3,199 results match your criteria Neuroimaging in Epilepsy Surgery


EEG Source Imaging (ESI) utility in clinical practice.

Biomed Tech (Berl) 2020 Jul 5. Epub 2020 Jul 5.

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Epilepsy surgery is an important treatment modality for medically refractory focal epilepsy. The outcome of surgery usually depends on the localization accuracy of the epileptogenic zone (EZ) during pre-surgical evaluation. Good localization can be achieved with various electrophysiological and neuroimaging approaches. Read More

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http://dx.doi.org/10.1515/bmt-2019-0128DOI Listing

Temporal-plus epilepsy in children: A connectomic analysis in magnetoencephalography.

Epilepsia 2020 Jul 3. Epub 2020 Jul 3.

Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.

Objective: Seizure recurrence following surgery for temporal lobe (TL) epilepsy may be related to extratemporal epileptogenic foci, so-called temporal-plus (TL+) epilepsy. Here, we sought to leverage whole brain connectomic profiling in magnetoencephalography (MEG) to identify neural networks indicative of TL+ epilepsy in children.

Methods: Clinical and MEG data were analyzed for 121 children with TL and TL+ epilepsy spanning 20 years at the Hospital for Sick Children. Read More

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http://dx.doi.org/10.1111/epi.16591DOI Listing

Magnetic resonance-guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery: a case report.

Acta Neurochir (Wien) 2020 Jul 2. Epub 2020 Jul 2.

Southern Tohoku Research Institute for Neuroscience, Fukushima, Japan.

We report the case of a patient with hypothalamic hamartoma (HH) who was successfully treated with magnetic resonance-guided focused ultrasound (MRgFUS) for ablation as a disconnection surgery. A 26-year-old man with gelastic epilepsy had been diagnosed with HH at 3 years of age, and antiepileptic drugs were administered due to worsening episodes. Magnetic resonance imaging showed a sessile parahypothalamic hamartoma and MRgFUS ablation was performed, creating an oval-shaped lesion at the boundary area of the HH. Read More

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http://dx.doi.org/10.1007/s00701-020-04468-6DOI Listing

Seizures in meningioma.

Handb Clin Neurol 2020 ;170:187-200

Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States. Electronic address:

More than one-third of patients with meningiomas will experience seizures at some point in their disease. Despite this, meningioma-associated epilepsy remains significantly understudied, as most investigations focus on tumor progression, extent of resection, and survival. Due to the impact of epilepsy on the patient's quality of life, identifying predictors of preoperative seizures and postoperative seizure freedom is critical. Read More

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http://dx.doi.org/10.1016/B978-0-12-822198-3.00053-7DOI Listing
January 2020

Catching the imposter in the brain: The case of Capgras delusion.

Cortex 2020 May 19. Epub 2020 May 19.

CNR Neuroscience Institute, Parma, Italy.

Here we describe a rare case of Capgras delusion - a misidentification syndrome characterized by the belief that a person has been replaced by an imposter - in a patient without evident neurological or psychiatric symptoms. Intriguingly, delusional belief was selective for both person and modality, as the patient believed that his son - not his daughter or other relatives - was substituted with an imposter only while being in presence of him and looking at his face, but not when merely listening to his voice. A neuroanatomical reconstruction obtained integrating morphological and functional patient's neuroimaging data highlighted two main peculiarities: a compression of the rostral portion of right temporal lobe due to a large arachnoid cyst, and a bilaterally reduced metabolism of frontal areas. Read More

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http://dx.doi.org/10.1016/j.cortex.2020.04.025DOI Listing

Withdrawal seizures: possible risk factors.

Expert Rev Neurother 2020 Jun 23:1-6. Epub 2020 Jun 23.

Department of Pediatrics, University of L'Aquila , L'Aquila, Italy.

Introduction: Most of the patients usually achieve seizure freedom under treatment with antiseizure medications (ASMs). Drug withdrawal in seizure-free patients is still one of the most challenging issues in the management of epilepsy. The decision-making process of whether the treatment should be discontinued must be based on the evaluation of possible long-term side effects of chronic treatment and, on the other hand, the risk of seizure relapse. Read More

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http://dx.doi.org/10.1080/14737175.2020.1780917DOI Listing

Electrical stimulation sensorimotor mapping with stereo-EEG.

Clin Neurophysiol 2020 May 18;131(8):1691-1701. Epub 2020 May 18.

Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Objective: We evaluated stereo-EEG electrical stimulation mapping (ESM) for localization of anatomic sensorimotor parcels in pediatric patients with drug-resistant epilepsy. We also analyzed sensorimotor and after-discharge thresholds, and the somatotopy of sensorimotor responses.

