Bou Assi Elie, Rihana Sandy, Nguyen Dang K, Sawan Mohamad
Polystim Neurotech Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada.
Biomedical Engineering Department, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
Epilepsy Res. 2019 May;152:42-51. doi: 10.1016/j.eplepsyres.2019.02.006. Epub 2019 Mar 11.
Recognition of insular epilepsy may sometimes be challenging due to the rapid speed at which insular seizures can spread throughout the cortex via extensive connections to surrounding cortices. The spectrum weighted adaptive directed transfer function, a multivariate causality-based effective connectivity measure, was applied to intracranial electroencephalography recordings to identify generators of seizure activity. A non-parametric test based on surrogate data testing was used to validate statistical significance of causal relations. Outflow and inflow of seizure activity were extracted from the computed transfer matrix. Recorded data of 21 seizures from seven patients were analyzed including five who were rendered seizure-free after operculo-insular resection. Effective connectivity analysis of 7 s following electrical onset confirmed an operculo-insular seizure origin in 5 patients with a good post-operative seizure outcome, and for whom the resected region was sampled by intracranial electroencephalography contacts. Different or additional seizure foci were identified in 2 patients with a bad post-operative seizure outcome. Findings highlight the feasibility of accurate operculo-insular seizure foci localization based on quantitative approaches.
由于岛叶癫痫发作可通过与周围皮质的广泛连接在整个皮质快速传播，有时识别岛叶癫痫具有挑战性。频谱加权自适应定向传递函数是一种基于多变量因果关系的有效连接性测量方法，应用于颅内脑电图记录以识别癫痫活动的起源。基于替代数据测试的非参数检验用于验证因果关系的统计学意义。从计算出的传递矩阵中提取癫痫活动的流出和流入。分析了7名患者的21次癫痫发作的记录数据，其中5名患者在进行岛盖 - 岛叶切除术后无癫痫发作。对电发作后7秒的有效连接性分析证实，5名术后癫痫发作结果良好且通过颅内脑电图触点对切除区域进行采样的患者存在岛盖 - 岛叶癫痫起源。2名术后癫痫发作结果不佳的患者中发现了不同的或额外的癫痫病灶。研究结果突出了基于定量方法准确定位岛盖 - 岛叶癫痫病灶的可行性。
