida
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 4668650, Japan
| |
Collapse
|
5
|
Buch VP, Parvizi J. Evolution of SEEG Strategy: Stanford Experience. Neurosurg Clin N Am 2024; 35:83-85. [PMID: 38000844 DOI: 10.1016/j.nec.2023.08.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Overall stereoelectroencephalography (SEEG) has a favorable risk profile, patient tolerability, and superior investigative capability of individualized 3-dimensional seizure onset activity over subdural electrodes. Further, our recent surgical approach to safely enable multinuclear thalamic propagation mapping can only be performed with SEEG. For these reasons, SEEG has become the gold standard of phase II monitoring at our institution, and believe the ability to develop precision network-centric approaches to therapy will be critical to enhance our ability to care for medically refractory, and importantly, even complex multifocal, generalized, or surgically refractory epilepsy patients.
Collapse
Affiliation(s)
- Vivek P Buch
- Stanford University, 453 Quarry Road Room 245C, Palo Alto, CA 94304, USA.
| | - Josef Parvizi
- Stanford University, 213 Quarry Road MC 5957 Fl 2, Palo Alto, CA 94304, USA
| |
Collapse
|
6
|
Feng T, Yang Y, Wei P, Wang C, Fan X, Wang K, Zhang H, Shan Y, Zhao G. The role of the orbitofrontal cortex and insula for prognosis of mesial temporal lobe epilepsy. Epilepsy Behav 2023; 138:109003. [PMID: 36470059 DOI: 10.1016/j.yebeh.2022.109003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE We investigated the network between the medial temporal lobe (MTL) and extratemporal structures in patients with mesial temporal lobe epilepsy (MTLE) in order to explain the recurrence of MTLE after surgery. This study contributes to our current understanding of MTLE with stereotactic electroencephalography (SEEG). METHODS We conducted a retrospective study of SEEG in 20 patients with MTLE in order to observe and analyze the intensity of interictal high-frequency oscillations (HFOs), as well as the dynamic course of coherence connectivity values of the MTL and extratemporal structures during the initial phase of the seizure. The results correlated with the patient prognosis. RESULTS First, the presence of HFOs was observed during the interictal period in all 20 patients; these were localized to the MTL in 17 patients and the orbitofrontal cortex in seven patients and the insula in six patients. The better the prognosis, the greater the localization of the HFOs concentration in the MTL structures (p < 0.05). Second, significantly enhanced connectivity of MTL structures with the orbitofrontal cortex and insula was observed in most patients with MTLE, before and after the seizure onset (p < 0.05). Finally, the connectivity between extratemporal structures, such as the orbitofrontal cortex and insula, and MTL structures was significantly stronger in patients who had a worse prognosis than in other patients, before and after seizure onset (p < 0.05). INTERPRETATION The epileptogenic network in recurrent MTLE is not limited to MTL structures but is also associated with the orbitofrontal cortex and insula. This can be used as a potential indicator for predicting the prognosis of patients after surgery, providing an important avenue for future clinical evaluation.
Collapse
Affiliation(s)
- Tao Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Yanfeng Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Penghu Wei
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Changming Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Xiaotong Fan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Kailiang Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Huaqiang Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Yongzhi Shan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China.
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; China International Neuroscience Institute (CHINA-INI), Beijing, China; Institute for Brain Disorder, Beijing, China.
