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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

EEG-fMRI in the presurgical evaluation of temporal lobe epilepsy

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Autor(es):
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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]
Número total de Autores: 14
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
Número total de Afiliações: 8
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: 9
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
Linha de fomento: 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
Linha de fomento: Bolsas no Brasil - Mestrado