Single and Multiple Clusters of Magnetoencephalographic Dipoles in Neocortical Epilepsy: Significance in Characterizing the Epileptogenic Zone
Purpose: To characterize the epileptogenic zone in neocortical epilepsy (NE) by using magnetoencephalography (MEG). Methods: We defined and compared locations of single and multiple clusters of equivalent current dipoles (ECDs) for interictal spikes with MRI findings, ictal‐onset zones (IOZs) from s...
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| Veröffentlicht in: | Epilepsia (Copenhagen) 2006-02, Vol.47 (2), p.355-364 |
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| creator | Oishi, Makoto Kameyama, Shigeki Masuda, Hiroshi Tohyama, Jun Kanazawa, Osamu Sasagawa, Mutsuo Otsubo, Hiroshi |
| description | Purpose: To characterize the epileptogenic zone in neocortical epilepsy (NE) by using magnetoencephalography (MEG).
Methods: We defined and compared locations of single and multiple clusters of equivalent current dipoles (ECDs) for interictal spikes with MRI findings, ictal‐onset zones (IOZs) from subdural electroencephalography (SDEEG), resected areas, and postsurgical outcomes of 20 patients who underwent cortical resection for medically intractable NE.
Results: Fourteen patients had single clusters; six had multiple clusters. Overlap of clusters and IOZs defined group A (nine patients), in which a single cluster coincided with the IOZ; group B1 (four patients), in which a single cluster was within or partially overlapped the IOZ; group B2 (five patients), in which multiple‐cluster sections overlapped IOZs; group C (two patients; one single; one multiple), in which no overlap was seen. More single clusters (nine of 14) than multiple clusters (none of six) coincided with the IOZ (p = 0.014). More patients with single clusters (10 of 14) than patients with multiple clusters (one of six) had seizure‐free outcomes (p = 0.049). Eight of nine patients in group A, versus three of 11 in groups B1, B2, and C, achieved seizure‐free outcomes (p = 0.0098). Correlations between MRI findings and postsurgical outcomes were not statistically significant; eight of 13 patients with single lesions, one of four with no lesions, and two of three with multifocal lesions had seizure‐free outcomes.
Conclusions: In neocortical epilepsy, MEG ECD clusters correlated with SDEEG IOZs. Single clusters indicated discrete epileptogenic zones that required complete resection for seizure‐free outcome. Multiple clusters necessitated that the multiple or extensive epileptogenic zones be completely identified and delineated by SDEEG. |
| doi_str_mv | 10.1111/j.1528-1167.2006.00428.x |
| format | Article |
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Methods: We defined and compared locations of single and multiple clusters of equivalent current dipoles (ECDs) for interictal spikes with MRI findings, ictal‐onset zones (IOZs) from subdural electroencephalography (SDEEG), resected areas, and postsurgical outcomes of 20 patients who underwent cortical resection for medically intractable NE.
Results: Fourteen patients had single clusters; six had multiple clusters. Overlap of clusters and IOZs defined group A (nine patients), in which a single cluster coincided with the IOZ; group B1 (four patients), in which a single cluster was within or partially overlapped the IOZ; group B2 (five patients), in which multiple‐cluster sections overlapped IOZs; group C (two patients; one single; one multiple), in which no overlap was seen. More single clusters (nine of 14) than multiple clusters (none of six) coincided with the IOZ (p = 0.014). More patients with single clusters (10 of 14) than patients with multiple clusters (one of six) had seizure‐free outcomes (p = 0.049). Eight of nine patients in group A, versus three of 11 in groups B1, B2, and C, achieved seizure‐free outcomes (p = 0.0098). Correlations between MRI findings and postsurgical outcomes were not statistically significant; eight of 13 patients with single lesions, one of four with no lesions, and two of three with multifocal lesions had seizure‐free outcomes.
