lsj (2022-06-27 10:16):
#Virtual resection predicts surgical outcome for drug-resistant epilepsy. 该研究使用了线性系统稳定性理论与分析方法,提出了一种新的颅内EEG癫痫发作起始区的标记——神经易脆性,并通过多中心的91名患者数据对该方法进行了回顾性验证。
IF:10.600Q1 Brain : a journal of neurology, 2019-12-01. DOI: 10.1093/brain/awz303 PMID: 31599323 PMCID:PMC6885672
Virtual resection predicts surgical outcome for drug-resistant epilepsy
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Abstract:
Patients with drug-resistant epilepsy often require surgery to become seizure-free. While laser ablation and implantable stimulation devices have lowered the morbidity of these procedures, seizure-free rates have not dramatically improved, particularly for patients without focal lesions. This is in part because it is often unclear where to intervene in these cases. To address this clinical need, several research groups have published methods to map epileptic networks but applying them to improve patient care remains a challenge. In this study we advance clinical translation of these methods by: (i) presenting and sharing a robust pipeline to rigorously quantify the boundaries of the resection zone and determining which intracranial EEG electrodes lie within it; (ii) validating a brain network model on a retrospective cohort of 28 patients with drug-resistant epilepsy implanted with intracranial electrodes prior to surgical resection; and (iii) sharing all neuroimaging, annotated electrophysiology, and clinical metadata to facilitate future collaboration. Our network methods accurately forecast whether patients are likely to benefit from surgical intervention based on synchronizability of intracranial EEG (area under the receiver operating characteristic curve of 0.89) and provide novel information that traditional electrographic features do not. We further report that removing synchronizing brain regions is associated with improved clinical outcome, and postulate that sparing desynchronizing regions may further be beneficial. Our findings suggest that data-driven network-based methods can identify patients likely to benefit from resective or ablative therapy, and perhaps prevent invasive interventions in those unlikely to do so.
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