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Complementary structural and functional abnormalities to localise epileptogenic tissueResearch in context

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العنوان: Complementary structural and functional abnormalities to localise epileptogenic tissueResearch in context
المؤلفون: Jonathan J. Horsley, Rhys H. Thomas, Fahmida A. Chowdhury, Beate Diehl, Andrew W. McEvoy, Anna Miserocchi, Jane de Tisi, Sjoerd B. Vos, Matthew C. Walker, Gavin P. Winston, John S. Duncan, Yujiang Wang, Peter N. Taylor
المصدر: EBioMedicine, Vol 97, Iss , Pp 104848- (2023)
بيانات النشر: Elsevier, 2023.
سنة النشر: 2023
المجموعة: LCC:Medicine
LCC:Medicine (General)
مصطلحات موضوعية: Epilepsy, Surgical prediction, Diffusion-weighted MRI, Intracranial EEG, Machine learning, Multi-modal analysis, Medicine, Medicine (General), R5-920
الوصف: Summary: Background: When investigating suitability for epilepsy surgery, people with drug-refractory focal epilepsy may have intracranial EEG (iEEG) electrodes implanted to localise seizure onset. Diffusion-weighted magnetic resonance imaging (dMRI) may be acquired to identify key white matter tracts for surgical avoidance. Here, we investigate whether structural connectivity abnormalities, inferred from dMRI, may be used in conjunction with functional iEEG abnormalities to aid localisation of the epileptogenic zone (EZ), improving surgical outcomes in epilepsy. Methods: We retrospectively investigated data from 43 patients (42% female) with epilepsy who had surgery following iEEG. Twenty-five patients (58%) were free from disabling seizures (ILAE 1 or 2) at one year. Interictal iEEG functional, and dMRI structural connectivity abnormalities were quantified by comparison to a normative map and healthy controls. We explored whether the resection of maximal abnormalities related to improved surgical outcomes, in both modalities individually and concurrently. Additionally, we suggest how connectivity abnormalities may inform the placement of iEEG electrodes pre-surgically using a patient case study. Findings: Seizure freedom was 15 times more likely in patients with resection of maximal connectivity and iEEG abnormalities (p = 0.008). Both modalities separately distinguished patient surgical outcome groups and when used simultaneously, a decision tree correctly separated 36 of 43 (84%) patients. Interpretation: Our results suggest that both connectivity and iEEG abnormalities may localise epileptogenic tissue, and that these two modalities may provide complementary information in pre-surgical evaluations. Funding: This research was funded by UKRI, CDT in Cloud Computing for Big Data, NIH, MRC, Wellcome Trust and Epilepsy Research UK.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2352-3964
Relation: http://www.sciencedirect.com/science/article/pii/S2352396423004140; https://doaj.org/toc/2352-3964
DOI: 10.1016/j.ebiom.2023.104848
URL الوصول: https://doaj.org/article/b91b12e796ba45a78c3f9fa0eb1a9aab
رقم الأكسشن: edsdoj.b91b12e796ba45a78c3f9fa0eb1a9aab
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:23523964
DOI:10.1016/j.ebiom.2023.104848