Improving surgical outcome with electric source imaging and high field magnetic resonance imaging

Saute, Ricardo Lutzky; Peixoto-Santos, José Eduardo; Velasco, Tonicarlo Rodrigues; Leite, João Pereira

doi:10.1016/j.seizure.2021.02.006

Cited by 3 publications

(3 citation statements)

References 135 publications

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“…However, in an actual clinical setting, the epileptic focus needs to be localized before introducing the DREADDs. The accuracy of focus localization has been largely improved by combining imaging/electrophysiological methods (e.g., MRI, FDG-PET, MEG, EEG, and ECoG) with current algorithms 36 , 37 . These points need further confirmation in future studies using NHP models of epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Chemogenetic attenuation of cortical seizures in nonhuman primates

et al. 2023

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Epilepsy is a disorder in which abnormal neuronal hyperexcitation causes several types of seizures. Because pharmacological and surgical treatments occasionally interfere with normal brain function, a more focused and on-demand approach is desirable. Here we examined the efficacy of a chemogenetic tool—designer receptors exclusively activated by designer drugs (DREADDs)—for treating focal seizure in a nonhuman primate model. Acute infusion of the GABAA receptor antagonist bicuculline into the forelimb region of unilateral primary motor cortex caused paroxysmal discharges with twitching and stiffening of the contralateral arm, followed by recurrent cortical discharges with hemi- and whole-body clonic seizures in two male macaque monkeys. Expression of an inhibitory DREADD (hM4Di) throughout the seizure focus, and subsequent on-demand administration of a DREADD-selective agonist, rapidly suppressed the wide-spread seizures. These results demonstrate the efficacy of DREADDs for attenuating cortical seizure in a nonhuman primate model.

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Section: Discussionmentioning

confidence: 99%

Chemogenetic attenuation of cortical seizures in nonhuman primates

et al. 2023

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“…Clinical aspects range from updates on the first epileptic seizure presentation in children and adults, uncommon epileptic syndromes in childhood and new information on the complex relationship between neurocysticercosis, seizures and epilepsy [4][5][6]. The Brazilian group of Lutzky Saute et al demonstrate how the combination of high field magnetic imaging and with electric source imaging may improve the chances of achieving seizure freedom through the surgical treatment of MRI negative pharmacoresistant epilepsies [7].…”

Section: Celebrating the Lasse 15th Editionmentioning

confidence: 99%

Introduction to the special issue

Yacubian

Carrizosa

Cavalheiro

2021

Seizure

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“…3 Accurately determining the epileptogenicity of TEs can be challenging, as standard methods in the presurgical evaluation, such as scalp electroencephalography (EEG) and seizure semiology, may not provide sufficient spatial resolution. 4,5 Additionally, 16%-31% of TLE patients are considered nonlesional on routine magnetic resonance imaging (MRI), in contrast to the finding that temporal TEs are often identified in MRIs of patients who were previously reported as having normal results. 6 Although the temporal pole is a crucial site within temporal lobe seizure networks, 5,7 scalp EEG recordings can barely differentiate between the origins of interictal epileptiform discharges (IEDs) at the sublobar level.…”

Section: Introductionmentioning

confidence: 99%

Semiautomated electric source imaging determines epileptogenicity of encephaloceles in temporal lobe epilepsy

Antal,

Altenmüller,

Dümpelmann

et al. 2024

Epilepsia

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ObjectiveWe aimed to assess the ability of semiautomated electric source imaging (ESI) from long‐term video‐electroencephalographic (EEG) monitoring (LTM) to determine the epileptogenicity of temporopolar encephaloceles (TEs) in patients with temporal lobe epilepsy.MethodsWe conducted a retrospective study involving 32 temporal lobe epilepsy patients with TEs as potentially epileptogenic lesions in structural magnetic resonance imaging scans. Findings were validated through invasive intracerebral stereo‐EEG in six of 32 patients and postsurgical outcome after tailored resection of the TE in 17 of 32 patients. LTM (mean duration = 6 days) was performed using the 10/20 system with additional T1/T2 for all patients and sphenoidal electrodes in 23 of 32 patients. Semiautomated detection and clustering of interictal epileptiform discharges (IEDs) were carried out to create IED types. ESI was performed on the averages of the two most frequent IED types per patient, utilizing individual head models, and two independent inverse methods (sLORETA [standardized low‐resolution brain electromagnetic tomography], MUSIC [multiple signal classification]). ESI maxima concordance and propagation in spatial relation to TEs were quantified for sources with good signal quality (signal‐to‐noise ratio > 2, explained signal > 60%).ResultsESI maxima correctly colocalized with a TE in 20 of 32 patients (62.5%) either at the onset or half‐rising flank of at least one IED type per patient. ESI maxima showed propagation from the temporal pole to other temporal or extratemporal regions in 14 of 32 patients (44%), confirming propagation originating in the area of the TE. The findings from both inverse methods validated each other in 14 of 20 patients (70%), and sphenoidal electrodes exhibited the highest signal amplitudes in 17 of 23 patients (74%). The concordance of ESI with the TE predicted a seizure‐free postsurgical outcome (Engel I vs. >I) with a diagnostic odds ratio of 2.1.SignificanceSemiautomated ESI from LTM often successfully identifies the epileptogenicity of TEs and the IED onset zone within the area of the TEs. Additionally, it shows potential predictive power for postsurgical outcomes in these patients.

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Improving surgical outcome with electric source imaging and high field magnetic resonance imaging

Cited by 3 publications

References 135 publications

Chemogenetic attenuation of cortical seizures in nonhuman primates

Chemogenetic attenuation of cortical seizures in nonhuman primates

Introduction to the special issue

Semiautomated electric source imaging determines epileptogenicity of encephaloceles in temporal lobe epilepsy

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