Resected Brain Tissue, Seizure Onset Zone and Quantitative EEG Measures: Towards Prediction of Post-Surgical Seizure Control

• DOI: 10.1371/journal.pone.0141023
• Publication Date: 2015-10-29T14:06:25Z
• Authors: Christian Rummel; Eugenio Abela; Ralph G. Andrzejak; Martinus Hauf; Claudio Pollo; Markus Müller; Christian Weissta...; Roland Wiest; Kaspar Schindler
• Keywords: Adult; Male; Signal filtering; Science; 610 Medicine & health; Young Adult; 03 medical and health sciences; Magnetic resonance imaging; Postoperative Complications; 0302 clinical medicine; Seizures; Image Processing, Computer-Assisted; Humans; Surgical and invasive medical procedures; Retrospective Studies; Epilepsy; Q; Tuberous sclerosis; R; Brain; Electroencephalography; Middle Aged; Magnetic Resonance Imaging; Surgical resection; Computed axial tomography; Medicine; Female; Tomography, X-Ray Computed; Research Article

Background Epilepsy surgery is a potentially curative treatment option for pharmacoresistent patients. If non-invasive methods alone do not allow to delineate the epileptogenic brain areas surgical candidates undergo long-term monitoring with intracranial EEG. Visual EEG analysis then used identify seizure onset zone targeted resection as standard procedure. Methods Despite of its great potential assess epileptogenicty tissue, quantitative has yet found way into routine clinical practice. To demonstrate that may yield clinically highly relevant information we retrospectively investigated how post-operative control associated four selected measures evaluated in resected tissue and zone. Importantly, exact spatial location electrodes was determined by coregistration pre-operative MRI post-implantation CT post-resection extent resection. Using data-driven thresholding, results were separated normally contributing salient channels. Results In patients favorable post-surgical significantly larger fraction channels three than unfavorable outcome terms (median over whole peri-ictal recordings). The same statistics revealed no association when studied. Conclusions We conclude provide objective markers target which be optimize epilepsy surgery. finding differentiation between better values consistent growing evidence spatially extended networks might more generation, evolution termination single localized region (i.e. “focus”) where seizures start.