Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
Clin Neurophysiol. 2020 Aug;131(8):1947-1955. doi: 10.1016/j.clinph.2020.05.029. Epub 2020 Jun 23.
Localization of epileptogenic brain regions is a crucial aim of pre-surgical evaluation of patients with drug-resistant epilepsy. Several methods have been proposed to identify the seizure onset zone, particularly based on the detection of fast activity. Most of these methods are inefficient to detect slower patterns of onset that account for 20-30% of commonly observed Stereo-Electro-Encephalography (SEEG) patterns. We seek to evaluate the performance of a new quantified measure called the Connectivity Epileptogenicity Index (cEI) in various types of seizure onset patterns.
We studied SEEG recorded seizures from 51 patients, suffering from focal drug-resistant epilepsy. The cEI combines a directed connectivity measure ("out-degrees") and the original epileptogenicity index (EI). Quantified results (Out-degrees, cEI and EI) were compared to visually defined seizure onset zone (vSOZ). We computed recall (sensitivity) and precision (proportion of correct detections within all detections) with vSOZ as a reference. The quality of the detector was quantified by the area under the precision-recall curve.
Best results (in terms of match with vSOZ) were obtained for cEI. For seizures with fast onset patterns, cEI and EI gave comparable results. For seizures with slow onset patterns, cEI gave a better estimation of the vSOZ than EI.
We observed that cEI discloses better performance than EI when seizures starts with slower patterns and equal to EI in seizures with fast onset patterns.
The cEI is a promising new tool for epileptologists, that helps characterizing the seizure onset zone in sEEG, in a robust way despite variations in seizure onset patterns.
在耐药性癫痫患者的术前评估中，定位致痫脑区是一个关键目标。已经提出了几种方法来识别发作起始区，特别是基于快速活动的检测。这些方法中的大多数都不能有效地检测到占常见观察到的立体脑电图（SEEG）模式 20-30%的较慢发作模式。我们旨在评估一种新的量化指标，称为连通性致痫指数（cEI）在各种发作起始模式中的性能。
我们研究了 51 名患有局灶性耐药性癫痫的患者的 SEEG 记录发作。cEI 结合了一种有向连通性测量方法（“出度”）和原始致痫性指数（EI）。量化结果（出度、cEI 和 EI）与视觉定义的发作起始区（vSOZ）进行了比较。我们以 vSOZ 为参考，计算了召回率（敏感性）和精度（所有检测中正确检测的比例）。以精度-召回曲线下面积来量化检测器的质量。
以与 vSOZ 的匹配度为标准，cEI 获得了最佳结果。对于快速起始模式的发作，cEI 和 EI 给出了可比的结果。对于缓慢起始模式的发作，cEI 比 EI 更能准确估计 vSOZ。
我们观察到，当发作以较慢的模式开始时，cEI 比 EI 表现出更好的性能，而当发作以较快的模式开始时，cEI 的性能与 EI 相当。
cEI 是一种有前途的新工具，可帮助癫痫学家以稳健的方式在 sEEG 中特征化发作起始区，尽管发作起始模式存在变化。
