Epileptogenic network of focal epilepsies mapped with cortico-cortical evoked potentials |
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| Affiliation: | 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;3. Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China;4. Beijing Key Laboratory of Neurostimulation, Beijing, China;5. Department of Neurosurgery, Beijing Fengtai Hospital, Beijing, China;6. Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA;1. Physics Department, University of Bucharest, Str. Atomistilor 405, Magurele, Jud. Ilfov CP MG-11, Bucharest-Magurele, Romania;2. Epilepsy Center, University Hospital of Freiburg, Breisacher Str. 64, Freiburg, Germany;3. Neurology Department, University Emergency Hospital, Splaiul Independentei 169, Bucharest, Romania;4. Neurology Department, Carol Davila University of Medicine and Pharmacy, Blvd. Eroii Sanitari 8, Bucharest, Romania;5. Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Şos. Berceni 12, Bucharest, Romania;6. FHC Inc, 1201 Main St, Bowdoin, ME, USA;1. University Emergency Hospital, Department of Neurology, Bucharest, Romania;2. Danish Epilepsy Centre, Department of Clinical Neurophysiology, Dianalund, Denmark;3. University of Bucharest, Physics Department, Bucharest, Romania;4. University of Texas Health Science Center at Houston, Houston, TX, United States;5. FHC Inc., Bowdoin, ME, United States;6. University of Medicine and Pharmacy ‘Carol Davila’, Department of Neurology, Bucharest, Romania;7. Aarhus University Hospital, Department of Clinical Neurophysiology, Aarhus, Denmark;1. Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;2. Department of Neurosurgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan;3. Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan;1. Department of Neurology, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Human Brain Research Center, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;3. Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;4. Department of Neurosurgery, Ehime University Graduate School of Medicine, Shizukawa Toon City, Ehime 791-0295, Japan;5. Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;6. Department of Neurosurgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan;1. Department of Clinical Neuroscience, Institute of Psychiatry, King’s College London, UK;2. Fortis Malar Hospital, Chennai, India;3. Department of Clinical Neurophysiology, King’s College Hospital, London, UK;4. Department of Neurosurgery, King’s College Hospital, London, UK;5. Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, Spain |
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| Abstract: | ObjectiveThe goal of this study was to investigate the spatial extent and functional organization of the epileptogenic network through cortico-cortical evoked potentials (CCEPs) in patients being evaluated with intracranial stereoelectroencephalography.MethodsWe retrospectively included 25 patients. We divided the recorded sites into three regions: epileptogenic zone (EZ); propagation zone (PZ); and noninvolved zone (NIZ). The root mean square of the amplitudes was calculated to reconstruct effective connectivity network. We also analyzed the N1/N2 amplitudes to explore the responsiveness influenced by epileptogenicity. Prognostic analysis was performed by comparing intra-region and inter-region connectivity between seizure-free and non-seizure-free groups.ResultsOur results confirmed that stimulation of the EZ caused the strongest responses on other sites within and outside the EZ. Moreover, we found a hierarchical connectivity pattern showing the highest connectivity strength within EZ, and decreasing connectivity gradient from EZ, PZ to NIZ. Prognostic analysis indicated a stronger intra-EZ connection in the seizure-free group.ConclusionThe EZ showed highest excitability and dominantly influenced other regions. Quantitative CCEPs can be useful in mapping epileptic networks and predicting surgical outcome.SignificanceThe generated computational connectivity model may enhance our understanding of epileptogenic networks and provide useful information for surgical planning and prognosis prediction. |
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| Keywords: | Focal epilepsy CCEPs Effective connectivity Epileptogenic network CCEPs" },{" #name" :" keyword" ," $" :{" id" :" k0030" }," $$" :[{" #name" :" text" ," _" :" cortico-cortical evoked potentials EEG" },{" #name" :" keyword" ," $" :{" id" :" k0040" }," $$" :[{" #name" :" text" ," _" :" electroencephalography EI" },{" #name" :" keyword" ," $" :{" id" :" k0050" }," $$" :[{" #name" :" text" ," _" :" epileptogenicity index EZ" },{" #name" :" keyword" ," $" :{" id" :" k0060" }," $$" :[{" #name" :" text" ," _" :" epileptogenic zone MRI" },{" #name" :" keyword" ," $" :{" id" :" k0070" }," $$" :[{" #name" :" text" ," _" :" magnetic resonance imaging MTL" },{" #name" :" keyword" ," $" :{" id" :" k0080" }," $$" :[{" #name" :" text" ," _" :" mesial temporal lobe NIZ" },{" #name" :" keyword" ," $" :{" id" :" k0090" }," $$" :[{" #name" :" text" ," _" :" noninvolved zone PZ" },{" #name" :" keyword" ," $" :{" id" :" k0100" }," $$" :[{" #name" :" text" ," _" :" propagation zone RMS" },{" #name" :" keyword" ," $" :{" id" :" k0110" }," $$" :[{" #name" :" text" ," _" :" root mean square SEEG" },{" #name" :" keyword" ," $" :{" id" :" k0120" }," $$" :[{" #name" :" text" ," _" :" stereoelectroencephalography SPES" },{" #name" :" keyword" ," $" :{" id" :" k0130" }," $$" :[{" #name" :" text" ," _" :" single-pulse electrical stimulation |
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