Conclusions: In neocortical epilepsy, MEG ECD clusters correlated with SDEEG IOZs. Single clusters indicated discrete epileptogenic zones that required complete resection for seizure‐free outcome. Multiple clusters necessitated that the multiple or extensive epileptogenic zones be completely identified and delineated by SDEEG.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/j.1528-1167.2006.00428.x</identifier><identifier>PMID: 16499760</identifier><identifier>CODEN: EPILAK</identifier><language>eng</language><publisher>350 Main Street , Malden , MA 02148 , USA and 9600 Garsington Road , Oxford , OX4 2XG , England: Blackwell Publishing Inc</publisher><subject>Adolescent ; Adult ; Anticonvulsants. Antiepileptics. Antiparkinson agents ; Biological and medical sciences ; Brain Mapping ; Child ; Disease-Free Survival ; Electrodes, Implanted ; Electroencephalography - statistics & numerical data ; Epilepsy - diagnosis ; Epilepsy - physiopathology ; Epilepsy - surgery ; Epileptogenic zone ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Ictal‐onset zone ; Magnetic Resonance Imaging - statistics & numerical data ; Magnetoencephalography ; Magnetoencephalography - statistics & numerical data ; Male ; Malformations of the nervous system ; Medical sciences ; Middle Aged ; Neocortex - pathology ; Neocortex - physiopathology ; Neocortex - surgery ; Neocortical epilepsy ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pharmacology. Drug treatments ; Preoperative Care ; Retrospective Studies ; Single and multiple clusters of dipoles ; Treatment Outcome</subject><ispartof>Epilepsia (Copenhagen), 2006-02, Vol.47 (2), p.355-364</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5438-4954e88eaf551b967d1cbab94f30170d4b9f5653a7c9d78c7f7cc0580123a6e73</citedby><cites>FETCH-LOGICAL-c5438-4954e88eaf551b967d1cbab94f30170d4b9f5653a7c9d78c7f7cc0580123a6e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1528-1167.2006.00428.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1528-1167.2006.00428.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17616726$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16499760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oishi, Makoto</creatorcontrib><creatorcontrib>Kameyama, Shigeki</creatorcontrib><creatorcontrib>Masuda, Hiroshi</creatorcontrib><creatorcontrib>Tohyama, Jun</creatorcontrib><creatorcontrib>Kanazawa, Osamu</creatorcontrib><creatorcontrib>Sasagawa, Mutsuo</creatorcontrib><creatorcontrib>Otsubo, Hiroshi</creatorcontrib><title>Single and Multiple Clusters of Magnetoencephalographic Dipoles in Neocortical Epilepsy: Significance in Characterizing the Epileptogenic Zone</title><title>Epilepsia (Copenhagen)</title><addtitle>Epilepsia</addtitle><description>Purpose: To characterize the epileptogenic zone in neocortical epilepsy (NE) by using magnetoencephalography (MEG).
Methods: We defined and compared locations of single and multiple clusters of equivalent current dipoles (ECDs) for interictal spikes with MRI findings, ictal‐onset zones (IOZs) from subdural electroencephalography (SDEEG), resected areas, and postsurgical outcomes of 20 patients who underwent cortical resection for medically intractable NE.
Results: Fourteen patients had single clusters; six had multiple clusters. Overlap of clusters and IOZs defined group A (nine patients), in which a single cluster coincided with the IOZ; group B1 (four patients), in which a single cluster was within or partially overlapped the IOZ; group B2 (five patients), in which multiple‐cluster sections overlapped IOZs; group C (two patients; one single; one multiple), in which no overlap was seen. More single clusters (nine of 14) than multiple clusters (none of six) coincided with the IOZ (p = 0.014). More patients with single clusters (10 of 14) than patients with multiple clusters (one of six) had seizure‐free outcomes (p = 0.049). Eight of nine patients in group A, versus three of 11 in groups B1, B2, and C, achieved seizure‐free outcomes (p = 0.0098). Correlations between MRI findings and postsurgical outcomes were not statistically significant; eight of 13 patients with single lesions, one of four with no lesions, and two of three with multifocal lesions had seizure‐free outcomes.
