Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
Neurosciences and Mental Health, Sickkids Center for Brain and Mental Health, Toronto, ON, Canada.
Clin Neurophysiol. 2018 Jun;129(6):1182-1191. doi: 10.1016/j.clinph.2018.03.007. Epub 2018 Mar 30.
To investigate whether advanced dynamic statistical parametric mapping (AdSPM) using magnetoencephalography (MEG) can better localize focal cortical dysplasia at bottom of sulcus (FCDB).
We analyzed 15 children with diagnosis of FCDB in surgical specimen and 3 T MRI by using MEG. Using AdSPM, we analyzed a ±50 ms epoch relative to each single moving dipole (SMD) and applied summation technique to estimate the source activity. The most active area in AdSPM was defined as the location of AdSPM spike source. We compared spatial congruence between MRI-visible FCDB and (1) dipole cluster in SMD method; and (2) AdSPM spike source.
AdSPM localized FCDB in 12 (80%) of 15 children whereas dipole cluster localized six (40%). AdSPM spike source was concordant within seizure onset zone in nine (82%) of 11 children with intracranial video EEG. Eleven children with resective surgery achieved seizure freedom with follow-up period of 1.9 ± 1.5 years. Ten (91%) of them had an AdSPM spike source in the resection area.
AdSPM can noninvasively and neurophysiologically localize epileptogenic FCDB, whether it overlaps with the dipole cluster or not.
This is the first study to localize epileptogenic FCDB using MEG.
研究使用脑磁图（MEG）的高级动态统计参数映射（AdSPM）是否能更好地定位沟底部局灶性皮质发育不良（FCDB）。
我们分析了 15 例手术标本和 3T MRI 诊断为 FCDB 的儿童的 MEG 数据。使用 AdSPM，我们分析了每个移动偶极子（SMD）的±50ms 时窗，并应用求和技术来估计源活动。AdSPM 中最活跃的区域被定义为 AdSPM 尖峰源的位置。我们比较了 MRI 可见的 FCDB 与（1）SMD 方法中的偶极子簇；和（2）AdSPM 尖峰源之间的空间一致性。
AdSPM 在 15 例儿童中的 12 例（80%）中定位了 FCDB，而偶极子簇在 6 例（40%）中定位了 FCDB。在 11 例有颅内视频脑电图的儿童中，AdSPM 尖峰源与癫痫发作起始区一致。这 11 例接受了切除术的儿童在随访 1.9±1.5 年后实现了无癫痫发作。其中 10 例（91%）的切除区有 AdSPM 尖峰源。
AdSPM 可以无创且神经生理学上定位致痫性 FCDB，无论其是否与偶极子簇重叠。
这是首次使用 MEG 定位致痫性 FCDB 的研究。
