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Resected brain tissue, seizure onset zone and quantitative EEG measures: towards prediction of post-surgical seizure control

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dc.contributor.author Rummel, Christian
dc.contributor.author Abela, Eugenio
dc.contributor.author Andrzejak, Ralph Gregor
dc.contributor.author Hauf, Martinus
dc.contributor.author Pollo, Claudio
dc.contributor.author Müller, Markus
dc.contributor.author Weisstanner, Christian
dc.contributor.author Wiest, Roland G.
dc.contributor.author Schindler, Kaspar A.
dc.date.accessioned 2016-05-23T12:49:47Z
dc.date.available 2016-05-23T12:49:47Z
dc.date.issued 2015
dc.identifier.citation Rummel C, Abela E, Andrzejak RG, Hauf M, Pollo C, Muller M, Weisstanner C, Wiest RG, Schindler KA. Resected brain tissue, seizure onset zone and quantitative EEG measures: towards prediction of post-surgical seizure control. PLoS ONE. 2015;10(10):e0141023. doi: 10.1371/journal.pone.0141023
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/26326
dc.description.abstract BACKGROUND/nEpilepsy surgery is a potentially curative treatment option for pharmacoresistent patients. If non-invasive methods alone do not allow to delineate the epileptogenic brain areas the surgical candidates undergo long-term monitoring with intracranial EEG. Visual EEG analysis is then used to identify the seizure onset zone for targeted resection as a standard procedure./n/nMETHODS/nDespite of its great potential to assess the epileptogenicty of brain tissue, quantitative EEG analysis has not yet found its way into routine clinical practice. To demonstrate that quantitative EEG may yield clinically highly relevant information we retrospectively investigated how post-operative seizure control is associated with four selected EEG measures evaluated in the resected brain tissue and the seizure onset zone. Importantly, the exact spatial location of the intracranial electrodes was determined by coregistration of pre-operative MRI and post-implantation CT and coregistration with post-resection MRI was used to delineate the extent of tissue resection. Using data-driven thresholding, quantitative EEG results were separated into normally contributing and salient channels./n/nRESULTS/nIn patients with favorable post-surgical seizure control a significantly larger fraction of salient channels in three of the four quantitative EEG measures was resected than in patients with unfavorable outcome in terms of seizure control (median over the whole peri-ictal recordings). The same statistics revealed no association with post-operative seizure control when EEG channels contributing to the seizure onset zone were studied./n/nCONCLUSIONS/nWe conclude that quantitative EEG measures provide clinically relevant and objective markers of target tissue, which may be used to optimize epilepsy surgery. The finding that differentiation between favorable and unfavorable outcome was better for the fraction of salient values in the resected brain tissue than in the seizure onset zone is consistent with growing evidence that spatially extended networks might be more relevant for seizure generation, evolution and termination than a single highly localized brain region (i.e. a “focus”) where seizures start.
dc.description.sponsorship This study was supported by the Swiss National Science Foundation (SNF) via the projects 122010, 124089, 140332 and 155950. R.G. Andrzejak was supported by grant No. FIS-2010-18204 of the Spanish Ministry of Education and Science and funding from the Volkswagen Foundation. M. Müller acknowledges the Consejo Nacionál de Ciencia y Technología, Mexico, project 156667. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PLoS ONE. 2015;10(10):e0141023.
dc.rights © 2015 Rummel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Resected brain tissue, seizure onset zone and quantitative EEG measures: towards prediction of post-surgical seizure control
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0141023
dc.subject.keyword Electroencephalography
dc.subject.keyword Magnetic resonance imaging
dc.subject.keyword Surgical and invasive medical procedures
dc.subject.keyword Epilepsy
dc.subject.keyword Surgical resection
dc.subject.keyword Computed axial tomography
dc.subject.keyword Signal filtering
dc.subject.keyword Tuberous sclerosis
dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/FIS-2010-18204
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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