Conclusions: In neocortical epilepsy, MEG ECD clusters correlated with SDEEG IOZs. Single clusters indicated discrete epileptogenic zones that required complete resection for seizure‐free outcome. Multiple clusters necessitated that the multiple or extensive epileptogenic zones be completely identified and delineated by SDEEG.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents</subject><subject>Biological and medical sciences</subject><subject>Brain Mapping</subject><subject>Child</subject><subject>Disease-Free Survival</subject><subject>Electrodes, Implanted</subject><subject>Electroencephalography - statistics & numerical data</subject><subject>Epilepsy - diagnosis</subject><subject>Epilepsy - physiopathology</subject><subject>Epilepsy - surgery</subject><subject>Epileptogenic zone</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Ictal‐onset zone</subject><subject>Magnetic Resonance Imaging - statistics & numerical data</subject><subject>Magnetoencephalography</subject><subject>Magnetoencephalography - statistics & numerical data</subject><subject>Male</subject><subject>Malformations of the nervous system</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neocortex - pathology</subject><subject>Neocortex - physiopathology</subject><subject>Neocortex - surgery</subject><subject>Neocortical epilepsy</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Preoperative Care</subject><subject>Retrospective Studies</subject><subject>Single and multiple clusters of dipoles</subject><subject>Treatment Outcome</subject><issn>0013-9580</issn><issn>1528-1167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhS0EokPhFZA3sEuw82PHiA0ahlKpBaTCho3lODcZjzxxaiei04foM9dhonZJ7YX_vnuudQ5CmJKUxvFhl9IyqxJKGU8zQlhKSJFV6c0ztHp4eI5WhNA8EWVFTtCrEHaEEM54_hKdUFYIwRlZobsr03cWsOobfDnZ0QzxsLZTGMEH7Fp8qboeRge9hmGrrOu8GrZG4y9mcBYCNj3-Dk47PxqtLN4MxsIQDh_xlel608bLWDlT663ySkdZcxtb4nELCzy6Dvqo-Mf18Bq9aJUN8GZZT9Hvr5tf62_JxY-z8_Xni0SXRV4lhSgLqCpQbVnSWjDeUF2rWhRtTignTVGLtmRlrrgWDa80b7nWJBpBs1wx4Pkpen_UHby7niCMcm-CBmtVD24KknEmsqwQ_wUpjzPnJILVEdTeheChlYM3e-UPkhI5hyZ3cs5GztnIOTT5LzR5E0vfLj2meg_NY-GSUgTeLYAK0eTWR09NeOQ4i5oZi9ynI_c3-np48gfk5ud53OT3vE60kg</recordid><startdate>200602</startdate><enddate>200602</enddate><creator>Oishi, Makoto</creator><creator>Kameyama, Shigeki</creator><creator>Masuda, Hiroshi</creator><creator>Tohyama, Jun</creator><creator>Kanazawa, Osamu</creator><creator>Sasagawa, Mutsuo</creator><creator>Otsubo, Hiroshi</creator><general>Blackwell Publishing Inc</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200602</creationdate><title>Single and Multiple Clusters of Magnetoencephalographic Dipoles in Neocortical Epilepsy: Significance in Characterizing the Epileptogenic Zone</title><author>Oishi, Makoto ; Kameyama, Shigeki ; Masuda, Hiroshi ; Tohyama, Jun ; Kanazawa, Osamu ; Sasagawa, Mutsuo ; Otsubo, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5438-4954e88eaf551b967d1cbab94f30170d4b9f5653a7c9d78c7f7cc0580123a6e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anticonvulsants. Antiepileptics. Antiparkinson agents</topic><topic>Biological and medical sciences</topic><topic>Brain Mapping</topic><topic>Child</topic><topic>Disease-Free Survival</topic><topic>Electrodes, Implanted</topic><topic>Electroencephalography - statistics & numerical data</topic><topic>Epilepsy - diagnosis</topic><topic>Epilepsy - physiopathology</topic><topic>Epilepsy - surgery</topic><topic>Epileptogenic zone</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Ictal‐onset zone</topic><topic>Magnetic Resonance Imaging - statistics & numerical data</topic><topic>Magnetoencephalography</topic><topic>Magnetoencephalography - statistics & numerical data</topic><topic>Male</topic><topic>Malformations of the nervous system</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neocortex - pathology</topic><topic>Neocortex - physiopathology</topic><topic>Neocortex - surgery</topic><topic>Neocortical epilepsy</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Preoperative Care</topic><topic>Retrospective Studies</topic><topic>Single and multiple clusters of