自动癫痫发作期脑电图源成像：一项回顾性、盲法临床验证研究。
Automated ictal EEG source imaging: A retrospective, blinded clinical validation study.
机构信息
Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Campus UZ Corneel Heymanslaan 10, 9000 Ghent, Belgium; Epilog NV, Vlasgaardstraat 52, 9000 Ghent, Belgium.
Department of Clinical Neurophysiology, Danish Epilepsy Centre, Visby Allé 5, 4293 Dianalund, Denmark; Neurology Clinic, Fundeni Clinical Institute, Soseaua Fundeni no. 258, Sector 2, 022328 Bucharest, Romania.
出版信息
Clin Neurophysiol. 2022 Sep;141:119-125. doi: 10.1016/j.clinph.2021.03.040. Epub 2021 Apr 27.
OBJECTIVE
EEG source imaging (ESI) is a validated tool in the multimodal workup of patients with drug resistant focal epilepsy. However, it requires special expertise and it is underutilized. To circumvent this, automated analysis pipelines have been developed and validated for the interictal discharges. In this study, we present the clinical validation of an automated ESI for ictal EEG signals.
METHODS
We have developed an automated analysis pipeline of ictal EEG activity, based on spectral analysis in source space, using an individual head model of six tissues. The analysis was done blinded to all other data. As reference standard, we used the concordance with the resected area and one-year postoperative outcome.
RESULTS
We analyzed 50 consecutive patients undergoing epilepsy surgery (34 temporal and 16 extra-temporal). Thirty patients (60%) became seizure-free. The accuracy of the automated ESI was 74% (95% confidence interval: 59.66-85.37%).
CONCLUSIONS
Automated ictal ESI has a high accuracy for localizing the seizure onset zone.
SIGNIFICANCE
Automating the ESI of the ictal EEG signals will facilitate implementation of this tool in the presurgical evaluation.
目的
脑电源成像（ESI）是一种在耐药性局灶性癫痫患者的多模态评估中经过验证的工具。然而，它需要特殊的专业知识，因此未得到充分利用。为了克服这一问题，已经开发并验证了用于发作间期放电的自动分析管道。在这项研究中，我们展示了一种用于发作期 EEG 信号的自动 ESI 的临床验证。
方法
我们开发了一种基于源空间频谱分析的发作期 EEG 活动的自动分析管道，使用了六个组织的个体头部模型。分析是在对所有其他数据不知情的情况下进行的。作为参考标准，我们使用与切除区域和一年后手术结果的一致性。
结果
我们分析了 50 例连续接受癫痫手术的患者（34 例颞叶和 16 例非颞叶）。30 例患者（60%）无癫痫发作。自动 ESI 的准确性为 74%（95%置信区间：59.66-85.37%）。
结论
自动发作 ESI 对定位癫痫起始区具有很高的准确性。
意义
自动发作期 EEG 信号的 ESI 将有助于在术前评估中实施该工具。
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