1. Localizing hidden Interictal Epileptiform Discharges with simultaneous intracerebral and scalp high-density EEG recordings.
- Author
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Zauli FM, Del Vecchio M, Pigorini A, Russo S, Massimini M, Sartori I, Cardinale F, d'Orio P, and Mikulan E
- Subjects
- Humans, Male, Female, Adult, Young Adult, Brain physiopathology, Epilepsies, Partial physiopathology, Epilepsies, Partial diagnosis, Middle Aged, Signal Processing, Computer-Assisted, Stereotaxic Techniques, Brain Mapping methods, Evoked Potentials physiology, Adolescent, Electroencephalography methods, Scalp physiopathology, Drug Resistant Epilepsy physiopathology, Drug Resistant Epilepsy diagnosis
- Abstract
Background: Scalp EEG is one of the main tools in the clinical evaluation of epilepsy. In some cases intracranial Interictal Epileptiform Discharges (IEDs) are not visible from the scalp. Recent studies have shown the feasibility of revealing them in the EEG if their timings are extracted from simultaneous intracranial recordings, but their potential for the localization of the epileptogenic zone is not yet well defined., New Method: We recorded simultaneous high-density EEG (HD-EEG) and stereo-electroencephalography (SEEG) during interictal periods in 8 patients affected by drug-resistant focal epilepsy. We identified IEDs in the SEEG and systematically analyzed the time-locked signals on the EEG by means of evoked potentials, topographical analysis and Electrical Source Imaging (ESI). The dataset has been standardized and is being publicly shared., Results: Our results showed that IEDs that were not clearly visible at single-trials could be uncovered by averaging, in line with previous reports. They also showed that their topographical voltage distributions matched the position of the SEEG electrode where IEDs had been identified, and that ESI techniques can reconstruct it with an accuracy of ∼2 cm. Finally, the present dataset provides a reference to test the accuracy of different methods and parameters., Comparison With Existing Methods: Our study is the first to systematically compare ESI methods on simultaneously recorded IEDs, and to share a public resource with in-vivo data for their evaluation., Conclusions: Simultaneous HD-EEG and SEEG recordings can unveil hidden IEDs whose origins can be reconstructed using topographical and ESI analyses, but results depend on the selected methods and parameters., Competing Interests: Declaration of Competing Interest Marcello Massimini is co-founder and shareholder of Intrinsic Powers. Simone Russo is the Chief Medical Officer of Manava Plus. All other authors report no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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