3,642 results match your criteria Neuroimaging in Epilepsy Surgery

A Retrospective Study of Parietal Lobe Epilepsy: Functional Anatomy and Surgical Treatment.

Altern Ther Health Med 2022 Jun 24. Epub 2022 Jun 24.

Context: Parietal lobe epilepsy (PLE) accounts for approximately 5% of all focal epilepsies worldwide,1 and few PLE patients have undergone epilepsy surgery in the past. With the introduction of functional neuroimaging methods, such as interictal fluorodeoxyglucose-positron emission tomography (FDG-PET), stereotactic electroencephalograms (SEEGs), and high-resolution magnetic resonance imaging (MRI), more patients with intractable neocortical epilepsy have been considered for surgical treatment.

Objective: The study intended to characterize the clinical features, aura, and presurgical evaluations of patients with PLE, by investigating their demographic and clinical characteristics, and to evaluate the prognostic value of the four diagnostic modalities-MRI, FDG-PET, scalp EEG, and SEEG-in terms of the localization of epileptogenic area. Read More

View Article and Full-Text PDF

Limited utility of structural MRI to identify the epileptogenic zone in young children with tuberous sclerosis.

J Neuroimaging 2022 Jun 21. Epub 2022 Jun 21.

Localization Laboratory, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background And Purpose: The success of epilepsy surgery in children with tuberous sclerosis complex (TSC) hinges on identification of the epileptogenic zone (EZ). We studied structural MRI markers of epileptogenic lesions in young children with TSC.

Methods: We included 26 children with TSC who underwent epilepsy surgery before the age of 3 years at five sites, with 12 months or more follow-up. Read More

View Article and Full-Text PDF

Networks underlie temporal onset of dysplasia-related epilepsy- a MELD study.

Ann Neurol 2022 Jun 20. Epub 2022 Jun 20.

Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.

Objective: To evaluate if focal cortical dysplasia (FCD) co-localization to cortical functional networks is associated with the temporal distribution of epilepsy onset in FCD.

Methods: International (20 center), retrospective cohort from the Multi-centre Epilepsy Lesion Detection project. Patients included if >3y, had 3D-preoperative-T1 MRI (1. Read More

View Article and Full-Text PDF

Neurosurgery in canine epilepsy.

Vet J 2022 Jun 16:105852. Epub 2022 Jun 16.

Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan.

Epilepsy surgery is functional neurosurgery applied to drug-resistant epilepsy. Although epilepsy surgery has been established and achieves fair to good outcomes in human medicine, it is still an underdeveloped area in veterinary medicine. With the spread of advanced imaging and neurosurgical modalities, intracranial surgery has become commonplace in the veterinary field, and, therefore, it is natural that expectations for epilepsy surgery increase. Read More

View Article and Full-Text PDF

The ILAE consensus classification of focal cortical dysplasia: An update proposed by an ad hoc task force of the ILAE diagnostic methods commission.

Epilepsia 2022 Jun 15. Epub 2022 Jun 15.

Charles Shor Epilepsy Center, Neurological Institute, Cleveland, Ohio, USA.

Ongoing challenges in diagnosing focal cortical dysplasia (FCD) mandate continuous research and consensus agreement to improve disease definition and classification. An International League Against Epilepsy (ILAE) Task Force (TF) reviewed the FCD classification of 2011 to identify existing gaps and provide a timely update. The following methodology was applied to achieve this goal: a survey of published literature indexed with ((Focal Cortical Dysplasia) AND (epilepsy)) between 01/01/2012 and 06/30/2021 (n = 1349) in PubMed identified the knowledge gained since 2012 and new developments in the field. Read More

View Article and Full-Text PDF

The Role of MRI in the Treatment of Drug-Resistant Focal Epilepsy.

Eur Neurol 2022 Jun 15:1-9. Epub 2022 Jun 15.

Neuroimaging of Epilepsy Laboratory [NOEL] and Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada.