| |
Collapse
|
7
|
Shlobin NA, Huang J, Wu C. Learning curves in robotic neurosurgery: a systematic review. Neurosurg Rev 2022; 46:14. [PMID: 36504244 DOI: 10.1007/s10143-022-01908-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The transition to performing procedures robotically generally entails a period of adjustment known as a learning curve as the surgeon develops a familiarity with the technology. However, no study has comprehensively examined robotic learning curves across the field of neurosurgery. We conducted a systematic review to characterize the scope of literature on robotic learning curves in neurosurgery, assess operative parameters that may involve a learning curve, and delineate areas for future investigation. PubMed, Embase, and Scopus were searched. Following deduplication, articles were screened by title and abstract for relevance. Remaining articles were screened via full text for final inclusion. Bibliographic and learning curve data were extracted. Of 746 resultant articles, 32 articles describing 3074 patients were included, of which 23 (71.9%) examined spine, 4 (12.5%) pediatric, 4 (12.5%) functional, and 1 (3.1%) general neurosurgery. The parameters assessed for learning curves were heterogeneous. In total, 8 (57.1%) of 14 studies found reduced operative time with increased cases, while the remainder demonstrated no learning curve. Six (60.0%) of 10 studies reported reduced operative time per component with increased cases, while the remainder indicated no learning curve. Radiation time, radiation time per component, robot time, registration time, setup time, and radiation dose were assessed by ≤ 4 studies each, with 0-66.7% of studies demonstrated a learning curve. Four (44.4%) of 9 studies on accuracy showed improvement over time, while the others indicated no improvement over time. The number of cases required to reverse the learning curve ranged from 3 to 75. Learning curves are common in robotic neurosurgery. However, existing studies demonstrate high heterogeneity in assessed parameters and the number of cases that comprise the learning curve. Future studies should seek to develop strategies to reduce the number of cases required to reach the learning curve.
Collapse
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA.
| | - Jonathan Huang
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA
| | - Chengyuan Wu
- Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| |
Collapse
|
8
|
Scoville JP, Joyce E, Hunsaker J, Reese J, Wilde H, Arain A, Bollo RL, Rolston JD. Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series. Oper Neurosurg (Hagerstown) 2021; 21:6-13. [PMID: 33733680 DOI: 10.1093/ons/opab040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/25/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.
Collapse
Affiliation(s)
- Jonathan P Scoville
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA
| | - Evan Joyce
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA
| | - Joshua Hunsaker
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Jared Reese
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Herschel Wilde
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Amir Arain
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Robert L Bollo
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA
| | - John D Rolston
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, Utah, USA
| |
Collapse
|
9
|
Trébuchon A, Liégeois-Chauvel C, Gonzalez-Martinez JA, Alario FX. Contributions of electrophysiology for identifying cortical language systems in patients with epilepsy. Epilepsy Behav 2020; 112:107407. [PMID: 33181892 DOI: 10.1016/j.yebeh.2020.107407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
A crucial element of the surgical treatment of medically refractory epilepsy is to delineate cortical areas that must be spared in order to avoid clinically relevant neurological and neuropsychological deficits postoperatively. For each patient, this typically necessitates determining the language lateralization between hemispheres and language localization within hemisphere. Understanding cortical language systems is complicated by two primary challenges: the extent of the neural tissue involved and the substantial variability across individuals, especially in pathological populations. We review the contributions made through the study of electrophysiological activity to address these challenges. These contributions are based on the techniques of magnetoencephalography (MEG), intracerebral recordings, electrical-cortical stimulation (ECS), and the electrovideo analyses of seizures and their semiology. We highlight why no single modality alone is adequate to identify cortical language systems and suggest avenues for improving current practice.
Collapse
Affiliation(s)
- Agnès Trébuchon
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Catherine Liégeois-Chauvel
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA
| | | | - F-Xavier Alario
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA; Aix-Marseille Univ, CNRS, LPC, Marseille, France.
