Habib Mohammad Ashfak, Ibrahim Fatimah, Mohktar Mas S, Kamaruzzaman Shahrul Bahyah, Rahmat Kartini, Lim Kheng Seang
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Department of Computer Science & Engineering, Chittagong University of Engineering & Technology, Chittagong, Bangladesh.
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia; Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
World Neurosurg. 2016 Apr;88:576-585. doi: 10.1016/j.wneu.2015.10.096. Epub 2015 Nov 5.
Electroencephalography source imaging (ESI) is a promising tool for localizing the cortical sources of both ictal and interictal epileptic activities. Many studies have shown the clinical usefulness of interictal ESI, but very few have investigated the utility of ictal ESI. The aim of this article is to examine the clinical usefulness of ictal ESI for epileptic focus localization in patients with refractory focal epilepsy, especially extratemporal lobe epilepsy.
Both ictal and interictal ESI were performed by the use of patient-specific realistic forward models and 3 different linear distributed inverse models. Lateralization as well as concordance between ESI-estimated focuses and single-photon emission computed tomography (SPECT) focuses were assessed.
All the ESI focuses (both ictal and interictal) were found lateralized to the same hemisphere as ictal SPECT focuses. Lateralization results also were in agreement with the lesion sides as visualized on magnetic resonance imaging. Ictal ESI results, obtained from the best-performing inverse model, were fully concordant with the same cortical lobe as SPECT focuses, whereas the corresponding concordance rate is 87.50% in case of interictal ESI.
Our findings show that ictal ESI gives fully lateralized and highly concordant results with ictal SPECT and may provide a cost-effective substitute for ictal SPECT.
脑电图源成像（ESI）是一种用于定位发作期和发作间期癫痫活动皮质源的有前景的工具。许多研究已显示发作间期ESI的临床实用性，但很少有研究调查发作期ESI的效用。本文旨在研究发作期ESI在难治性局灶性癫痫患者，尤其是颞叶外癫痫患者中癫痫灶定位的临床实用性。
通过使用患者特异性逼真的正向模型和3种不同的线性分布式逆模型进行发作期和发作间期ESI。评估ESI估计病灶与单光子发射计算机断层扫描（SPECT）病灶之间的定位以及一致性。
所有ESI病灶（发作期和发作间期）均定位在与发作期SPECT病灶相同的半球。定位结果也与磁共振成像显示的病灶侧一致。从表现最佳的逆模型获得的发作期ESI结果与SPECT病灶完全一致于同一脑叶，而发作间期ESI的相应一致率为87.50%。
我们的研究结果表明，发作期ESI与发作期SPECT相比具有完全定位且高度一致的结果，并且可能为发作期SPECT提供一种经济有效的替代方法。
