The role of quantitative markers in surgical prognostication after stereoelectroencephalography
Abstract Objective Stereoelectroencephalography (SEEG) is the reference method in the presurgical exploration of drug‐resistant focal epilepsy. However, prognosticating surgery on an individual level is difficult. A quantified estimation of the most epileptogenic regions by searching for relevant bi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-11-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51900 |
| _version_ | 1797627586692513792 |
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| author | Julia Makhalova Tanguy Madec Samuel Medina Villalon Aude Jegou Stanislas Lagarde Romain Carron Didier Scavarda Elodie Garnier Christian G. Bénar Fabrice Bartolomei |
| author_facet | Julia Makhalova Tanguy Madec Samuel Medina Villalon Aude Jegou Stanislas Lagarde Romain Carron Didier Scavarda Elodie Garnier Christian G. Bénar Fabrice Bartolomei |
| author_sort | Julia Makhalova |
| collection | DOAJ |
| description | Abstract Objective Stereoelectroencephalography (SEEG) is the reference method in the presurgical exploration of drug‐resistant focal epilepsy. However, prognosticating surgery on an individual level is difficult. A quantified estimation of the most epileptogenic regions by searching for relevant biomarkers can be proposed for this purpose. We investigated the performances of ictal (Epileptogenicity Index, EI; Connectivity EI, cEI), interictal (spikes, high‐frequency oscillations, HFO [80–300 Hz]; Spikes × HFO), and combined (Spikes × EI; Spikes × cEI) biomarkers in predicting surgical outcome and searched for prognostic factors based on SEEG‐signal quantification. Methods Fifty‐three patients operated on following SEEG were included. We compared, using precision‐recall, the epileptogenic zone quantified using different biomarkers (EZq) against the visual analysis (EZC). Correlations between the EZ resection rates or the EZ extent and surgical prognosis were analyzed. Results EI and Spikes × EI showed the best precision against EZc (0.74; 0.70), followed by Spikes × cEI and cEI, whereas interictal markers showed lower precision. The EZ resection rates were greater in seizure‐free than in non‐seizure‐free patients for the EZ defined by ictal biomarkers and were correlated with the outcome for EI and Spikes × EI. No such correlation was found for interictal markers. The extent of the quantified EZ did not correlate with the prognosis. Interpretation Ictal or combined ictal–interictal markers overperformed the interictal markers both for detecting the EZ and predicting seizure freedom. Combining ictal and interictal epileptogenicity markers improves detection accuracy. Resection rates of the quantified EZ using ictal markers were the only statistically significant determinants for surgical prognosis. |
| first_indexed | 2024-03-11T10:27:25Z |
| format | Article |
| id | doaj.art-2bfa96abd1a54e0fb27c84f4d8c16cfe |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-11T10:27:25Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-2bfa96abd1a54e0fb27c84f4d8c16cfe2023-11-15T11:57:14ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-11-0110112114212610.1002/acn3.51900The role of quantitative markers in surgical prognostication after stereoelectroencephalographyJulia Makhalova0Tanguy Madec1Samuel Medina Villalon2Aude Jegou3Stanislas Lagarde4Romain Carron5Didier Scavarda6Elodie Garnier7Christian G. Bénar8Fabrice Bartolomei9APHM, Timone Hospital, Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology Marseille FranceAix Marseille Univ, INSERM, INS, Inst Neurosci Syst Marseille FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology Marseille FranceAPHM, Timone Hospital, Functional, and Stereotactic Neurosurgery Marseille FranceAPHM, Department of Pediatric Neurosurgery Marseille FranceAix Marseille Univ, INSERM, INS, Inst Neurosci Syst Marseille FranceAix Marseille Univ, INSERM, INS, Inst Neurosci Syst Marseille FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology Marseille FranceAbstract Objective Stereoelectroencephalography (SEEG) is the reference method in the presurgical exploration of drug‐resistant focal epilepsy. However, prognosticating surgery on an individual level is difficult. A quantified estimation of the most epileptogenic regions by searching for relevant biomarkers can be proposed for this purpose. We investigated the performances of ictal (Epileptogenicity Index, EI; Connectivity EI, cEI), interictal (spikes, high‐frequency oscillations, HFO [80–300 Hz]; Spikes × HFO), and combined (Spikes × EI; Spikes × cEI) biomarkers in predicting surgical outcome and searched for prognostic factors based on SEEG‐signal quantification. Methods Fifty‐three patients operated on following SEEG were included. We compared, using precision‐recall, the epileptogenic zone quantified using different biomarkers (EZq) against the visual analysis (EZC). Correlations between the EZ resection rates or the EZ extent and surgical prognosis were analyzed. Results EI and Spikes × EI showed the best precision against EZc (0.74; 0.70), followed by Spikes × cEI and cEI, whereas interictal markers showed lower precision. The EZ resection rates were greater in seizure‐free than in non‐seizure‐free patients for the EZ defined by ictal biomarkers and were correlated with the outcome for EI and Spikes × EI. No such correlation was found for interictal markers. The extent of the quantified EZ did not correlate with the prognosis. Interpretation Ictal or combined ictal–interictal markers overperformed the interictal markers both for detecting the EZ and predicting seizure freedom. Combining ictal and interictal epileptogenicity markers improves detection accuracy. Resection rates of the quantified EZ using ictal markers were the only statistically significant determinants for surgical prognosis.https://doi.org/10.1002/acn3.51900 |
| spellingShingle | Julia Makhalova Tanguy Madec Samuel Medina Villalon Aude Jegou Stanislas Lagarde Romain Carron Didier Scavarda Elodie Garnier Christian G. Bénar Fabrice Bartolomei The role of quantitative markers in surgical prognostication after stereoelectroencephalography Annals of Clinical and Translational Neurology |
| title | The role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| title_full | The role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| title_fullStr | The role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| title_full_unstemmed | The role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| title_short | The role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| title_sort | role of quantitative markers in surgical prognostication after stereoelectroencephalography |
| url | https://doi.org/10.1002/acn3.51900 |
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