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Detection and localization of interictal ripples with magnetoencephalography in the presurgical evaluation of drug-resistant insular epilepsy

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机构: [1]Department of Neurology, Hebei Medical University, Shijiazhuang 050017, China [2]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China [3]Beijing Key Laboratory of Neuromodulation, Beijing 100053, China [4]Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China [5]Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China
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关键词: Insular epilepsy Magnetoencephalography High-frequency oscillations Seizure

摘要:
Precise noninvasive presurgical localization of insular epilepsy is important. The objective of the present study was to detect and localize interictal high-frequency oscillations (HFOs) in patients with insular epilepsy at the source levels using magnetoencephalography (MEG). We investigated whether HFOs can delineate epileptogenic areas. We analysed MEG data with new accumulated source imaging (HFOs, 80-250 Hz ripples during spikes) and conventional dipole modelling (spikes) methods for localizing epileptic foci. We evaluated the relationship of the resection of focal brain regions containing interictal HFOs and the spikes with the postsurgical seizure outcome. Interictal HFOs were localized in the insular epileptogenic zone (EZ) in 18 out of 21 patients undergoing surgical treatment for clinically diagnosed insular epilepsy. While dipole clusters of spikes were involved in the insular EZ in 15 patients. Both the HFOs and the dipole cluster were localized in the insula in 14 patients. The seizure-free percentage was 87% for the resection of brain regions generating HFOs, whereas 80% for the resection of brain regions generating spikes. There was a much higher chance of freedom from seizures with complete resection of the HFO-generating regions than with partial resection or no resection (P = 0.031). No such difference was seen for spike-generating regions. Our results suggest that HFOs from insular epilepsy could be noninvasively detected and quantitatively assessed with MEG technology. MEG HFOs (ripples during spikes) may be valuable for the localization of the epileptogenic zone in insular epilepsy.

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基金编号: Z161100002616001 2015AA020514

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 3 区 神经科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 神经科学
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出版当年[2017]版:
Q2 NEUROSCIENCES
最新[2023]版:
Q3 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Department of Neurology, Hebei Medical University, Shijiazhuang 050017, China
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通讯机构: [1]Department of Neurology, Hebei Medical University, Shijiazhuang 050017, China [2]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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