Methods: ESM was performed with 50 Hz, biphasic, 2-3 s trains, using 1-9 mA current. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.04.159DOI Listing

Functional Networks in Epilepsy Presurgical Evaluation.

Neurosurg Clin N Am 2020 Jul 23;31(3):395-405. Epub 2020 Apr 23.

Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada. Electronic address:

Continuing advancements in neuroimaging methodology allow for increasingly detailed in vivo characterization of structural and functional brain networks, leading to the recognition of epilepsy as a disorder of large-scale networks. In surgical candidates, analysis of functional networks has proved invaluable for the identification of eloquent brain areas, such as hemispherical language dominance. More recently, connectome-based biomarkers have demonstrated potential to further inform clinical decision making in drug-refractory epilepsy. Read More

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http://dx.doi.org/10.1016/j.nec.2020.03.004DOI Listing

Functional connectome contractions in temporal lobe epilepsy: Microstructural underpinnings and predictors of surgical outcome.

Epilepsia 2020 Jun 26;61(6):1221-1233. Epub 2020 May 26.

Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.

Objective: Temporal lobe epilepsy (TLE) is the most common drug-resistant epilepsy in adults. Although it is commonly related to hippocampal pathology, increasing evidence suggests structural changes beyond the mesiotemporal lobe. Functional anomalies and their link to underlying structural alterations, however, remain incompletely understood. Read More

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http://dx.doi.org/10.1111/epi.16540DOI Listing

Epilepsy and Electroencephalographic Abnormalities in SATB2-Associated Syndrome.

Pediatr Neurol 2020 Apr 13. Epub 2020 Apr 13.

Section of Genetics and Metabolism, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address:

Background: Seizures are an under-reported feature of the SATB2-associated syndrome phenotype. We describe the electroencephalographic findings and seizure semiology and treatment in a population of individuals with SATB2-associated syndrome.

Methods: We performed a retrospective review of 101 individuals with SATB2-associated syndrome who were reported to have had a previous electroencephalographic study to identify those who had at least one reported abnormal result. Read More

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http://dx.doi.org/10.1016/j.pediatrneurol.2020.04.006DOI Listing

Post-traumatic Stress Disorder With Flashbacks of an Old Childhood Memory Triggered by Right Temporal Lobe Epilepsy Surgery in Adulthood.

Front Psychiatry 2020 28;11:351. Epub 2020 Apr 28.

Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

Background: A plethora of data show that the hippocampus and the amygdala are involved in post-traumatic stress disorder (PTSD). Neural dysfunctions leading to PTSD (e.g. Read More

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http://dx.doi.org/10.3389/fpsyt.2020.00351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198875PMC

Epilepsy surgery beyond 50 years: Long-term seizure and cognitive outcomes.

J Neurol Sci 2020 Jul 1;414:116872. Epub 2020 May 1.

Epilepsy Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Avinguda de Fernando Abril Martorell, 106, 46026 Valencia, Spain.

Introduction: Surgery is a well-demonstrated effective treatment for patients with refractory epilepsy. However, there are scarce data about the efficacy in older patients. Endpoint was to evaluate the outcome of epilepsy surgery in pharmacorresistant patients operated in middle-late adulthood. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116872DOI Listing

Epilepsy Lesion Localization is not Predicted by Developmental Venous Anomaly Location or its FDG-PET Metabolic Activity.

J Neuroimaging 2020 May 8. Epub 2020 May 8.

Department of Neuroradiology, The Hospital of the University of Pennsylvania, Philadelphia, PA.

Background And Purpose: This study's purpose is to correlate location and metabolic activity of developmental venous anomalies (DVAs) in epilepsy patients to the seizure focus as determined by ictal/interictal encephaloelectrogram (EEG).

Methods: A retrospective search was performed for epilepsy patients with DVAs who underwent brain F-fluorodeoxyglucose positron emission tomography ( F-FDG-PET) and magnetic resonance imaging (MRI). MRI exams were analyzed to characterize DVA location and associated structural findings. Read More

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http://dx.doi.org/10.1111/jon.12722DOI Listing

Genuine cross-frequency coupling networks in human resting-state electrophysiological recordings.

PLoS Biol 2020 May 6;18(5):e3000685. Epub 2020 May 6.

Neuroscience Center, HiLIFE-Helsinki Institute of Life Science, University of Helsinki, Finland.

