Contribution to the cerebral forward model by depth electric stimulation and SEEG measurements: Application in epilepsy

Abstract : The study of epilepsy requires the identification of cerebral structures which are involved in generation of seizures and connexion processes. Several methods of clinical investigation contributed to these studies : imaging (PET, MRI), electrophysiology (EEG, SEEG, MEG). The EEG provides a temporal resolution enough to analyze these processes. However, the localization of deep sources and their dynamical properties are difficult to understand. SEEG is a modality of intracerebral electrophysiological and anatomical high temporal resolution reserved for some difficult cases of pre-surgical diagnosis : drug-resistant epilepsy. The definition of the epileptogenic zone, as proposed by Talairach and Bancaud is an electro-clinical definition based on the results of intracerebral SEEG recordings. It takes into account not only the anatomical localization of partial epileptic discharge, but also the dynamic evolution of this discharge (active neural networks at the time of seizure) and clinical symptoms. Recently, a novel diagnostic technique allows an accurate localization of the epileptogenic zone using Depth Brain Stimulation (DBS). This exogenous source can activate the epileptic networks and generate an electrophysiological reaction. Therefore, coupling DBS with SEEG measurements is very advantageous : firstly, to contribute to the modeling and understanding of the (epileptic) brain and to help the diagnosis, secondly, to access the estimation of head model as an electrical conductor (conductive properties of tissues). In addition, supplementary information about head model improves the solution to the inverse problem (source localization methods) used in many applications in EEG and SEEG. The inverse solution requires repeated computation of the forward problem, i.e. the simulation of EEG and SEEG fields for a given dipolar source in the brain using a volume-conduction model of the head. As for DBS, the location of source is well defined. Therefore, in this thesis, we search for the best head model for the forward problem from real synchronous measurements of EEG and SEEG with DBS in several patients. So, the work of the thesis breaks up into different parts for which we need to accomplish the following tasks : Creation of database 3000 DBS measurements for 42 patients ; Extraction of DBS signal from SEEG and EEG measurements using multidimensional analysis : 5 methods have been developed or adapted and validate first in a simulation study and, secondly, in a real SEEG application ; Localization of SEEG electrodes in MR and CT images, including segmentation of brain matter ; SEEG forward modeling using infinite medium, spherical and realistic models based on MRI and CT of the patient ; Comparison between different head models and validation with real in vivo DBS measurements ; Validation of realistic 5-compartment FEM head models by incorporating the conductivities of cerebrospinal fluid (CSF), gray and white matters
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Janis Hofmanis. Contribution to the cerebral forward model by depth electric stimulation and SEEG measurements: Application in epilepsy. Other. Université de Lorraine, 2013. English. ⟨NNT : 2013LORR0209⟩. ⟨tel-01750509⟩

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