Spike-related haemodynamic responses overlap with high frequency oscillations in patients with focal epilepsy
Notice bibliographique
Résumé
Simultaneous scalp EEG/functional MRI measures non-invasively haemodynamic responses to interictal epileptic discharges, which are related to the epileptogenic zone. High frequency oscillations are also an excellent indicator of this zone, but are primarily recorded from intracerebral EEG. We studied the spatial overlap of these two important markers in patients with drug-resistant epilepsy to assess if their combination could help better define the extent of the epileptogenic zone. We included patients who underwent EEG-functional MRI and later intracerebral EEG. Based on intracerebral EEG findings, we separated patients with unifocal seizures from patients with multifocal or unknown onset seizures. Haemodynamic t-maps were coregistered with the intracerebral electrode positions. Each EEG channel was classified as pertaining to one of the following categories: primary haemodynamic cluster (maximum t-value), secondary cluster (t-value > 90% of the primary cluster) or outside the primary and secondary clusters. We marked high frequency oscillations (ripples: 80-250 Hz; fast ripples: 250-500 Hz) during 1 h of slow wave sleep, and compared their rates in each haemodynamic category. After classifying channels as high- or low-rate, the proportion of high-rate channels within the primary or primary plus secondary clusters was compared to the proportion expected by chance. Twenty-five patients, 11 with unifocal and 14 with multifocal/unknown seizure onsets, were studied. We found a significantly higher median high frequency oscillation rate in the primary cluster compared to secondary cluster and outside these two clusters for the unifocal group (P < 0.0001), but not for the multifocal/unknown group. For the unifocal group, the number of high-rate channels within the primary or primary plus secondary clusters was significantly higher than expected by chance. This held only for the high-ripple-rate channels in the multifocal/unknown group. At the patient level, most patients (18/25, or 72%) had at least one high-rate channel within a primary cluster. In patients with unifocal epilepsy, the maximum haemodynamic response (primary cluster) related to scalp interictal discharges overlaps with the tissue generating high frequency oscillations at high rates. If intracranial EEG is warranted, this response should be explored. As a tentative clinical use of the combination of these techniques we propose that higher high frequency oscillation rates inside than outside the maximum response indicates that the patient has indeed a focal epileptogenic zone demarcated by this response, whereas similar rates inside and outside may indicate a widespread epileptogenic zone or an epileptogenic zone not covered by the implantation.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».