高分辨率 EEG 研究和 SEEG 验证的发作期癫痫活动的源定位。
Source localization of ictal epileptic activity investigated by high resolution EEG and validated by SEEG.
机构信息
INSERM, UMR751, Marseille, F-13000, France.
出版信息
Neuroimage. 2010 Jun;51(2):642-53. doi: 10.1016/j.neuroimage.2010.02.067. Epub 2010 Mar 4.
High resolution electroencephalography (HR-EEG) combined with source localization methods has mainly been used to study interictal spikes and there have been few studies comparing source localization of scalp ictal patterns with depth EEG. To address this issue, 10 patients with four different scalp ictal patterns (ictal spikes, rhythmic activity, paroxysmal fast activity, obscured) were investigated by both HR-EEG and stereoelectroencephalography (SEEG). Sixty-four scalp-EEG sensors and a sampling rate of 1kHz were used to record scalp ictal patterns. Five different source models (moving dipole, rotating dipole, MUSIC, LORETA, and sLORETA) were used in order to perform source localization. Seven to 10 intracerebral electrodes were implanted during SEEG investigations. For each source model, the concordance between ictal source localization and epileptogenic zone defined by SEEG was assessed. Results were considered to agree if they localized in the same sublobar area as defined by a trained epileptologist. Across the study population, the best concordance between source localization methods and SEEG (9/10) was obtained with equivalent current dipole modeling. MUSIC and LORETA had a concordance of 7/10 whereas sLORETA had a concordance of only 5/10. Four of our patients classified into different groups (ictal spikes, paroxysmal fast activity, obscured) had complete concordance between source localization methods and SEEG. A high signal to noise ratio, a short time window of analysis (<1s) and bandpass filtering around the frequency of rhythmic activity allowed improvement of the source localization results. A high level of agreement between source localization methods and SEEG can be obtained for ictal spike patterns and for scalp-EEG paroxysmal fact activities whereas scalp rhythmic discharges can be accurately localized but originated from seizure propagation network.
高分辨率脑电图 (HR-EEG) 结合源定位方法主要用于研究发作间期棘波,而比较头皮发作模式与深部脑电图源定位的研究较少。为解决这一问题,对 10 例具有 4 种不同头皮发作模式(发作性棘波、节律性活动、阵发性快活动、模糊)的患者进行了 HR-EEG 和立体脑电图 (SEEG) 检查。使用 64 个头皮-EEG 传感器和 1kHz 的采样率记录头皮发作模式。使用了 5 种不同的源模型(移动偶极子、旋转偶极子、MUSIC、LORETA 和 sLORETA)来进行源定位。在 SEEG 研究期间植入了 7 到 10 个颅内电极。对于每个源模型,评估了发作源定位与 SEEG 定义的致痫区之间的一致性。如果它们定位在同一亚区,即由受过训练的癫痫学家定义的区域,则认为结果一致。在整个研究人群中,基于等效电流偶极子模型的源定位方法与 SEEG 的一致性最好(9/10)。MUSIC 和 LORETA 的一致性为 7/10,而 sLORETA 的一致性仅为 5/10。我们的 4 名患者分为不同的组(发作性棘波、阵发性快活动、模糊),其源定位方法与 SEEG 的一致性完全一致。高信噪比、分析时间窗口短(<1s)以及围绕节律性活动频率的带通滤波可改善源定位结果。对于发作性棘波模式和头皮 EEG 阵发性快活动,可以获得源定位方法与 SEEG 之间的高度一致,而头皮节律性放电虽然可以准确定位,但起源于癫痫传播网络。