高密度电源成像技术在癫痫间期放电中的应用：需要多少个电极和在哪个时间点？
High-density Electric Source Imaging of interictal epileptic discharges: How many electrodes and which time point?
机构信息
EEG and Epilepsy Unit, University Hospitals and Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; Department of Neurology, Epilepsy-Center Berlin-Brandenburg, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
EEG and Epilepsy Unit, University Hospitals and Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; Functional Brain Mapping Lab, Department of Basic Neurosciences, University of Geneva, Campus Biotech, 9 Chemin des Mines, 1202 Geneva, Switzerland.
出版信息
Clin Neurophysiol. 2020 Dec;131(12):2795-2803. doi: 10.1016/j.clinph.2020.09.018. Epub 2020 Oct 15.
OBJECTIVE
To assess the value of caudal EEG electrodes over cheeks and neck for high-density electric source imaging (ESI) in presurgical epilepsy evaluation, and to identify the best time point during averaged interictal epileptic discharges (IEDs) for optimal ESI accuracy.
METHODS
We retrospectively examined presurgical 257-channel EEG recordings of 45 patients with pharmacoresistant focal epilepsy. By stepwise removal of cheek and neck electrodes, averaged IEDs were downsampled to 219, 204, and 156 EEG channels. Additionally, ESI at the IED's half-rise was compared to other time points. The respective sources of maximum activity were compared to the resected brain area and postsurgical outcome.
RESULTS
Caudal channels had disproportionately more artefacts. In 30 patients with favourable outcome, the 204-channel array yielded the most accurate results with ESI maxima < 10 mm from the resection in 67% and inside affected sublobes in 83%. Neither in temporal nor in extratemporal cases did the full 257-channel setup improve ESI accuracy. ESI was most accurate at 50% of the IED's rising phase.
CONCLUSION
Information from cheeks and neck electrodes did not improve high-density ESI accuracy, probably due to higher artefact load and suboptimal biophysical modelling.
SIGNIFICANCE
Very caudal EEG electrodes should be used for ESI with caution.
目的
评估颅底 EEG 电极在面颊和颈部对于术前癫痫评估中高密度电源成像（ESI）的价值，并确定在平均发作间期癫痫放电（IED）期间最佳时间点以获得最佳 ESI 准确性。
方法
我们回顾性检查了 45 例药物难治性局灶性癫痫患者的术前 257 通道 EEG 记录。通过逐步去除面颊和颈部电极，平均 IED 被下采样至 219、204 和 156 个 EEG 通道。此外，还比较了 IED 半升时的 ESI 与其他时间点的 ESI。各自的最大活动源与切除的脑区和术后结果进行了比较。
结果
颅底通道的伪影不成比例地更多。在 30 例预后良好的患者中，204 通道阵列产生了最准确的结果，其中 ESI 最大值<10mm 与切除部位的距离为 67%，在受累亚叶内的距离为 83%。无论是在颞叶还是在颞叶外病例中，完整的 257 通道设置都没有提高 ESI 准确性。ESI 在 IED 上升阶段的 50%时最准确。
结论
面颊和颈部电极的信息并没有提高高密度 ESI 的准确性，可能是由于更高的伪影负荷和次优的生物物理建模。
意义
非常颅底 EEG 电极应谨慎用于 ESI。
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