Phase synchronization of neuronal oscillations in specific frequency bands coordinates anatomically distributed neuronal processing and communication. Typically, oscillations and synchronization take place concurrently in many distinct frequencies, which serve separate computational roles in cognitive functions. While within-frequency phase synchronization has been studied extensively, less is known about the mechanisms that govern neuronal processing distributed across frequencies and brain regions. Read More

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http://dx.doi.org/10.1371/journal.pbio.3000685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233600PMC

[Intracranial EEG monitoring methods].

Ideggyogy Sz 2020 Mar;73(3-4):79-83

Pécsi Tudományegyetem, Klinikai Központ, Neurológiai Klinika, Pécs.

Resective surgery is considered to be the best option towards achieving seizure-free state in drug-resistant epilepsy. Intracranial EEG (iEEG) is necessary if the seizure-onset zone is localized near to an eloquent cortical area, or if the results of presurgical examinations are discordant, or if an extratemporal epilepsy patient is MRI-negative. Nowadays, 3 kinds of electrodes are used: (1) foramen ovale (FO) electrodes; (2) subdural strip or grid electrodes (SDG); (3) deep electrodes (stereo-electroencephalographia, SEEG). Read More

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http://dx.doi.org/10.18071/isz.73.0079DOI Listing

Clinico-Genetic, Imaging and Molecular Delineation of COQ8A-Ataxia: A Multicenter Study of 59 Patients.

Ann Neurol 2020 Apr 26. Epub 2020 Apr 26.

Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.

Objective: TO FOSTER TRIAL-READINESS OF COENZYME Q8A (COQ8A)-ATAXIA, WE MAP THE CLINICOGENETIC, MOLECULAR, AND NEUROIMAGING SPECTRUM OF COQ8A-ATAXIA IN A LARGE WORLDWIDE COHORT, AND PROVIDE FIRST PROGRESSION DATA, INCLUDING TREATMENT RESPONSE TO COENZYME Q10 (COQ10).: METHODS: CROSS-MODAL ANALYSIS OF A MULTICENTER COHORT OF 59 COQ8A PATIENTS, INCLUDING GENOTYPE-PHENOTYPE CORRELATIONS, 3D-PROTEIN MODELING, IN VITRO MUTATION ANALYSES, MAGNETIC RESONANCE IMAGING (MRI) MARKERS, DISEASE PROGRESSION, AND COQ10 RESPONSE DATA.: RESULTS: FIFTY-NINE PATIENTS (39 NOVEL) WITH 44 PATHOGENIC COQ8A VARIANTS (18 NOVEL) WERE IDENTIFIED. Read More

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http://dx.doi.org/10.1002/ana.25751DOI Listing
April 2020
9.977 Impact Factor

Impact of epilepsy surgery on quality of life and burden of caregivers in children and adolescents.

Epilepsy Behav 2020 May 19;106:106961. Epub 2020 Mar 19.

Department of Neurosciences and Behavioural Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Center for Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address:

Objective: The objective of this study was to analyze the impact of pediatric epilepsy surgery on the quality of life (QOL), determining whether patients improve, worsen, or maintain their preoperative patterns, as it relates to the burden of caregivers, as well as evaluating potential related factors, from both the children and caregivers perspectives.

Material And Methods: This is a retrospective study of children and adolescents who underwent epilepsy surgery and were evaluated through clinical data, videoelectroencephalogram (V-EEG), neuroimaging findings, neuropsychological testing, and aspects of QOL. These assessments were performed prior to surgery and after six months and two years of follow-up. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.106961DOI Listing
May 2020
2.257 Impact Factor

Serum Neurosteroid Levels Are Associated With Cortical Thickness in Individuals Diagnosed With Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury.

Clin EEG Neurosci 2020 Mar 18:1550059420909676. Epub 2020 Mar 18.

Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Posttraumatic stress disorder (PTSD) co-occurring with mild traumatic brain injury (mTBI) is common in veterans. Worse clinical outcome in those with PTSD has been associated with decreased serum neurosteroid levels. Furthermore, decreased cortical thickness has been associated with both PTSD and mTBI. Read More

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http://dx.doi.org/10.1177/1550059420909676DOI Listing

Perinatal thalamic injury: MRI predictors of electrical status epilepticus in sleep and long-term neurodevelopment.

Neuroimage Clin 2020 Feb 25;26:102227. Epub 2020 Feb 25.

Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Objective: Perinatal thalamic injury is associated with epilepsy with electrical status epilepticus in sleep (ESES). The aim of this study was to prospectively quantify the risk of ESES and to assess neuroimaging predictors of neurodevelopment.

Methods: We included patients with perinatal thalamic injury. Read More

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http://dx.doi.org/10.1016/j.nicl.2020.102227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076143PMC
February 2020

EEG Monitoring of the Epileptic Newborn.

