Electric Source Imaging in Presurgical Evaluation of Epilepsy: An Inter-Analyser Agreement Study

Mattioli, Pietro; Cleeren, Evy; Hadady, Levente; Cossu, Alberto; Cloppenborg, Thomas; Arnaldi, Dario; Beniczky, Sándor

doi:10.3390/diagnostics12102303

Cited by 2 publications

(3 citation statements)

References 33 publications

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“…Several aspects tailored to the individual patient involve subjective decisions of the expert performing the analysis. A recent study, which included 25 consecutive patients analyzed by six different experts, showed that when experts used the same analysis pipeline and same software, the inter-analyzer agreement was substantial [15]. These results support the need for standardization in ESI methodology, applied in clinical practice.…”

Section: Electroencephalogram Source Imagingmentioning

confidence: 65%

Recent advances in clinical electroencephalography

Frauscher,

Rossetti,

Beniczky

2024

Current Opinion in Neurology

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Purpose of review Clinical electroencephalography (EEG) is a conservative medical field. This explains likely the significant gap between clinical practice and new research developments. This narrative review discusses possible causes of this discrepancy and how to circumvent them. More specifically, we summarize recent advances in three applications of clinical EEG: source imaging (ESI), high-frequency oscillations (HFOs) and EEG in critically ill patients. Recent findings Recently published studies on ESI provide further evidence for the accuracy and clinical utility of this method in the multimodal presurgical evaluation of patients with drug-resistant focal epilepsy, and opened new possibilities for further improvement of the accuracy. HFOs have received much attention as a novel biomarker in epilepsy. However, recent studies questioned their clinical utility at the level of individual patients. We discuss the impediments, show up possible solutions and highlight the perspectives of future research in this field. EEG in the ICU has been one of the major driving forces in the development of clinical EEG. We review the achievements and the limitations in this field. Summary This review will promote clinical implementation of recent advances in EEG, in the fields of ESI, HFOs and EEG in the intensive care.

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Section: Electroencephalogram Source Imagingmentioning

confidence: 65%

Recent advances in clinical electroencephalography

Frauscher,

Rossetti,

Beniczky

2024

Current Opinion in Neurology

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“…The evaluators' confidence in the method was based on the literature on EEG-fMRI, which showed the frequent but far from perfect concordance of BOLD responses with epileptic foci 28 as well as personal experience in their clinical practice. A similar methodology has been used in evaluating EEG-fMRI for surgery, 29 the contribution of EEG source analysis, [30][31][32] resting-state functional connectivity, 33 and interictal PET findings. 34 The current study demonstrates that EEG-fMRI provides additional value when combined with traditional pre-surgical investigations of medically refractory epilepsy by increasing confidence in the identification of epilepsy syndrome, localization, and surgical candidacy.…”

Section: Discussionmentioning

confidence: 99%

“…The evaluators' confidence in the method was based on the literature on EEG‐fMRI, which showed the frequent but far from perfect concordance of BOLD responses with epileptic foci 28 as well as personal experience in their clinical practice. A similar methodology has been used in evaluating EEG‐fMRI for surgery, 29 the contribution of EEG source analysis, 30 , 31 , 32 resting‐state functional connectivity, 33 and interictal PET findings. 34 …”

Section: Discussionmentioning

confidence: 99%

Electroencephalography–functional magnetic resonance imaging for clinical evaluation in focal epilepsy

Ikemoto,

Pana,

von Ellenrieder

et al. 2023

Epilepsia Open

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ObjectiveWe aimed to evaluate the contribution of simultaneous recording of electroencephalography–functional magnetic resonance imaging (EEG‐fMRI) in the diagnosis of epilepsy syndrome, localization of the epileptogenic zone (EZ), and decision‐making regarding surgical treatment.MethodsWe performed a retrospective study to evaluate patients with focal epilepsy who underwent EEG‐fMRI. Two evaluators assessed epilepsy syndrome, presumed focus, and surgical candidacy and defined confidence levels. They assessed these clinical characteristics first without EEG‐fMRI and then including EEG‐fMRI to assess how the results of EEG‐fMRI changed the evaluations. We also determined how the clinical evaluation was affected by the concordance level between the blood oxygen level‐dependent (BOLD) response and the presumed focus location, and by the confidence level of the BOLD response itself based on the t‐value of the primary and secondary clusters.ResultsFifty‐one scans from 48 patients were included. The BOLD map affected 66.7% of the evaluations by altering evaluation items (epilepsy syndrome, presumed focus, or surgical candidacy) or their confidence levels. EEG‐fMRI results increased the confidence levels of the epilepsy syndrome, presumed focus, or surgical candidacy in 47.1% of patients but reduced clinical confidence in these features in 11.8%. More specifically, the confidence levels increased for epilepsy syndrome in 28.5%, identification of presumed focus in 33.9%, and determination of surgical candidacy in 29.4%. The BOLD signal confidence level, whether high or low, did not influence these clinical factors.SignificancePrevious studies have emphasized the utility of EEG‐fMRI for the localization of the epileptogenic zone. This study demonstrated the potential of EEG‐fMRI to influence clinical confidence when determining epilepsy syndrome, the presumed epileptic focus, and surgical candidacy.

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Electric Source Imaging in Presurgical Evaluation of Epilepsy: An Inter-Analyser Agreement Study

Cited by 2 publications

References 33 publications

Recent advances in clinical electroencephalography

Recent advances in clinical electroencephalography

Electroencephalography–functional magnetic resonance imaging for clinical evaluation in focal epilepsy

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