| |
Collapse
|
10
|
Liu C, Yu T, Ren ZW, Xu CP, Wang XY, Qiao L, Ni DY, Zhang GJ, Li YJ. Properties of afterdischarges from electrical stimulation in patients with epilepsy. Epilepsy Res 2017; 137:39-44. [PMID: 28910667 DOI: 10.1016/j.eplepsyres.2017.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/22/2017] [Accepted: 09/03/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the properties of afterdischarges (ADs) from intracerebral electrical stimulation (ES) in patients with epilepsy who underwent stereotactic electroencephalography (SEEG) and determine the relationship between epileptogenic zone (EZ) or irritative zone (IZ) and ADs. METHODS We retrospectively analyzed 10 patients with intractable epilepsy who underwent SEEG. ESs were delivered following the given parameters: bipolar, biphasic, 50Hz, 0.2ms pulse duration, 0.5-10mA. The properties of ADs were documented, including their incidence, location, threshold, morphology and evolution. RESULTS A total of 213 ADs (5%) were elicited by 4701 trains of ES. Stimulation through contacts implanted in the hippocampus (59%) generally evoked more ADs than contacts elsewhere (19%). AD thresholds for hippocampal stimulation were significantly lower than those for stimulation in grey matter. Polyspikes (58%) were the most common AD morphology. Evolution occurred more commonly with sequential spikes (47%) than with other AD morphologies (14%). There was no significant correlation between the location of ADs and EZ. However, ADs were significantly more frequently localized to IZ than areas outside IZ (P<0.05). CONCLUSIONS There seemed to be a lack of correlation between the location of ADs and EZ. However, ADs were more likely to be elicited in IZ.
Collapse
|
11
|
Abstract
While open surgical resection for medically refractory epilepsy remains the gold standard in current neurosurgical practice, modern techniques have targeted areas for improvement over open surgical resection. This review focuses on how a variety of these new techniques are attempting to address these various limitations. Stereotactic electroencephalography offers the possibility of localizing deep epileptic foci, improving upon subdural grid placement which limits localization to neocortical regions. Laser interstitial thermal therapy (LITT) and stereotactic radiosurgery can minimally or non-invasively ablate specific regions of interest, with near real-time feedback for laser interstitial thermal therapy. Finally, neurostimulation offers the possibility of seizure reduction without needing to ablate or resect any tissue. However, because these techniques are still being evaluated in current practice, there are no evidence-based guidelines for their use, and more research is required to fully evaluate their proper role in the current management of medically refractory epilepsy.
Collapse
Affiliation(s)
- Robert A McGovern
- Department of Neurological Surgery, The Neurological Institute, Columbia University Medical Center, 710 W. 168th St, New York, NY, 10032, USA.
| | - Garrett P Banks
- Department of Neurological Surgery, The Neurological Institute, Columbia University Medical Center, 710 W. 168th St, New York, NY, 10032, USA
| | - Guy M McKhann
- Department of Neurological Surgery, The Neurological Institute, Columbia University Medical Center, 710 W. 168th St, New York, NY, 10032, USA
| |
Collapse
|
12
|
Mercier MR, Bickel S, Megevand P, Groppe DM, Schroeder CE, Mehta AD, Lado FA. Evaluation of cortical local field potential diffusion in stereotactic electro-encephalography recordings: A glimpse on white matter signal. Neuroimage 2016; 147:219-232. [PMID: 27554533 DOI: 10.1016/j.neuroimage.2016.08.037] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 08/14/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022] Open
Abstract
While there is a strong interest in meso-scale field potential recording using intracranial electroencephalography with penetrating depth electrodes (i.e. stereotactic EEG or S-EEG) in humans, the signal recorded in the white matter remains ignored. White matter is generally considered electrically neutral and often included in the reference montage. Moreover, re-referencing electrophysiological data is a critical preprocessing choice that could drastically impact signal content and consequently the results of any given analysis. In the present stereotactic electroencephalography study, we first illustrate empirically the consequences of commonly used references (subdermal, white matter, global average, local montage) on inter-electrode signal correlation. Since most of these reference montages incorporate white matter signal, we next consider the difference between signals recorded in cortical gray matter and white matter. Our results reveal that electrode contacts located in the white matter record a mixture of activity, with part arising from the volume conduction (zero time delay) of activity from nearby gray matter. Furthermore, our analysis shows that white matter signal may be correlated with distant gray matter signal. While residual passive electrical spread from nearby matter may account for this relationship, our results suggest the possibility that this long distance correlation arises from the white matter fiber tracts themselves (i.e. activity from distant gray matter traveling along axonal fibers with time lag larger than zero); yet definitive conclusions about the origin of the white matter signal would require further experimental substantiation. By characterizing the properties of signals recorded in white matter and in gray matter, this study illustrates the importance of including anatomical prior knowledge when analyzing S-EEG data.