Curr Neurol Neurosci Rep 2020 Mar 12;20(4). Epub 2020 Mar 12.

Child Neurology Unit, Presidio Ospedaliero Provinciale Santa Maria Nuova, AUSL-IRCCS di Reggio Emilia, viale Risorgimento 80, 42123, Reggio Emilia, Italy.

Purpose Of Review: Although differentiating neonatal-onset epilepsies from acute symptomatic neonatal seizures has been increasingly recognized as crucial, existing guidelines, and recommendations on EEG monitoring are mainly based on acute symptomatic seizures, especially secondary to hypoxic-ischemic encephalopathy. We aimed to narratively review current knowledge on neonatal-onset epilepsies of genetic, metabolic, and structural non-acquired origin, with special emphasis on EEG features and monitoring.

Recent Findings: A wide range of rare conditions are increasingly described, reducing undiagnosed cases. Read More

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http://dx.doi.org/10.1007/s11910-020-1027-7DOI Listing

Hippocampal subfield measurement and ILAE hippocampal sclerosis subtype classification with in vivo 4.7 tesla MRI.

Epilepsy Res 2020 Mar 16;161:106279. Epub 2020 Jan 16.

Division of Neurology, Department of Medicine, University of Alberta, 11350 83 Ave NW, Edmonton, AB, T6G 2G3, Canada.

Objective: Neuropathological studies indicate that hippocampal sclerosis (HS) consists of three subtypes (ILAE types 1-3 HS). However, HS subtypes currently can only be diagnosed by pathological analysis of hippocampal tissue resected during epilepsy surgery or at autopsy. In vivo diagnosis of HS subtypes holds potential to improve our understanding of these variants in the ipsilateral as well as contralateral hippocampus. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2020.106279DOI Listing

Scalp ripples as prognostic biomarkers of epileptogenicity in pediatric surgery.

Ann Clin Transl Neurol 2020 Mar 25;7(3):329-342. Epub 2020 Feb 25.

Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Objective: To assess the ability of high-density Electroencephalography (HD-EEG) and magnetoencephalography (MEG) to localize interictal ripples, distinguish between ripples co-occurring with spikes (ripples-on-spike) and independent from spikes (ripples-alone), and evaluate their localizing value as biomarkers of epileptogenicity in children with medically refractory epilepsy.

Methods: We retrospectively studied 20 children who underwent epilepsy surgery. We identified ripples on HD-EEG and MEG data, localized their generators, and compared them with intracranial EEG (icEEG) ripples. Read More

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http://dx.doi.org/10.1002/acn3.50994DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086004PMC

The coexistence of psychogenic nonepileptic and epileptic seizures in the same patient is more frequent than expected: Is there any clinical feature for defining these patients?

Epilepsy Behav 2020 Apr 21;105:106940. Epub 2020 Feb 21.

Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey.

Objectives: This study aimed to investigate the prevalence of psychogenic nonepileptic seizures (PNES) and PNES-epilepsy coexistence within all video-electroencephalography (EEG) monitoring unit (VEMU) referrals and to identify semiological and electrophysiological features to differentiate patients with PNES-epilepsy coexistence from PNES-only.

Methods: We retrospectively reviewed medical files, VEMU reports, and videos of 1983 adult patients. Demographical, historical, clinical, neuroimaging, and electrophysiological parameters of all patients were recorded. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.106940DOI Listing

Misleading Focal Clinical, Neurophysiologic, and Imaging Features in 2 Children With Generalized Epilepsy Who Underwent Invasive Electroencephalographic (EEG) Monitoring.

J Child Neurol 2020 May 16;35(6):418-424. Epub 2020 Feb 16.

Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.

Children and adults with genetic generalized epilepsy may have focal clinical seizure symptoms as well as electroencephalographic (EEG) findings. This may pose a diagnostic challenge to clinicians, especially when concomitant focal neuroimaging findings exist and the epilepsy is medically refractory. We sought to highlight the challenges that clinicians may face through the description of 2 children with suspected genetic generalized epilepsy who had both focal seizure symptoms and EEG/neuroimaging findings and underwent invasive EEG monitoring. Read More

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http://dx.doi.org/10.1177/0883073819901228DOI Listing

Computational modelling of the long-term effects of brain stimulation on the local and global structural connectivity of epileptic patients.

PLoS One 2020 6;15(2):e0221380. Epub 2020 Feb 6.

Interdisciplinary Computing and Complex BioSystems (ICOS) Research Group, School of Computing, Newcastle University, Newcastle upon Tyne, England, United Kingdom.

