EEG-fMRI in the presurgical evaluation of temporal lobe epilepsy

Autor(es):Mostrar menos -

Coan, Ana C. ^[1] ; Chaudhary, Umair J. ^{[2, 3]} ; Grouiller, Frederic ^[4] ; Campos, Brunno M. ^[1] ; Perani, Suejen ^{[2, 3]} ; De Ciantis, Alessio ^{[2, 3]} ; Vulliemoz, Serge ^{[5, 6, 7]} ; Diehl, Beate ^{[2, 3]} ; Beltramini, Guilherme C. ^[8] ; Carmichael, David W. ^{[2, 3]} ; Thornton, Rachel C. ^{[2, 3]} ; Covolan, Roberto J. ^[8] ; Cendes, Fernando ^[1] ; Lemieux, Louis ^{[2, 3]}

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Dept Neurol, Neuroimaging Lab, Campinas, SP - Brazil

^[2] UCL, Inst Neurol, Dept Clin & Expt Epilepsy, London - England

^[3] Epilepsy Soc, MRI Unit, Chesham Lane, Gerrards Cross SL9 0RJ, Bucks - England

^[4] Univ Hosp Geneva, Dept Radiol & Med Informat, Geneva - Switzerland

^[5] Univ Hosp Geneva, Dept Neurol, EEG & Epilepsy Unit, Geneva - Switzerland

^[6] Univ Hosp Geneva, Dept Neurol, Funct Brain Mapping Lab, Geneva - Switzerland

^[7] Univ Geneva, Fac Med, Geneva - Switzerland

^[8] Univ Estadual Campinas, Gleb Wataghin Phys Inst, Neurophys Grp, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY; v. 87, n. 6, p. 642-649, JUN 2016.
• Citações Web of Science: 7

Resumo

Objective Drug-resistant temporal lobe epilepsy (TLE) often requires thorough investigation to define the epileptogenic zone for surgical treatment. We used simultaneous interictal scalp EEG-fMRI to evaluate its value for predicting long-term postsurgical outcome. Methods 30 patients undergoing presurgical evaluation and proceeding to temporal lobe (TL) resection were studied. Interictal epileptiform discharges (IEDs) were identified on intra-MRI EEG and used to build a model of haemodynamic changes. In addition, topographic electroencephalographic correlation maps were calculated between the average IED during videoEEG and intra-MRI EEG, and used as a condition. This allowed the analysis of all data irrespective of the presence of IED on intra-MRI EEG. Mean follow-up after surgery was 46 months. International League Against Epilepsy (ILAE) outcomes 1 and 2 were considered good, and 3-6 poor, surgical outcome. Haemodynamic maps were classified according to the presence (Concordant) or absence (Discordant) of Blood Oxygen Level-Dependent (BOLD) change in the TL overlapping with the surgical resection. Results The proportion of patients with good surgical outcome was significantly higher (13/16; 81%) in the Concordant than in the Discordant group (3/14; 21%) (chi(2) test, Yates correction, p=0.003) and multivariate analysis showed that Concordant BOLD maps were independently related to good surgical outcome (p=0.007). Sensitivity and specificity of EEG-fMRI results to identify patients with good surgical outcome were 81% and 79%, respectively, and positive and negative predictive values were 81% and 79%, respectively. Interpretation The presence of significant BOLD changes in the area of resection on interictal EEG-fMRI in patients with TLE retrospectively confirmed the epileptogenic zone. Surgical resection including regions of haemodynamic changes in the TL may lead to better postoperative outcome. (AU)

• Processo FAPESP: 09/54552-9 - Estudo da progressão de dano na epilepsia de lobo temporal mesial com ou sem sinais de esclerose hipocampal
• Beneficiário: Ana Carolina Coan
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 11/03477-7 - Análise da resposta hemodinâmica em pacientes com epilepsia de lobo temporal mesial através do uso simultâneo de eletrencefalografia e ressonância magnética funcional
• Beneficiário: Brunno Machado de Campos
• Modalidade de apoio: Bolsas no Brasil - Mestrado