Collapse
Affiliation(s)
- Manuel R Mercier
- Department of Neurology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA; Department of Neuroscience, Albert Einstein College of Medicine, 1410 Pelham Parkway South, Bronx, NY 10461, USA; Centre de Recherche Cerveau et Cognition (CerCo), CNRS, UMR5549, Pavillon Baudot CHU Purpan, BP 25202, 31052 Toulouse Cedex, France
| | - Stephan Bickel
- Department of Neurology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA
| | - Pierre Megevand
- Department of Neurosurgery, Hofstra-Northwell School of Medicine and Feinstein Institute for Medical Research, Manhasset, New York, NY 11030, USA
| | - David M Groppe
- Department of Neurosurgery, Hofstra-Northwell School of Medicine and Feinstein Institute for Medical Research, Manhasset, New York, NY 11030, USA
| | - Charles E Schroeder
- Cognitive Neuroscience and Schizophrenia Program, Nathan Kline Institute, Orangeburg, NY 10962, USA; Department of Neurosurgery, Columbia College of Physicians and Surgeons, New York, NY 10032, USA
| | - Ashesh D Mehta
- Department of Neurosurgery, Hofstra-Northwell School of Medicine and Feinstein Institute for Medical Research, Manhasset, New York, NY 11030, USA
| | - Fred A Lado
- Department of Neurology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA; Department of Neuroscience, Albert Einstein College of Medicine, 1410 Pelham Parkway South, Bronx, NY 10461, USA.
| |
Collapse
|
13
|
Mullin JP, Sexton D, Al-Omar S, Bingaman W, Gonzalez-Martinez J. Outcomes of Subdural Grid Electrode Monitoring in the Stereoelectroencephalography Era. World Neurosurg 2016; 89:255-8. [PMID: 26893042 DOI: 10.1016/j.wneu.2016.02.034] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/05/2016] [Accepted: 02/06/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Subdural grid (SDG) electrodes have been the gold standard of invasive monitoring in medically refractory epilepsy; however, in some centers, application of SDGs has been reduced by the progressive application of stereoelectroencephalography (SEEG). This study reviews the efficacy of SDG electrode monitoring after the incorporation of the SEEG methodology at our institution. METHODS We retrospectively reviewed 102 patients undergoing intracranial monitoring via SDG electrodes during the years 2010-2013 at our institution. The series includes all patients who underwent SDG placement after the incorporation of SEEG in our extraoperative invasive monitoring armamentarium. RESULTS Average patient age was 29.9 years old; the series included 31 pediatric patients. There were 49 male patients and 53 female patients. The mean length of follow-up was 21.5 months. The epileptogenic zone was localized in 99 (97%) patients. Surgical resection was performed in 84 patients, and 70% experienced Engel class I freedom from seizures. CONCLUSIONS Invasive monitoring via SDG electrodes continues to be an efficacious option for select patients with medically refractory epilepsy, mainly when the hypothetical epileptogenic zone is anatomically restricted to superficial cortical areas and in close relation with eloquent cortex. This is the first report of epilepsy outcomes after SDG monitoring at a center that also performs SEEG monitoring. Our results suggest a complementary benefit of performing both techniques at 1 institution.
Collapse
Affiliation(s)
- Jeffrey P Mullin
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
| | - Daniel Sexton
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Soha Al-Omar
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - William Bingaman
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jorge Gonzalez-Martinez
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|