Computational studies of the influence of different network parameters on the dynamic and topological network effects of brain stimulation can enhance our understanding of different outcomes between individuals. In this study, a brain stimulation session along with the subsequent post-stimulation brain activity is simulated for a period of one day using a network of modified Wilson-Cowan oscillators coupled according to diffusion imaging based structural connectivity. We use this computational model to examine how differences in the inter-region connectivity and the excitability of stimulated regions at the time of stimulation can affect post-stimulation behaviours. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221380PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004372PMC

Advanced neuroimaging techniques for evaluating pediatric epilepsy.

Authors:
Yun Jeong Lee

Clin Exp Pediatr 2020 Mar 6;63(3):88-95. Epub 2020 Feb 6.

Department of Pediatrics, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone, particularly when it is interpreted by experienced neuroradiologists. Read More

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http://dx.doi.org/10.3345/kjp.2019.00871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073377PMC

Ictal and interictal source imaging on intracranial EEG predicts epilepsy surgery outcome in children with focal cortical dysplasia.

Clin Neurophysiol 2020 Mar 20;131(3):734-743. Epub 2020 Jan 20.

Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Fetal-Neonatal Neuroimaging Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA. Electronic address:

Objective: To localize the seizure onset zone (SOZ) and irritative zone (IZ) using electric source imaging (ESI) on intracranial EEG (iEEG) and assess their clinical value in predicting epilepsy surgery outcome in children with focal cortical dysplasia (FCD).

Methods: We analyzed iEEG data from 25 children with FCD-associated medically refractory epilepsy (MRE) who underwent surgery. We performed ESI on ictal onset to localize SOZ (ESI-SOZ) and on interictal discharges to localize IZ (ESI-IZ). Read More

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http://dx.doi.org/10.1016/j.clinph.2019.12.408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093832PMC

Functional Activation Patterns of Deep Brain Stimulation of the Anterior Nucleus of the Thalamus.

World Neurosurg 2020 Apr 27;136:357-363.e2. Epub 2020 Jan 27.

Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA.

Background: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a recently approved therapy for patients with drug-resistant epilepsy. To date, there is a poor understanding of the mechanism of action and lack of in vivo biomarkers. We propose a method for investigating the in vivo stimulation effects using blood-oxygen-level-dependent (BOLD) magnetic resonance imaging (MRI) and present the brain activation pattern associated with ANT DBS. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.01.108DOI Listing

Comparison of the Asleep-Awake-Asleep Technique and Monitored Anesthesia Care During Awake Craniotomy: A Systematic Review and Meta-analysis.

J Neurosurg Anesthesiol 2020 Jan 16. Epub 2020 Jan 16.

Neuroanaesthesia and Neurosciences Intensive Care Unit.

Awake craniotomy (AC) is the preferred surgical option for intractable epilepsy and resection of tumors adjacent to or within eloquent cortical areas. Monitored anesthesia care (MAC) or an asleep-awake-asleep (SAS) technique is most widely used during AC. We used a random-effects modeled meta-analysis to synthesize the most recent evidence to determine whether MAC or SAS is safer and more effective for AC. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000675DOI Listing
January 2020

Seizures in patients with cancer.

Cancer 2020 Apr 22;126(7):1379-1389. Epub 2020 Jan 22.

Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts.

Seizures are common in patients with cancer and either result from brain lesions, paraneoplastic syndromes, and complications of cancer treatment or are provoked by systemic illness (metabolic derangements, infections). Evaluation should include a tailored history, neurologic examination, laboratory studies, neuroimaging, and electroencephalogram. In unprovoked seizures, antiepileptic drug (AED) treatment is required, and a nonenzyme-inducing AED is preferred. Read More

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http://dx.doi.org/10.1002/cncr.32708DOI Listing

Contralateral Preoperative Resting-State Functional MRI Network Integration Is Associated with Surgical Outcome in Temporal Lobe Epilepsy.

Radiology 2020 Mar 21;294(3):622-627. Epub 2020 Jan 21.

From the Athinoula A. Martinos Center for Biomedical Imaging, 149 13th St, Suite 2301, Charlestown, MA 02129 (M.N.D., N.T., L.D., S.M.S.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.N.D., A.J.C., S.M.S.); Sapporo Neuroimaging Research Group, Sapporo, Japan (N.T.); and Department of Anatomy and Neurosciences, Vrije Universiteit Medical Center, Amsterdam, the Netherlands (L.D.).