Background: Epilepsy is a prevalent chronic condition affecting about 50 million people worldwide. A third of patients with focal epilepsy suffer from seizures unresponsive to medication. Uncontrolled seizures damage the brain, are associated with cognitive decline, and have negative impact on well-being. Read More

View Article and Full-Text PDF

Neuroimaging at 7 Tesla: a pictorial narrative review.

Quant Imaging Med Surg 2022 Jun;12(6):3406-3435

Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Neuroimaging using the 7-Tesla (7T) human magnetic resonance (MR) system is rapidly gaining popularity after being approved for clinical use in the European Union and the USA. This trend is the same for functional MR imaging (MRI). The primary advantages of 7T over lower magnetic fields are its higher signal-to-noise and contrast-to-noise ratios, which provide high-resolution acquisitions and better contrast, making it easier to detect lesions and structural changes in brain disorders. Read More

View Article and Full-Text PDF

Epilepsy surgery for children and adolescents: evidence-based but underused.

Lancet Child Adolesc Health 2022 Jul 12;6(7):484-494. Epub 2022 May 12.

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.

Paediatric epilepsy surgery is an increasingly used evidence-based management option with low risks for complications. Developments in neuroimaging techniques and other advanced diagnostics have widened the spectrum of children who could benefit from the procedure, and surgery is now considered a standard management approach for epilepsy. Available data indicate that early surgery improves outcomes. Read More

View Article and Full-Text PDF

Pathology of surgically remediable epilepsy: How to evaluate.

Indian J Pathol Microbiol 2022 May;65(Supplement):S176-S188

Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, Kerala, India.

Epilepsy surgery is a well-established treatment modality in selected cases of medically refractory epilepsy. Advances in neuroimaging technology has greatly facilitated detection of lesions that are surgically amenable. Hippocampal sclerosis is the most common pathology encountered among specimens from epilepsy-related surgeries. Read More

View Article and Full-Text PDF

Neurosurgical management of patients with neurocutaneous melanosis: a systematic review.

Neurosurg Focus 2022 05;52(5):E8

2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.

Objective: Neurocutaneous melanocytosis (NCM), also referred to as neurocutaneous melanosis, is a rare neurocutaneous disorder characterized by excess melanocytic proliferation in the skin, leptomeninges, and cranial parenchyma. NCM most often presents in pediatric patients within the first 2 years of life and is associated with high mortality due to proliferation of melanocytes in the brain. Prognosis is poor, as patients typically die within 3 years of symptom onset. Read More

View Article and Full-Text PDF

Multidisciplinary team meetings: the epilepsy experience.

John S Duncan

Pract Neurol 2022 May 9. Epub 2022 May 9.

Department of Epilepsy, UCL Queen Square Institute of Neurology, London, UK

Multidisciplinary team (MDT) meetings are essential for ensuring optimal and consistent management for patients with complex problems and a variety of treatment options. Epilepsy surgery MDTs are a good example of complex decision making and planning to the best possible outcomes. The meetings need to run to an agreed format, with participants from neurology, neurophysiology, neuroimaging, neuropsychology, neuropsychiatry and neurosurgery all contributing succinct opinions to enable an informed discussion. Read More

View Article and Full-Text PDF

Rituximab in Rasmussen's encephalitis: A single center experience and review of the literature.

Epilepsy Behav Rep 2022 9;19:100540. Epub 2022 Apr 9.

Department of Radiology, Star Imaging Centre and Research Centre, Pune, India.

Rasmussen's encephalitis (RE) is a rare chronic inflammatory disease of the brain resulting in unilateral hemispheric atrophy with drug-resistant focal epilepsy associated with a variable degree of progressive hemiparesis and cognitive decline. The precise etiology of RE is unknown but presumed to have a neuroinflammatory pathobiological basis. Only surgery halts progression of the disease, but may occur at the expense of a fixed but otherwise inevitable neurological deficit. Read More

View Article and Full-Text PDF

Long-Term Management of Seizures after Surgical Treatment of Supratentorial Cavernous Malformations : A Retrospective Single Centre Study.

J Korean Neurosurg Soc 2022 May 29;65(3):415-421. Epub 2022 Apr 29.

Department of Neurosurgery, Medical University of Warsaw, Warszawa, Poland.