dipoles</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oishi, Makoto</creatorcontrib><creatorcontrib>Kameyama, Shigeki</creatorcontrib><creatorcontrib>Masuda, Hiroshi</creatorcontrib><creatorcontrib>Tohyama, Jun</creatorcontrib><creatorcontrib>Kanazawa, Osamu</creatorcontrib><creatorcontrib>Sasagawa, Mutsuo</creatorcontrib><creatorcontrib>Otsubo, Hiroshi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Epilepsia (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oishi, Makoto</au><au>Kameyama, Shigeki</au><au>Masuda, Hiroshi</au><au>Tohyama, Jun</au><au>Kanazawa, Osamu</au><au>Sasagawa, Mutsuo</au><au>Otsubo, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single and Multiple Clusters of Magnetoencephalographic Dipoles in Neocortical Epilepsy: Significance in Characterizing the Epileptogenic Zone</atitle><jtitle>Epilepsia (Copenhagen)</jtitle><addtitle>Epilepsia</addtitle><date>2006-02</date><risdate>2006</risdate><volume>47</volume><issue>2</issue><spage>355</spage><epage>364</epage><pages>355-364</pages><issn>0013-9580</issn><eissn>1528-1167</eissn><coden>EPILAK</coden><abstract>Purpose: To characterize the epileptogenic zone in neocortical epilepsy (NE) by using magnetoencephalography (MEG).
Methods: We defined and compared locations of single and multiple clusters of equivalent current dipoles (ECDs) for interictal spikes with MRI findings, ictal‐onset zones (IOZs) from subdural electroencephalography (SDEEG), resected areas, and postsurgical outcomes of 20 patients who underwent cortical resection for medically intractable NE.
Results: Fourteen patients had single clusters; six had multiple clusters. Overlap of clusters and IOZs defined group A (nine patients), in which a single cluster coincided with the IOZ; group B1 (four patients), in which a single cluster was within or partially overlapped the IOZ; group B2 (five patients), in which multiple‐cluster sections overlapped IOZs; group C (two patients; one single; one multiple), in which no overlap was seen. More single clusters (nine of 14) than multiple clusters (none of six) coincided with the IOZ (p = 0.014). More patients with single clusters (10 of 14) than patients with multiple clusters (one of six) had seizure‐free outcomes (p = 0.049). Eight of nine patients in group A, versus three of 11 in groups B1, B2, and C, achieved seizure‐free outcomes (p = 0.0098). Correlations between MRI findings and postsurgical outcomes were not statistically significant; eight of 13 patients with single lesions, one of four with no lesions, and two of three with multifocal lesions had seizure‐free outcomes.
Conclusions: In neocortical epilepsy, MEG ECD clusters correlated with SDEEG IOZs. Single clusters indicated discrete epileptogenic zones that required complete resection for seizure‐free outcome. Multiple clusters necessitated that the multiple or extensive epileptogenic zones be completely identified and delineated by SDEEG.</abstract><cop>350 Main Street , Malden , MA 02148 , USA and 9600 Garsington Road , Oxford , OX4 2XG , England</cop><pub>Blackwell Publishing Inc</pub><pmid>16499760</pmid><doi>10.1111/j.1528-1167.2006.00428.x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences Brain Mapping Child Disease-Free Survival Electrodes, Implanted Electroencephalography - statistics & numerical data Epilepsy - diagnosis Epilepsy - physiopathology Epilepsy - surgery Epileptogenic zone Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Ictal‐onset zone Magnetic Resonance Imaging - statistics & numerical data Magnetoencephalography Magnetoencephalography - statistics & numerical data Male Malformations of the nervous system Medical sciences Middle Aged Neocortex - pathology Neocortex - physiopathology Neocortex - surgery Neocortical epilepsy Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pharmacology. Drug treatments Preoperative Care Retrospective Studies Single and multiple clusters of dipoles Treatment Outcome |
| title | Single and Multiple Clusters of Magnetoencephalographic Dipoles in Neocortical Epilepsy: Significance in Characterizing the Epileptogenic Zone |
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