Background Although most patients with medically refractory temporal lobe epilepsy (TLE) experience seizure freedom after anterior temporal lobectomy, approximately 40% may continue to have seizures. Functional network integration, as measured with preoperative resting-state functional MRI, may help stratify patients who are more likely to experience postoperative seizure freedom. Purpose To relate preoperative resting-state functional MRI and surgical outcome in patients with medically refractory TLE. Read More

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http://dx.doi.org/10.1148/radiol.2020191008DOI Listing

Accelerated long-term forgetting after amygdalohippocampectomy in temporal lobe epilepsy.

J Clin Neurosci 2020 Feb 16;72:43-49. Epub 2020 Jan 16.

REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey.

Aim Of The Study: Temporal lobe epilepsy (TLE) has been associated with the phenomenon of accelerated long-term forgetting (ALF). In this study, we aimed to demonstrate the effect of surgery on the ALF phenomena thus contributing to potential explanation of the causal mechanism.

Materials And Methods: We evaluated 51 patients with TLE related to hippocampal sclerosis who had amygdalohippocampectomy and had remained seizure-free after surgery. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.01.038DOI Listing
February 2020

Central sulcus is a barrier to causal propagation in epileptic networks.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:2555-2559

the functional interactions of different brain regions are dependent of their underlying structural connectivity. These interactions are important for normal brain activity as well as in epileptic disorders where spontaneous epileptic discharges are generated. To understand the effects of brain topography on both normal and epileptic functional networks, we evaluated propagation frequency with respect to geodesic distance and the specific role of sulcal patterns in modulating these functional connections. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8857401DOI Listing

Estimation of the epileptogenic-zone with HFO sub-groups exhibiting various levels of epileptogenicity

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:2543-2546

High-Frequency-Oscillations (HFO) are biomarkers of the epileptogenic-zone (EZ) and thus a potential aid in guiding epilepsy-surgery. HFO are normally sub-divided according to their oscillating-frequency into Ripples (80-250 Hz) and Fast-Ripples (FR) (250-500 Hz) and are known to also occur in the non-epileptic brain. We address two challenges faced by HFO: firstly, estimating the margins of the EZ using the HFO occurrence-rate from each intracranial EEG channel; secondly, selecting HFO sub-groups with a higher probability of being purely epileptic. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856733DOI Listing

Impaired vigilance networks in temporal lobe epilepsy: Mechanisms and clinical implications.

Epilepsia 2020 02 4;61(2):189-202. Epub 2020 Jan 4.

Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee.

Mesial temporal lobe epilepsy (mTLE) is a neurological disorder in which patients suffer from frequent consciousness-impairing seizures, broad neurocognitive deficits, and diminished quality of life. Although seizures in mTLE originate focally in the hippocampus or amygdala, mTLE patients demonstrate cognitive deficits that extend beyond temporal lobe function-such as decline in executive function, cognitive processing speed, and attention-as well as diffuse decreases in neocortical metabolism and functional connectivity. Given prior observations that mTLE patients exhibit impairments in vigilance, and that seizures may disrupt the activity and long-range connectivity of subcortical brain structures involved in vigilance regulation, we propose that subcortical activating networks underlying vigilance play a critical role in mediating the widespread neural and cognitive effects of focal mTLE. Read More

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http://dx.doi.org/10.1111/epi.16423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033006PMC
February 2020
4.571 Impact Factor

Focal EEG abnormalities and focal ictal semiology in generalized epilepsy.

Seizure 2020 Apr 20;77:7-14. Epub 2019 Dec 20.

Epilepsy Center, Neurological Institute, Department of Neurology, University Hospitals of Cleveland Medical Center, Cleveland, OH, USA; Division of Pediatric Epilepsy & Neurology, Department of Pediatrics, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address:

In clinical practice, the diagnosis of focal vs generalized epilepsy dictates the management of the patient. The distinction between generalized and focal epilepsy is at times imperfect and some epilepsies have features that fall in between these two extremes. An example is the occurrence of focal interictal and focal ictal abnormalities in generalized epilepsies. Read More

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http://dx.doi.org/10.1016/j.seizure.2019.12.013DOI Listing

Hippocampal profiling: Localized magnetic resonance imaging volumetry and T2 relaxometry for hippocampal sclerosis.

Epilepsia 2020 02 24;61(2):297-309. Epub 2019 Dec 24.

Epilepsy Society MRI Unit, Chalfont St Peter, UK.

Objective: Hippocampal sclerosis (HS) is the most common cause of drug-resistant temporal lobe epilepsy, and its accurate detection is important to guide epilepsy surgery. Radiological features of HS include hippocampal volume loss and increased T2 signal, which can both be quantified to help improve detection. In this work, we extend these quantitative methods to generate cross-sectional area and T2 profiles along the hippocampal long axis to improve the localization of hippocampal abnormalities. Read More

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http://dx.doi.org/10.1111/epi.16416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065164PMC
February 2020

Reflex epileptic features in patients with focal epilepsy of unknown cause.