Objective: Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate. Read More

View Article and Full-Text PDF

Drug-resistant focal epilepsy in children is associated with increased modal controllability of the whole brain and epileptogenic regions.

Commun Biol 2022 04 28;5(1):394. Epub 2022 Apr 28.

Department of Bioengineering, Electrical & Systems Engineering, Physics & Astronomy, Neurology, and Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.

Network control theory provides a framework by which neurophysiological dynamics of the brain can be modelled as a function of the structural connectome constructed from diffusion MRI. Average controllability describes the ability of a region to drive the brain to easy-to-reach neurophysiological states whilst modal controllability describes the ability of a region to drive the brain to difficult-to-reach states. In this study, we identify increases in mean average and modal controllability in children with drug-resistant epilepsy compared to healthy controls. Read More

View Article and Full-Text PDF

Comparison of Thresholds between Bipolar and Monopolar Electrical Cortical Stimulation.

Neurol Med Chir (Tokyo) 2022 Jun 22;62(6):294-299. Epub 2022 Apr 22.

Department of Neurosurgery, Sapporo Medical University School of Medicine.

Electrical cortical stimulation is widely performed and is the gold standard for functional mapping in intractable epilepsy patients; however, a standard protocol has not yet been established. With respect to stimulation methods, two techniques can be applied: monopolar and bipolar stimulation. We compared the threshold to induce clinical symptoms between these two stimulation techniques. Read More

View Article and Full-Text PDF

Novel User-Friendly Application for MRI Segmentation of Brain Resection following Epilepsy Surgery.

Diagnostics (Basel) 2022 Apr 18;12(4). Epub 2022 Apr 18.

Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.

Delineation of resected brain cavities on magnetic resonance images (MRIs) of epilepsy surgery patients is essential for neuroimaging/neurophysiology studies investigating biomarkers of the epileptogenic zone. The gold standard to delineate the resection on MRI remains manual slice-by-slice tracing by experts. Here, we proposed and validated a semiautomated MRI segmentation pipeline, generating an accurate model of the resection and its anatomical labeling, and developed a graphical user interface (GUI) for user-friendly usage. Read More

View Article and Full-Text PDF

Multimodal Presurgical Evaluation of Medically Refractory Focal Epilepsy in Adults: An Update for Radiologists.

AJR Am J Roentgenol 2022 Apr 20. Epub 2022 Apr 20.

Associate Professor of Radiology, Neuroradiology, Vice Chair of Imaging Informatics, Department of Radiology, Northwestern University Feinberg School of Medicine.

Surgery is a potentially curative treatment option for patients with medically refractory focal epilepsy. Advanced neuroimaging modalities often improve surgical outcomes by contributing key information during the highly individualized surgical planning process and intraoperative localization. Hence, neuroradiologists play an integral role as part of the multidisciplinary management team. Read More

View Article and Full-Text PDF

Dynamical Network Models From EEG and MEG for Epilepsy Surgery-A Quantitative Approach.

Front Neurol 2022 29;13:837893. Epub 2022 Mar 29.

Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.

There is an urgent need for more informative quantitative techniques that non-invasively and objectively assess strategies for epilepsy surgery. Invasive intracranial electroencephalography (iEEG) remains the clinical gold standard to investigate the nature of the epileptogenic zone (EZ) before surgical resection. However, there are major limitations of iEEG, such as the limited spatial sampling and the degree of subjectivity inherent in the analysis and clinical interpretation of iEEG data. Read More

View Article and Full-Text PDF

Simultaneous stereo-EEG and high-density scalp EEG recordings to study the effects of intracerebral stimulation parameters.

Brain Stimul 2022 May-Jun;15(3):664-675. Epub 2022 Apr 12.

Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy. Electronic address:

Background: Cortico-cortical evoked potentials (CCEPs) recorded by stereo-electroencephalography (SEEG) are a valuable tool to investigate brain reactivity and effective connectivity. However, invasive recordings are spatially sparse since they depend on clinical needs. This sparsity hampers systematic comparisons across-subjects, the detection of the whole-brain effects of intracortical stimulation, as well as their relationships to the EEG responses evoked by non-invasive stimuli. Read More

View Article and Full-Text PDF

A brain atlas of axonal and synaptic delays based on modelling of cortico-cortical evoked potentials.

