High-resolution electric source imaging for presurgical evaluation of tuberous sclerosis complex patients. (January 2022)

• Record Type: Journal Article
• Authors: Mouthaan, Brian E.; Jansen, Floor E.; Colon, Albert J.; Huiskamp, Geertjan M.; van Eijsden, Pieter; Leijten, Frans S.S.; Braun, Kees P.J.
• Is Part Of: Clinical neurophysiology. Volume 133(2022)
• Page Start: 126
• Page End: 134
• Publication Date: 2022-01
• Subjects: Electroencephalography -- Source localization -- Long-term monitoring -- Clinical value -- Accuracy -- Bourneville; AMT-PET α[11C]-methyl-l-tryptophan-positron emission tomography -- DTI diffusion tensor imaging -- ECoG electrocorticography -- EEG electroencephalography -- EZ epileptogenic zone -- GRID intracranial GRID EEG -- HR-ESI high resolution electric source imaging -- MEG magnetoencephalography -- MRI magnetic resonance imaging -- MSI magnetic source imaging -- MUSIC multiple signal classification -- PHS patient-history-based semiology -- SEEG stereo depth EEG -- sLORETA standardized low-resolution brain electromagnetic tomography -- SPECT single photon emission computed tomography -- TSC tuberous sclerosis complex -- VS video-based semiology; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2021.09.020
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Patient-history-based and video-based semiology poorly localize the epileptogenic zone in tuberous sclerosis patients. High resolution electric source imaging is more often concordant with the epileptogenic zone compared to ictal EEG. High resolution electric source imaging positively impacts clinical management in 50% of patients. Abstract: Objective: We retrospectively assessed the localizing value of patient-history-based semiology (PHS), video-based semiology (VS), long-term monitoring video electroencephalography (LTM-VEEG) and interictal high resolution electric source imaging (HR-ESI) in the presurgical workup of patients with tuberous sclerosis complex (TSC). Methods: Data from 24 consecutive TSC surgical candidates who underwent both HR-ESI and LTM-VEEG was retrospectively collected. PHS and VS were analyzed to hypothesize the symptomatogenic zone localization. LTM-VEEG and HR-ESI localization results were extracted from the diagnostic reports. Localizing value was compared between modalities, taken the resected/disconnected area of surgical patients in consideration. HR-ESI's impact on the epileptogenic zone hypothesis and surgical workup was evaluated. Results: Semiology, interictal EEG, ictal EEG and HR-ESI were localizing in 25%, 54%, 63% and 79% of patients. Inter-modality concordance ranged between 33–89%. In good surgical outcome patients, PHS, VS, interictal EEG, ictal EEG and HR-ESI showed concordance with resected area in 1/9 (11%), 0/9 (0%), 4/9 (44%), 3/9 (33%) and 6/9 patients (67%). HR-ESI positively impacts clinical management in 50% of patients. Conclusions: In presurgical evaluation of TSC patients, semiology often has limited localizing value. Presurgical work-up benefits from HR-ESI. Significance: Our findings may advice future presurgical epilepsy workup of TSC patients with the ultimate aim to improve outcome.