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Seizure localization using three-dimensional surface projections of intracranial EEG power

  • Lee, Hyang Woon (이향운, Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA, Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, South Korea) , Blumenfeld, Hal (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA, Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA, Department of Neurobiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Farooque, Pue (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Han, Xiao (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Jhun, Stephen (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Chen, William C. (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Goncharova, Irina (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Vives, Kenneth (Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Spencer, Dennis D. (Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , Zaveri, Hitten (Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA) , ,
  • NEUROIMAGE[1053-8119], 2013, v.83, 616-626

초록/요약

Intracranial EEG (icEEG) provides a critical road map for epilepsy surgery but it has become increasingly difficult to interpret as technology has allowed the number of icEEG channels to grow. Borrowing methods from neuroimaging, we aimed to simplify data analysis and increase consistency between reviewers by using 3D surface projections of intracranial EEG poweR (3D-SPIER). We analyzed 139 seizures from 48 intractable epilepsy patients (28 temporal and 20 extratemporal) who had icEEG recordings, epilepsy surgery, and at least one year of post-surgical follow-up. We coregistered and plotted icEEG 13 frequency band signal power over time onto MRI-based surface renderings for each patient to create color 3D-SPIER movies. Two independent reviewers interpreted the icEEG data using visual analysis vs. 3D-SPIER, blinded to any clinical information. Overall agreement rates between 3D-SPIER and icEEG visual analysis or surgery were about 90% for side of seizure onset, 80% for lobe, and just under 80% for sublobar localization. These agreement rates were improved when flexible thresholds or frequency ranges were allowed for 3D-SPIER, especially for sublobar localization. Interestingly, agreement was better for patients with good surgical outcome than for patients with poor outcome. Localization using 3D-SPIER was measurably faster and considered qualitatively easier to interpret than visual analysis. These findings suggest that 3D-SPIER could be an improved diagnostic method for presurgical seizure localization in patients with intractable epilepsy and may also be useful for mapping normal brain function. (C) 2013 Elsevier Inc. All rights reserved.

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