Medina Villalon Samuel, Makhalova Julia, López-Madrona Victor J, Garnier Elodie, Badier Jean-Michel, Bartolomei Fabrice, Bénar Christian G
APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
Sci Rep. 2024 Feb 19;14(1):4071. doi: 10.1038/s41598-024-54359-4.
Stereoelectroencephalography is a powerful intracerebral EEG recording method for the presurgical evaluation of epilepsy. It consists in implanting depth electrodes in the patient's brain to record electrical activity and map the epileptogenic zone, which should be resected to render the patient seizure-free. Stereoelectroencephalography has high spatial accuracy and signal-to-noise ratio but remains limited in the coverage of the explored brain regions. Thus, the implantation might provide a suboptimal sampling of epileptogenic regions. We investigate the potential of improving a suboptimal stereoelectroencephalography recording by performing source localization on stereoelectroencephalography signals. We propose combining independent component analysis, connectivity measures to identify components of interest, and distributed source modelling. This approach was tested on two patients with two implantations each, the first failing to characterize the epileptogenic zone and the second giving a better diagnosis. We demonstrate that ictal and interictal source localization performed on the first stereoelectroencephalography recordings matches the findings of the second stereo-EEG exploration. Our findings suggest that independent component analysis followed by source localization on the topographies of interest is a promising method for retrieving the epileptogenic zone in case of suboptimal implantation.
立体脑电图是一种用于癫痫术前评估的强大的脑内脑电图记录方法。它包括在患者大脑中植入深度电极，以记录电活动并绘制癫痫发作起始区的图谱，而该区域应被切除以使患者不再发作。立体脑电图具有高空间精度和信噪比，但在探索的脑区覆盖范围方面仍存在局限性。因此，植入可能无法对癫痫发作起始区进行最佳采样。我们研究了通过对立体脑电图信号进行源定位来改善次优立体脑电图记录的潜力。我们提出将独立成分分析、用于识别感兴趣成分的连通性测量方法以及分布式源建模相结合。该方法在两名患者身上进行了测试，每名患者都进行了两次植入，第一次未能明确癫痫发作起始区，第二次则给出了更好的诊断结果。我们证明，对第一次立体脑电图记录进行发作期和发作间期源定位与第二次立体脑电图探查的结果相符。我们的研究结果表明，在植入不理想的情况下，先进行独立成分分析，然后在感兴趣的地形图上进行源定位，是一种用于检索癫痫发作起始区的有前景的方法。
