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Article Dans Une Revue Brain Topography: a Journal of Cerebral Function and Dynamics Année : 2020

Respective contribution of ictal and inter-ictal electrical source imaging to epileptogenic zone localization

Résumé

Interictal electrical source imaging (ESI) encompasses a risk of false localization due to complex relationships between irritative and epileptogenic networks. This study aimed to compare the localizing value of ESI derived from ictal and inter-ictal EEG discharges and to evaluate the localizing value of ESI according to three different subgroups: MRI lesion, presumed etiology and morphology of ictal EEG pattern. We prospectively analyzed 54 of 78 enrolled patients undergoing pre-surgical investigation for refractory epilepsy. Ictal and inter-ictal ESI results were interpreted blinded to- and subse-quently compared with stereoelectroencephalography as a reference method. Anatomical concordance was assessed at a sub-lobar level. Sensitivity and specificity of ictal, inter-ictal and ictal plus inter-ictal ESI were calculated and compared according to the different subgroups. Inter-ictal and ictal ESI sensitivity (84% and 75% respectively) and specificity (38% and 50% respectively) were not statistically different. Regarding the sensitivity, ictal ESI was never higher than inter-ictal ESI. Regarding the specificity, ictal ESI was higher than inter-ictal ESI in malformations of cortical development (MCD) (60% vs. 43%) and in MRI positive patients (49% vs. 30%). Within the ictal ESI analysis, we showed a higher specificity for ictal spikes (59%) and rhythmic discharges > 13 Hz (50%) than rhythmic discharges < 13 Hz (37%) and (ii) for MCD (60%) than in other etiologies (29%). This prospective study demonstrates the relevance of a combined interpretation of distinct inter-ictal and ictal analysis. Inter-ictal analysis gave the highest sensitivity. Ictal analysis gave the highest specificity especially in patients with MCD or a lesion on MRI.
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Dates et versions

hal-02931212 , version 1 (23-11-2020)

Identifiants

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Estelle Rikir, Louis G Maillard, Chifaou Abdallah, Martine Gavaret, Fabrice Bartolomei, et al.. Respective contribution of ictal and inter-ictal electrical source imaging to epileptogenic zone localization. Brain Topography: a Journal of Cerebral Function and Dynamics, 2020, 33 (3), pp.384-402. ⟨10.1007/s10548-020-00768-3⟩. ⟨hal-02931212⟩
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