Visualization of the Spatiotemporal Propagation of Interictal Spikes in Temporal Lobe Epilepsy: A MEG Pilot Study.

IF 2.3 3区 医学 Q3 CLINICAL NEUROLOGY
Brain Topography Pub Date : 2024-01-01 Epub Date: 2023-11-15 DOI:10.1007/s10548-023-01017-z
Daniel J Zhou, Valentina Gumenyuk, Olga Taraschenko, Bartosz T Grobelny, Steven M Stufflebeam, Noam Peled
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引用次数: 0

Abstract

Magnetoencephalography (MEG) is clinically used to localize interictal spikes in discrete brain areas of epilepsy patients through the equivalent current dipole (ECD) method, but does not account for the temporal dynamics of spike activity. Recent studies found that interictal spike propagation beyond the temporal lobe may be associated with worse postsurgical outcomes, but studies using whole-brain data such as in MEG remain limited. In this pilot study, we developed a tool that visualizes the spatiotemporal dynamics of interictal MEG spikes normalized to spike-free sleep activity to assess their onset and propagation patterns in patients with temporal lobe epilepsy (TLE). We extracted interictal source data containing focal epileptiform activity in awake and asleep states from seven patients whose MEG ECD clusters localized to the temporal lobe and normalized the data against spike-free sleep recordings. We calculated the normalized activity over time per cortical label, confirmed maximal activity at onset, and mapped the activity over a 10 ms interval onto each patient's brain using a custom-built Multi-Modal Visualization Tool. The onset of activity in all patients appeared near the clinically determined epileptogenic zone. By 10 ms, four of the patients had propagated source activity restricted to within the temporal lobe, and three had propagated source activity spread to extratemporal regions. Using this tool, we show that noninvasively identifying the onset and propagation of interictal spike activity in MEG can be achieved, which may help provide further insight into epileptic networks and guide surgical planning and interventions in patients with TLE.

Abstract Image

颞叶癫痫间歇峰的时空传播可视化:一项脑磁图先导研究。
脑磁图(MEG)在临床上通过等效电流偶极子(ECD)方法定位癫痫患者离散脑区间峰,但不能解释峰活动的时间动态。最近的研究发现,颞叶以外的间期尖峰传播可能与较差的术后结果有关,但使用全脑数据(如MEG)的研究仍然有限。在这项初步研究中,我们开发了一种工具,可以可视化脑磁图间期峰的时空动态,以标准化为无峰睡眠活动,以评估颞叶癫痫(TLE)患者的发作和传播模式。我们从7名MEG ECD簇定位于颞叶的患者中提取了包含清醒和睡眠状态局灶性癫痫样活动的间歇源数据,并将这些数据与无尖峰睡眠记录进行了标准化。我们计算了每个皮质标签随时间的标准化活动,确认了发病时的最大活动,并使用定制的多模态可视化工具将10毫秒间隔内的活动映射到每个患者的大脑上。所有患者的活动发生在临床确定的癫痫区附近。到10 ms时,4名患者的传播源活动仅限于颞叶内,3名患者的传播源活动已扩散到颞叶外区域。使用该工具,我们发现可以实现无创识别MEG间期尖峰活动的发生和传播,这可能有助于进一步了解癫痫网络,并指导TLE患者的手术计划和干预。
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来源期刊
Brain Topography
Brain Topography 医学-临床神经学
CiteScore
4.70
自引率
7.40%
发文量
41
审稿时长
3 months
期刊介绍: Brain Topography publishes clinical and basic research on cognitive neuroscience and functional neurophysiology using the full range of imaging techniques including EEG, MEG, fMRI, TMS, diffusion imaging, spectroscopy, intracranial recordings, lesion studies, and related methods. Submissions combining multiple techniques are particularly encouraged, as well as reports of new and innovative methodologies.
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