Brain 2022 Jun;145(5):1653-1667

Neurology Department, University Emergency Hospital, Bucharest, Romania.

Epilepsy presurgical investigation may include focal intracortical single-pulse electrical stimulations with depth electrodes, which induce cortico-cortical evoked potentials at distant sites because of white matter connectivity. Cortico-cortical evoked potentials provide a unique window on functional brain networks because they contain sufficient information to infer dynamical properties of large-scale brain connectivity, such as preferred directionality and propagation latencies.  Here, we developed a biologically informed modelling approach to estimate the neural physiological parameters of brain functional networks from the cortico-cortical evoked potentials recorded in a large multicentric database. Read More

View Article and Full-Text PDF

Long-term Outcome of Epilepsy and Cortical Malformations Due to Abnormal Migration and Postmigrational Development: A Cohort Study.

Neurology 2022 Apr 11. Epub 2022 Apr 11.

IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network EpiCARE, Bologna, Italy.

Objective: To evaluate the long-term outcome of patients with epilepsy and malformations of cortical development (MCD).

Methods: We conducted a historical cohort study of patients with epilepsy and MCD due to impaired neuronal migration and postmigration organization, and with a follow-up period of ≥5 years. For each patient, MCD was classified after accurate neuroimaging reappraisal by an expert neuroradiologist. Read More

View Article and Full-Text PDF

Connectomic Profiles and Cognitive Trajectories After Epilepsy Surgery in Children.

Neurology 2022 May 11;98(22):e2233-e2244. Epub 2022 Apr 11.

From the Program in Neuroscience and Mental Health (O.N.A., D.J.M., J.M.Y., S.M.W., M.L.S., G.M.I.), Hospital for Sick Children Research Institute; Institute of Medical Science (O.N.A., G.M.I.), University of Toronto; Department of Psychology (J.M.Y., E.N.K., M.L.S.), Hospital for Sick Children, University of Toronto; Institute of Biomaterials and Biomedical Engineering (S.M.W., G.M.I.), University of Toronto; Division of Neurosurgery (H.S., G.M.I.), Hospital for Sick Children, Department of Surgery, University of Toronto; Division of Neurology (A.O., H.O., R.S., O.C.S., P.J., E.J.D.) and Diagnostic Imaging (E.W.), Hospital for Sick Children, University of Toronto; and Department of Psychology (M.L.S.), University of Toronto Mississauga, Ontario, Canada.

Background And Objectives: Neurocognitive outcomes after surgery for temporal lobe epilepsy in childhood are variable. Postoperative changes are not directly predicted by seizure freedom, and associations between epilepsy, neuropsychological function, and developing neural networks are poorly understood. Here, we leveraged whole-brain connectomic profiling in magnetoencephalography (MEG) to retrospectively study associations between brain connectivity and neuropsychological function in children with temporal lobe epilepsy undergoing resective surgery. Read More

View Article and Full-Text PDF

Prediction of Naming Outcome With fMRI Language Lateralization in Left Temporal Epilepsy Surgery.

Neurology 2022 Jun 11;98(23):e2337-e2346. Epub 2022 Apr 11.

From the Departments of Neurology (W.L.G., A.H., S.J.S., L.L.C., C.H., M.R., L.A., C.T.A., C.E.C., J.R.B.), Anesthesiology (W.L.G.), and Neurosurgery (W.M.M.), Medical College of Wisconsin, Milwaukee; Departments of Neurology (R.M.B.) and Radiology (M.J.L.), Cleveland Clinic Foundation, OH; Departments of Neurology (J.T.L.) and Imaging Sciences (M.E.T.), University of Rochester, NY; Departments of Neurology (D.L.D., D.W.L.) and Pediatrics (D.L.D.), Emory University, Atlanta, GA; Department of Neurology (D.L.D., T.G.), University of Washington, Seattle; Departments of Psychology (M.J.) and Radiology (V.L.M.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (J.B.A., J.P.S.), University of Alabama at Birmingham; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; Department of Neurology (S.B.), University of California, Los Angeles; and Department of Neurology (J.V.), University of Cincinnati, OH.

