In:
Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), ( 2022-12-01), p. 1-10
Kurzfassung:
The authors investigated alterations in functional connectivity (FC) and EEG power during ictal onset patterns of low-voltage fast activity (LVFA) in drug-resistant focal epilepsy. They hypothesized that such changes would be useful to classify epilepsy surgical outcomes. METHODS In a cohort of 79 patients with drug-resistant focal epilepsy who underwent stereoelectroencephalography (SEEG) evaluation as well as resective surgery, FC changes during the peri-LVFA period were measured using nonlinear regression ( h 2 ) and power spectral properties within/between three regions: the seizure onset zone (SOZ), early propagation zone (PZ), and noninvolved zone (NIZ). Desynchronization and power desynchronization h 2 indices were calculated to assess the degree of EEG desynchronization during LVFA. Multivariate logistic regression was employed to control for confounding factors. Finally, receiver operating characteristic curves were generated to evaluate the performance of desynchronization indices in predicting surgical outcome. RESULTS Fifty-three patients showed ictal LVFA and distinct zones of the SOZ, PZ, and NIZ. Among them, 39 patients (73.6%) achieved seizure freedom by the final follow-up. EEG desynchronization, measured by h 2 analysis, was found in the seizure-free group during LVFA: FC decreased within the SOZ and between regions compared with the pre-LVFA and post-LVFA periods. In contrast, the non–seizure-free group showed no prominent EEG desynchronization. The h 2 desynchronization index, but not the power desynchronization index, enabled classification of seizure-free versus non–seizure-free patients after resective surgery. CONCLUSIONS EEG desynchronization during the peri-LVFA period, measured by within-zone and between-zone h 2 analysis, may be helpful for identifying patients with favorable postsurgical outcomes and also may potentially improve epileptogenic zone identification in the future.
Materialart:
Online-Ressource
ISSN:
0022-3085
,
1933-0693
DOI:
10.3171/2022.11.JNS221469
Sprache:
Unbekannt
Verlag:
Journal of Neurosurgery Publishing Group (JNSPG)
Publikationsdatum:
2022
ZDB Id:
2026156-1
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