Magnetoencephalography Profile of Patients with Drug-Resistant Focal Epilepsy and Normal MRI.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Annals of Indian Academy of Neurology Pub Date : 2024-09-01 Epub Date: 2024-09-30 DOI:10.4103/aian.aian_251_24

Ajay Asranna, Asheeb Abdulhak, Lakshminarayanapuram Gopal Viswanathan, Ravindranandh Chowdary Mundlamuri, Raghavendra Kenchaiah, Mariyappa Narayanan, Bhargava Gautham, Velumurugan Jayabal, Rose Dawn Bharath, Jitender Saini, Chandana Nagaraj, Sandhya Mangalore, Karthik Kulanthaivelu, Nishanth Sadashiva, A Mahadevan, Jamuna Rajeswaran, Arivazhagan Arimappamagan, Bhaskara Rao Malla, Sanjib Sinha

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Abstract

Background and objectives: Magnetoencephalography (MEG) could be a valuable tool in the presurgical evaluation of drug-resistant epilepsy (DRE), especially when the initial evaluation is inconclusive. In this retrospective study, we describe the profile of MEG in patients with DRE and normal magnetic resonance imaging (MRI).

Methods: We included patients with focal epilepsy and normal MRI who underwent presurgical evaluation for DRE. MEG profiles of these patients, including the frequency of spikes, density of clusters, number of clusters, and concordance with video electroencephalography (VEEG), were analyzed.

Results: Of the 73 patients included, magnetic source imaging (MSI) provided localizing information in 51 (69.9%) patients. Among patients with localizing MEG findings, localizing information on VEEG too was noted in 42 (57.5% of the whole cohort). Thirty-one (42.5%) patients had concordant findings with region-specific localization, six (8.2%) patients had partial concordance, and five (6.8%) subjects showed discordant findings. There was a moderate agreement for the presumed epileptogenic zone in comparing findings derived from MEG and VEEG (kappa value of 0.451, P < 0.001). The agreement was lower when MEG localized to the frontal lobe (kappa value of 0.379, P = 0.001) than the temporal lobe (kappa value 0.442, P = 0.002).

Conclusions: MEG can provide localizing information in most patients with a normal MRI. A moderate degree of agreement between localization by MEG and VEEG was noted. These findings highlight the usefulness of MSI in the presurgical evaluation of MRI-negative DRE.

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耐药性局灶性癫痫患者的脑磁图特征和正常磁共振成像。

背景和目的：脑磁图（MEG）是耐药性癫痫（DRE）手术前评估的重要工具，尤其是在初步评估结果不确定的情况下。在这项回顾性研究中，我们描述了磁共振成像（MRI）正常的 DRE 患者的脑磁图特征：我们纳入了接受 DRE 手术前评估的局灶性癫痫且磁共振成像正常的患者。方法：我们纳入了接受 DRE 手术前评估的局灶性癫痫患者和磁共振成像正常的患者，分析了这些患者的 MEG 图谱，包括尖峰频率、集群密度、集群数量以及与视频脑电图 (VEEG) 的一致性：结果：在纳入的 73 名患者中，有 51 名（69.9%）患者的磁源成像（MSI）提供了定位信息。在有定位 MEG 发现的患者中，有 42 人（占总人数的 57.5%）的 VEEG 也提供了定位信息。31名患者（42.5%）的特定区域定位结果一致，6名患者（8.2%）部分一致，5名受试者（6.8%）的结果不一致。在比较 MEG 和 VEEG 得出的结果时，推测的致痫区有一定程度的一致性（kappa 值为 0.451，P < 0.001）。当 MEG 定位在额叶时（kappa 值为 0.379，P = 0.001），一致性低于颞叶（kappa 值为 0.442，P = 0.002）：结论：MEG 可为大多数磁共振成像正常的患者提供定位信息。结论：MEG 可为大多数磁共振成像正常的患者提供定位信息，MEG 定位与 VEEG 定位之间具有中等程度的一致性。这些发现凸显了 MSI 在磁共振成像阴性 DRE 的术前评估中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Indian Academy of Neurology Nervous System Diseases-

CiteScore

2.20

自引率

11.80%

发文量

293

审稿时长

29 weeks

期刊介绍： The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.