Clin Neurol Neurosurg 2020 Mar 9;190:105633. Epub 2019 Dec 9.

Istanbul University, Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology Unit, Istanbul, Turkey.

Objectives: There is a gap of knowledge regarding reflex seizures in patients with focal epilepsy of unknown cause (FEUC). We aimed to evaluate the prevalence, demographic and clinical characteristics of reflex seizures in patients with FEUC to provide an insight to the underlying ictogenic mechanisms and to draw attention to this important but under-investigated topic.

Patients And Methods: After carefully questioning for reflex triggers, 186 patients diagnosed according to ILAE criteria and followed-up for a minimum of 5 years were included. Read More

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http://dx.doi.org/10.1016/j.clineuro.2019.105633DOI Listing

Differential DNA Methylation Patterns in Patients with Epilepsy due to Malformations of Cortical Development: A Pilot Study.

Neurol India 2019 Nov-Dec;67(6):1469-1471

Division of Genetic, Genomic and Metabolic Disorders, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.

Objective: To study the DNA methylation profiles in brain tissue of patients with refractory epilepsy due to malformations of cortical development (MCDs).

Materials And Methods: Clinical, neuroimaging, and pathology characteristics were defined for 13 patients who underwent resective surgery for epilepsy. Methylation analysis was performed using Illumina 450k Methylation Microarray. Read More

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http://dx.doi.org/10.4103/0028-3886.273638DOI Listing

Epileptogenicity Maps of Intracerebral Fast Activities (60-100 Hz) at Seizure Onset in Epilepsy Surgery Candidates.

Front Neurol 2019 28;10:1263. Epub 2019 Nov 28.

Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Université Grenoble Alpes, Grenoble, France.

Fast activities (FA) at seizure onset have been increasingly described as a useful signature of the epileptogenic zone (EZ) in patients undergoing intracranial EEG recordings. Different computer-based signal analysis methods have thus been developed for objectively quantifying ictal FA. Whether these methods detect FA in all forms of focal epilepsies, whether they provide similar information than visual analysis (VA), and whether they might help for the surgical decision remain crucial issues. Read More

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http://dx.doi.org/10.3389/fneur.2019.01263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892969PMC
November 2019

Surgical treatment of drug-resistant epilepsy caused by gliomas in eloquent areas: experience report.

Arq Neuropsiquiatr 2019 11;77(11):797-805

Universidade de São Paulo, Departamento de Neurocirurgia, São Paulo SP Brasil.

Introduction: Drug-resistant epilepsy associated with central nervous system tumors is generally caused by low grade gliomas. This group of tumors is usually found in brain eloquent areas, such as the insular lobe, rolandic cortex and supplementary motor area and, historically, possess a greater risk of postoperative deficits.

Objective: The aim of this investigation was to present our surgical experience on patients with drug-resistant epilepsy caused by gliomas in eloquent areas. Read More

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http://dx.doi.org/10.1590/0004-282X20190160DOI Listing
November 2019

How to interpret images in epileptic seizures: correlation between clinical and functional MRI findings.

Radiologia 2020 Mar - Apr;62(2):102-111. Epub 2019 Nov 28.

Unidad de Epilepsia, Servei de Neurologia, Institut de Neurociències, Hospital Clínic de Barcelona, Barcelona, España.

Neuroimaging studies are essential in patients with epilepsy, both for diagnosis and surgical management. This article focuses on adult epileptic patients, reviewing the updated clinical criteria published by the International League Against Epilepsy for the definitions of seizures, epilepsy, and status epilepticus. It also describes the different types of epilepsy, the different presentations, the signs, the radiologic approach to managing seizures, and the differences between generalized and focal seizures. Read More

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http://dx.doi.org/10.1016/j.rx.2019.09.002DOI Listing
November 2019

Automatic labeling of the fanning and curving shape of Meyer's loop for epilepsy surgery: an atlas extracted from high-definition fiber tractography.

BMC Neurol 2019 Nov 28;19(1):302. Epub 2019 Nov 28.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, Beijing, 100053, China.

Background: Visual field defects caused by injury to Meyer's loop (ML) are common in patients undergoing anterior temporal lobectomy during epilepsy surgery. Evaluation of the anatomical shapes of the curving, fanning and sharp angles of ML to guide surgeries is important but still challenging for diffusion tensor imaging. We present an advanced diffusion data-based ML atlas and labeling protocol to reproduce anatomical features in individuals within a short time. Read More

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http://dx.doi.org/10.1186/s12883-019-1537-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882219PMC
November 2019

Automated detection of hippocampal sclerosis using clinically empirical and radiomics features.

