Dense Array EEGによるPresurgical Planning

EGI社の256ch高密度脳波計(Dense Array EEG)を用いた、てんかん外科の術前評価に 関する文献をご紹介いたします。256chDense Array EEGによる信号源推定は、EGI独自の FDM(有限差分法)方式により顔を含む頭全体から脳波を測定し、各部位の骨の厚みを考慮した 頭部モデルを用いており、前頭葉内側部などの病変検出も可能となります。

Comparing dense array EEG ESI to cEEG, structural MRI, and interictal PET

Feng, R., Hu, J., Pan, L., Wu, J., Lang, L., Jiang, S., . . . Zhou, L. (2015). Application of 256-channel dense array electroencephalographic source imaging in presurgical workup of temporal lobe epilepsy. Clinical Neurophysiology. doi:10.1016/j.clinph.2015.03.009. Link to original paper.

  • Resective surgery was performed on 43 patients with intractable temporal lobe epilepsy after a comprehensive presurgical workup with dense array EEG ESI, cEEG, semiology, structure MRI, and interical PET.
  • 256-channel EEG for 30-60 minutes, followed by source localization, showed higher sensitivity and specificity for identifying the epileptogenic zone, based on surgical outcomes, compared to PET, MRI, semiology, and cEEG.

“In the presurgical workup of TLE, the clinical yield of 256-channel dESI is high. Patterns of dESI results are related to surgical prognosis, and they can be instructive for presurgical planning.”

Comparing dense array scalp EEG to simultaneous intracranial EEG

Yamazaki, M., Tucker, D.M., Fujimoto, A., Yamazoe, T., Okanishi, T., Yokota, T., Enoki, H., & Yamamoto, T. (2012). Comparison of dense array EEG with simultaneous intracranial EEG for interictal spike detection and localization. Epilepsy Research 98(23), 166–173. Link to original paper.

  • The first study to compare dense array EEG (dEEG) directly with simultaneous intracranial EEG (icEEG).
  • icEEG and 256-channel scalp dEEG were recorded simultaneously in seven patients with mesial temporal lobe epilepsy. The scalp dEEG analysis detected 45% of the spikes that were detected using icEEG. Analyzing the same data using a 10-20 montage to simulate conventional EEG, only 22% of the icEEG spikes were detected.
  • By applying source estimation algorithms to the dEEG data, the researchers determined that all spikes detected with scalp dEEG were localized to the mesial temporal lobe and close to the position confirmed by icEEG.

The authors conclude that 256-channel dEEG represents a significant improvement over conventional EEG in guiding placement of icEEG electrodes. Thus, use of high-channel scalp dEEG may be clinically useful for presurgical planning.

Comparing dense array EEG to conventional EEG, MRI, PET, and SPECT

Brodbeck, V., Spinelli, L., Lascano, A.M., Wissmeier, M., Vargas, M., Vulliemoz, S., Pollo, C., Schaller, K., Michel, C.M., & Seeck, M. (2011). Electroencephalographic source imaging: a prospective study of 152 operated epileptic patients. Brain 134(10), 2887–2897. doi:10.1093/brain/awr243. Link to original paper.

  • The first large-scale study (152 patients) of the relative contribution of 128- and 256-channel dense array EEG (dEEG) to the presurgical planning process.
  • Presurgical tests included MRI, PET, SPECT, and interictal electrical source imaging (ESI) with either conventional EEG (19-29 electrodes) or dEEG.
  • The authors noted that, compared to other methods, ESI with dEEG is relatively inexpensive and reduces workload because it does not require sedation.

Electrical source imaging (ESI) using dEEG recording of interictal epileptogenic discharges combined with individual MRI head models had the highest sensitivity and specificity, compared to the other imaging methods, for identifying the correct part of the brain to remove during surgery.

More research papers on this subject

Birot, G., Spinelli, L., Vulliemoz, S., Megevand, P., Brunet, D., Seeck, M., & Michel, C. M. (2014). Head model and electrical source imaging: A study of 38 epileptic patients. Neuroimage Clin 5, 77-83. doi: 10.1016/j.nicl.2014.06.005

Brodbeck, V., Lascano, A. M., Spinelli, L., Seeck, M., & Michel, C. M. (2009). Accuracy of EEG source imaging of epileptic spikes in patients with large brain lesions. Clinical Neurophysiology, 120(4), 679-685. doi:10.1016/j.clinph.2009.01.011

Brodbeck, V., Spinelli, L., Lascano, A., Pollo, C., Schaller, K., Vargas, M., Wissmeyer, M., Michel, C. & Seeck, M. (2010). Electrical source imaging for presurgical focus localization in epilepsy patients with normal MRI. Epilepsia, 51(4), 583–591.

Brodbeck, V., Thut, G., Spinelli, L., Romei, V., Tyrand, R., Michel, C. M., & Seeck, M. (2010). Effects of repetitive Transcranial Magnetic Stimulation on spike pattern and topography in patients with focal epilepsy. Brain Topography, 22, 267-280. doi:10.1007/s10548-009-0125-2

Del Felice, A., Foroni, R., Manganotti, P., Storti, S. F., Ricciardi, G. K., Bashat, D. B., . . . Nicolato, A. (2014). The use of electrical source imaging in targeting lesional mesial temporal epilepsy for radiosurgical treatment. Epileptic Disorders, 16(4), 528-532. doi:10.1684/epd.2014.0697

Grouiller, F., Delattre, B. M., Pittau, F., Heinzer, S., Lazeyras, F., Spinelli, L., . . . Vargas, M. I. (2015). All-in-one interictal presurgical imaging in patients with epilepsy: single-session EEG/PET/(f) MRI. European Journal of Nuclear Medicine and Molecular Imaging, 42(7), 1133-1143.