Background And Objectives: Naming decline after left temporal lobe epilepsy (TLE) surgery is common and difficult to predict. Preoperative language fMRI may predict naming decline, but this application is still lacking evidence. We performed a large multicenter cohort study of the effectiveness of fMRI in predicting naming deficits after left TLE surgery. Read More

View Article and Full-Text PDF

fMRI Has Added Value in Predicting Naming After Epilepsy Surgery.

Joseph I Tracy

Neurology 2022 Jun 11;98(23):959-960. Epub 2022 Apr 11.

From the Department of Neurology, Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA.

View Article and Full-Text PDF

Neuroimaging gradient alterations and epileptogenic prediction in focal cortical dysplasia IIIa.

J Neural Eng 2022 04 21;19(2). Epub 2022 Apr 21.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

Focal cortical dysplasia type IIIa (FCD IIIa) is a highly prevalent temporal lobe epilepsy but the seizure outcomes are not satisfactory after epilepsy surgery. Hence, quantitative neuroimaging, epileptogenic alterations, as well as their values in guiding surgery are worth exploring.We examined 69 patients with pathologically verified FCD IIIa using multimodal neuroimaging and stereoelectroencephalography (SEEG). Read More

View Article and Full-Text PDF

Connectomic profiling and Vagus nerve stimulation Outcomes Study (CONNECTiVOS): a prospective observational protocol to identify biomarkers of seizure response in children and youth.

BMJ Open 2022 04 8;12(4):e055886. Epub 2022 Apr 8.

Division of Neurosurgery, Hospital for Sick Children, Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada

Introduction: Vagus nerve stimulation (VNS) is a neuromodulation therapy that can reduce the seizure burden of children with medically intractable epilepsy. Despite the widespread use of VNS to treat epilepsy, there are currently no means to preoperatively identify patients who will benefit from treatment. The objective of the present study is to determine clinical and neural network-based correlates of treatment outcome to better identify candidates for VNS therapy. Read More

View Article and Full-Text PDF

Neuroimaging of Epilepsy.

Continuum (Minneap Minn) 2022 04;28(2):306-338

Purpose Of Review: This article provides an overview of imaging modalities, important imaging pathologies, and the role each imaging modality can play in the diagnosis, evaluation, and treatment of epilepsy, including epilepsy surgery.

Recent Findings: The Harmonized Neuroimaging of Epilepsy Structural Sequences (HARNESS-MRI) protocol was proposed to standardize MRI imaging for all patients with seizures. The role of 7-Tesla MRI in finding previously occult epileptogenic lesions is under investigation, and the technique is increasingly used. Read More

View Article and Full-Text PDF

Neuroimaging and thalamic connectomics in epilepsy neuromodulation.

Epilepsy Res 2022 05 30;182:106916. Epub 2022 Mar 30.

Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.

Neuromodulation is an increasingly utilized therapy for the treatment of people with drug-resistant epilepsy. To date, the most common and effective target has been the thalamus, which is known to play a key role in multiple forms of epilepsy. Neuroimaging has facilitated rapid developments in the understanding of functional targets, surgical and programming techniques, and the effects of thalamic stimulation. Read More

View Article and Full-Text PDF

Profiling PI3K-AKT-MTOR variants in focal brain malformations reveals new insights for diagnostic care.

Brain 2022 Apr;145(3):925-938

Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA.

Focal malformations of cortical development including focal cortical dysplasia, hemimegalencephaly and megalencephaly, are a spectrum of neurodevelopmental disorders associated with brain overgrowth, cellular and architectural dysplasia, intractable epilepsy, autism and intellectual disability. Importantly, focal cortical dysplasia is the most common cause of focal intractable paediatric epilepsy. Gain and loss of function variants in the PI3K-AKT-MTOR pathway have been identified in this spectrum, with variable levels of mosaicism and tissue distribution. Read More

View Article and Full-Text PDF