Epilepsia 2019 12 25;60(12):2519-2529. Epub 2019 Nov 25.

CAS, Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China.

Objective: Temporal lobe epilepsy is a common form of epilepsy that might be amenable to surgery. However, magnetic resonance imaging (MRI)-negative hippocampal sclerosis (HS) can hamper early diagnosis and surgical intervention for patients in clinical practice, resulting in disease progression. Our aim was to automatically detect and evaluate the structural alterations of HS. Read More

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http://dx.doi.org/10.1111/epi.16392DOI Listing
December 2019
4.571 Impact Factor

Quantitative analysis of intracranial electrocorticography signals using the concept of statistical parametric mapping.

Sci Rep 2019 11 22;9(1):17385. Epub 2019 Nov 22.

Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit Medical Center, Detroit, MI, 48201, USA.

Statistical parametric mapping (SPM) is a technique with which one can delineate brain activity statistically deviated from the normative mean, and has been commonly employed in noninvasive neuroimaging and EEG studies. Using the concept of SPM, we developed a novel technique for quantification of the statistical deviation of an intracranial electrocorticography (ECoG) measure from the nonepileptic mean. We validated this technique using data previously collected from 123 patients with drug-resistant epilepsy who underwent resective epilepsy surgery. Read More

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http://dx.doi.org/10.1038/s41598-019-53749-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874664PMC
November 2019
5.078 Impact Factor

Human Left Anterior Cingulate Stimulation Elicits a Reproducible Micturition Response.

Stereotact Funct Neurosurg 2019 21;97(4):278-281. Epub 2019 Nov 21.

Department of Neurosurgery, Spectrum Health Medical Group, Grand Rapids, Michigan, USA.

Electrical stimulation of a brain region producing a micturition response has never previously been described in the human. This report identifies the anterior cingulate gyrus as a brain region important in the micturition response. Stereo electroencephalography was performed in a 38-year-old female with medically refractory epilepsy. Read More

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http://dx.doi.org/10.1159/000503886DOI Listing

Quantitative Analysis of [18F]FFMZ and [18F]FDG PET Studies in the Localization of Seizure Onset Zone in Drug-Resistant Temporal Lobe Epilepsy.

Stereotact Funct Neurosurg 2019 13;97(4):232-240. Epub 2019 Nov 13.

Unidad Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico,

Background: Positron emission tomography (PET) imaging in epilepsy is an in vivo technique that allows the localization of a possible seizure onset zone (SOZ) during the interictal period. Stereo-electro-encephalography (SEEG) is the gold standard to define the SOZ. The objective of this research was to evaluate the accuracy of PET imaging in localizing the site of SOZ compared with SEEG. Read More

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http://dx.doi.org/10.1159/000503692DOI Listing

Temporal lobe surgery and memory: Lessons, risks, and opportunities.

Epilepsy Behav 2019 12 9;101(Pt A):106596. Epub 2019 Nov 9.

NYU Langone Health, Department of Neurology, 222 East 41st Street 9th Floor, New York, NY 10017, United States of America; NYU Comprehensive Epilepsy Center, 223 East 34th Street, New York, NY 10016, United States of America. Electronic address:

Careful study of the clinical outcomes of temporal lobe epilepsy (TLE) surgery has greatly advanced our knowledge of the neuroanatomy of human memory. After early cases resulted in profound amnesia, the critical role of the hippocampus and associated medial temporal lobe (MTL) structures to declarative memory became evident. Surgical approaches quickly changed to become unilateral and later, to be more precise, potentially reducing cognitive morbidity. Read More

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http://dx.doi.org/10.1016/j.yebeh.2019.106596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885125PMC
December 2019

Electrical stimulation of the cingulate elicits involuntary singing.

Epileptic Disord 2019 Oct;21(5):449-452

Geisel School of Medicine at Dartmouth, Hanover, Dartmouth-Hitchcock Medical Center, Lebanon, USA.

Human neural networks important for singing have not been clearly elucidated. Here, we present a case of electrical brain stimulation of the right non-language dominant cingulate gyrus during brain surgery for epilepsy which resulted in involuntary singing of spoken language. We postulate that the current observation provides the strongest evidence as of yet that the cingulate gyrus is directly involved in voluntary motor control of singing. Read More

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http://dx.doi.org/10.1684/epd.2019.1096DOI Listing
October 2019