Dataset Information

High-frequency neuronal network modulations encoded in scalp EEG precede the onset of focal seizures.

ABSTRACT: Modulations of neuronal network interactions by seizure precursors are only partially understood and difficult to measure, in part due to inherent intra- and inter-patient seizure heterogeneities and EEG variability. This study investigated preictal neuromodulations associated with seizures originating in the temporal and/or frontal lobes, using information theoretic parameters estimated from awake scalp EEGs in two frequency ranges, ?100 Hz and >100 Hz, respectively. Seizure-related activity at high frequencies has not been extensively estimated in awake scalp EEGs. Based on the statistical similarity of preictal and ictal information parameters, preictal network interactions appeared to be specifically modulated at frequencies >100 Hz, but not at lower frequencies. The dynamics of these parameters varied distinctly according to the origin of seizure onset (temporal versus frontal). Although preliminary, and based on a small patient sample for which the potential heterogeneity of multiple anticonvulsive medications was difficult to control, these results suggest that preictal modulations may be estimated from high-frequency scalp EEGs using directional information measures with high specificity to ictal events, and may thus be promising for improving seizure prediction.

SUBMITTER: Stamoulis C

PROVIDER: S-EPMC3320023 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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High-frequency neuronal network modulations encoded in scalp EEG precede the onset of focal seizures.

Stamoulis Catherine C Gruber Lawrence J LJ Schomer Donald L DL Chang Bernard S BS

Epilepsy & behavior : E&B 20120310 4

Modulations of neuronal network interactions by seizure precursors are only partially understood and difficult to measure, in part due to inherent intra- and inter-patient seizure heterogeneities and EEG variability. This study investigated preictal neuromodulations associated with seizures originating in the temporal and/or frontal lobes, using information theoretic parameters estimated from awake scalp EEGs in two frequency ranges, ≤100 Hz and >100 Hz, respectively. Seizure-related activity at ...[more]

PMID: 22410338

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Project description:ObjectiveOur objective was to evaluate the relationship between scalp-EEG and stereoelectroencephalography (SEEG) seizure-onset patterns (SOP) in patients with MRI-negative drug-resistant focal epilepsy.MethodsWe analyzed retrospectively 41 patients without visible lesion on brain MRI who underwent video-EEG followed by SEEG. We defined five types of SOPs on scalp-EEG and eight types on SEEG. We examined how various clinical variables affected scalp-EEG SOPs.ResultsThe most prevalent scalp SOPs were rhythmic sinusoidal activity (56.8%), repetitive epileptiform discharges (22.7%), and paroxysmal fast activity (15.9%). The presence of paroxysmal fast activity on scalp-EEG was always seen without delay from clinical onset and correlated with the presence of low-voltage fast activity in SEEG (sensitivity = 22.6%, specificity = 100%). The main factor explaining the discrepancy between the scalp and SEEG SOPs was the delay between clinical and scalp-EEG onset. There was a correlation between the scalp and SEEG SOPs when the scalp onset was simultaneous with the clinical onset (p = 0.026). A significant delay between clinical and scalp discharge onset was observed in 25% of patients and featured always with a rhythmic sinusoidal activity on scalp, corresponding to similar morphology of the discharge on SEEG. The presence of repetitive epileptiform discharges on scalp was associated with an underlying focal cortical dysplasia (sensitivity = 30%, specificity = 90%). There was no significant association between the scalp SOP and the epileptogenic zone location (deep or superficial), or surgical outcome.SignificanceIn patients with MRI-negative focal epilepsy, scalp SOP could suggest the SEEG SOP and some etiology (focal cortical dysplasia) but has no correlation with surgical prognosis. Scalp SOP correlates with the SEEG SOP in cases of simultaneous EEG and clinical onset; otherwise, scalp SOP reflects the propagation of the SEEG discharge.Plain language summaryWe looked at the correspondence between the electrical activity recorded during the start of focal seizure using scalp and intracerebral electrodes in patients with no visible lesion on MRI. If there is a fast activity on scalp, it reflects similar activity inside the brain. We found a good correspondence between scalp and intracerebral electrical activity for cases without significant delay between clinical and scalp electrical onset (seen in 75% of the cases we studied). Visualizing repetitive epileptic activity on scalp could suggest a particular cause of the epilepsy: a subtype of brain malformation called focal cortical dysplasia.

Project description:The success of stereoelectroencephalographic (SEEG) investigations depends crucially on the hypotheses on the putative location of the seizure onset zone. This information is derived from non-invasive data either based on visual analysis or advanced source localization algorithms. While source localization applied to interictal spikes recorded on scalp is the classical method, it does not provide unequivocal information regarding the seizure onset zone. Raw ictal activity contains a mixture of signals originating from several regions of the brain as well as EMG artifacts, hampering direct input to the source localization algorithms. We therefore introduce a methodology that disentangles the various sources contributing to the scalp ictal activity using independent component analysis and uses equivalent current dipole localization as putative locus of ictal sources. We validated the results of our analysis pipeline by performing long-term simultaneous scalp - intracerebral (SEEG) recordings in 14 patients and analyzing the wavelet coherence between the independent component encoding the ictal discharge and the SEEG signals in 8 patients passing the inclusion criteria. Our results show that invasively recorded ictal onset patterns, including low-voltage fast activity, can be captured by the independent component analysis of scalp EEG. The visibility of the ictal activity strongly depends on the depth of the sources. The equivalent current dipole localization can point to the seizure onset zone (SOZ) with an accuracy that can be as high as 10 mm for superficially located sources, that gradually decreases for deeper seizure generators, averaging at 47 mm in the 8 analyzed patients. Independent component analysis is therefore shown to have a promising SOZ localizing value, indicating whether the seizure onset zone is neocortical, and its approximate location, or located in mesial structures. That may contribute to a better crafting of the hypotheses used as basis of the stereo-EEG implantations.

Dataset Information

High-frequency neuronal network modulations encoded in scalp EEG precede the onset of focal seizures.

Publications

High-frequency neuronal network modulations encoded in scalp EEG precede the onset of focal seizures.

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