Grouiller, F., Thornton, R., Groening, K., Spinelli, L., Duncan, J., Schaller, K., Siniatchkin, M., Lemieux, L., Seeck, M., Michel, C. & Vulliemoz, S. (2011). With or without spikes: localization of focal epileptic activity by simultaneous electroencephalography and functional magnetic resonance imaging. Brain 134(Pt 10), 2867-2886.

Holmes M. (2008) Dense array EEG: Methodology and new hypothesis on epilepsy syndromes. Epilepsia, 49(Suppl. 3), 3-14.

Holmes, M., Brown, M., Tucker, D., Saneto, R., Miller, K., Wig, G. & Ojemann, J. (2008). Source analysis of extratemporal seizure using dense array EEG: comparison with intracranial recordings. Journal of Pediatric Neurosurgery 44(6), 474-479.

Holmes, M., Tucker, D., Quiring, J., Hakimian, S., Miller, J. & Ojemann, J. (2010). Comparing noninvasive dense array andintracranialelectroencephalography for localization of seizures. Neurosurgery 66, 354–362.

Kargiotis, O., Lascano, A. M., Garibotto, V., Spinelli, L., Genetti, M., Wissmeyer, M., . . . Vulliemoz, S. (2014). Localization of epileptogenic tuber with electric source imaging in patients with tuberous sclerosis. Epilepsy Research, 108(2), 267-279. doi:10.1016/j.eplepsyres.2013.11.003

Lantz, G., Grave de Peralta, R., Spinelli, L., Seeck, M., & Michel, C. M. (2003). Epileptic source localization with high density EEG: how many electrodes are needed? Clinical Neurophysiology, 114(1), 63-69.

Lantz, G., Grouiller, F., Spinelli, L., Seeck, M., & Vulliemoz, S. (2011). Localisation of focal epileptic activity in children using high density EEG source imaging. Epileptologie, 28, 84-90.

Lascano, A. M., Grouiller, F., Genetti, M., Spinelli, L., Seeck, M., Schaller, K., & Michel, C. M. (2014). Surgically relevant localization of tcentral sulcus with high-density somatosensory-evoked potentials compared with functional magnetic resonance imaging. Neurosurgery 74(5), 517-526. doi: 10.1227/NEU.0000000000000298

Lascano, A. M., Perneger, T., Vulliemoz, S., Spinelli, L., Garibotto, V., Korff, C. M., . . . Seeck, M. (2015). Yield of MRI, high-density electric source imaging (HD-ESI), SPECT and PET in epilepsy surgery candidates. Clinical Neurophysiology. doi:10.1016/j.clinph.2015.03.025

Malpass, K. (2011). Epilepsy: Electric source imaging — an inexpensive and reliable method to estimate the epileptic focus. Nature Reviews Neurology 7, 658. doi:10.1038/nrneurol.2011.186

Megevand, P., Spinelli, L., Genetti, M., Brodbeck, V., Momjian, S., Schaller, K., . . . Seeck, M. (2014). Electric source imaging of interictal activity accurately localises the seizure onset zone. J Neurol Neurosurg Psychiatry 85(1), 38-43. doi: 10.1136/jnnp-2013-305515

Michel, C. M., Lantz, G., Spinelli, L., de Peralta Menendez, R., Landis, T., & Seeck, M. (2004). 128-channel EEG source imaging in epilepsy: clinical yield and localization precision. Journal of Clinical Neurophysiology, 21(2), 71-83.

Michel, C. M., Murray, M. M., Lantz, G., Gonzalez, S., Spinelli, L., & Grave de Peralta, R. (2004). EEG source imaging. Clinical Neurophysiology, 115(10), 2195-2222. doi:10.1016/j.clinph.2004.06.001

Pittau, F., Grouiller, F., Spinelli, L., Seeck, M., Michel, C. M., & Vulliemoz, S. (2014). The role of functional neuroimaging in pre-surgical epilepsy evaluation. Front Neurol, 5, 31. doi:10.3389/fneur.2014.00031

Ramon, C., Holmes, M., Freeman, W., McElroy, R. & Rezvanian, E. (2008). Comparative analysis of temporal dynamics of EEG and phase synchronization of EEG to localize epileptic sites from high density scalp EEG interictal recordings. Conference Proceedings IEEE Engineering in Medicine & Biology Society, 2008, 4548-4550.

Sperli, F., Spinelli, L., Seeck, M., Kurian, M., Michel, C. M., & Lantz, G. (2006). EEG source imaging in pediatric epilepsy surgery: a new perspective in presurgical workup. Epilepsia, 47(6), 981-990.

Sohrabpour, A., Lu, Y., Kankirawatana, P., Blount, J., Kim, H., & He, B. (2015). Effect of EEG electrode number on epileptic source localization in pediatric patients. Clin Neurophysiol. doi:10.1016/j.clinph.2014.05.038

Storti, S. F., Boscolo Galazzo, I., Del Felice, A., Pizzini, F. B., Arcaro, C., Formaggio, E., . . . Manganotti, P. (2013). Combining ESI, ASL and PET for quantitative assessment of drug-resistant focal epilepsy. Neuroimage doi: 10.1016/j.neuroimage.2013.06.028

Yamazaki, M., Terrill, M., Fujimoto, A., Yamamoto, T., Tucker, D. (2012). Integrating dense array EEG in the presurgical evaluation of temporal lobe epilepsy. ISRN Neurology, 2012, 924081.doi:10.5402/2012/924081.

Yamazaki, M., Tucker, D., Terrill, M., Fujimoto, A., Yamamoto, T. (2013). Dense array EEG source estimation in neocortical epilepsy. Frontiers in Neurology,4(42), 1–7 doi:10.3389/fneur.2013.00042