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Invasive techniques are becoming increasingly important in the presurgical evaluation of epilepsy. Adopting the electrophysiological source imaging (ESI) of interictal scalp electroencephalography (EEG) to localize the epileptogenic zone remains a challenge. The accuracy of the preoperative localization of the epileptogenic zone is key to curing epilepsy. The T1 MRI and the boundary element method were used to build the realistic head model. To solve the inverse problem, the distributed inverse solution and equivalent current dipole (ECD) methods were employed to locate the epileptogenic zone. Furthermore, a combination of inverse solution algorithms and Granger causality connectivity measures was evaluated. The ECD method exhibited excellent focalization in lateralization and localization, achieving a coincidence rate of 99.02% (p<0.05) with the stereo electroencephalogram. The combination of ECD and the directed transfer function led to excellent matching between the information flow obtained from intracranial and scalp EEG recordings. The ECD inverse solution method showed the highest performance and could extract the discharge information at the cortex level from noninvasive low-density EEG data. Thus, the accurate preoperative localization of the epileptogenic zone could reduce the number of intracranial electrode implantations required.


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Interictal Electrophysiological Source Imaging Based on Realistic Epilepsy Head Model in Presurgical Evaluation: A Prospective Study

Show Author's information Ruowei Qu1Zhaonan Wang1Shifeng Wang2Le Wang3Alan Wang4Guizhi Xu1( )
State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin 300401, China
Tianjin Universal Medical Imaging Diagnostic Center, Tianjin 300110, China
Department of Functional Neurosurgery, Huanhu Hospital, Tianjin 300350, China
Auckland Bioengineering Institute, The University of Auckland, Grafton, Auckland 1010, New Zealand

Abstract

Invasive techniques are becoming increasingly important in the presurgical evaluation of epilepsy. Adopting the electrophysiological source imaging (ESI) of interictal scalp electroencephalography (EEG) to localize the epileptogenic zone remains a challenge. The accuracy of the preoperative localization of the epileptogenic zone is key to curing epilepsy. The T1 MRI and the boundary element method were used to build the realistic head model. To solve the inverse problem, the distributed inverse solution and equivalent current dipole (ECD) methods were employed to locate the epileptogenic zone. Furthermore, a combination of inverse solution algorithms and Granger causality connectivity measures was evaluated. The ECD method exhibited excellent focalization in lateralization and localization, achieving a coincidence rate of 99.02% (p<0.05) with the stereo electroencephalogram. The combination of ECD and the directed transfer function led to excellent matching between the information flow obtained from intracranial and scalp EEG recordings. The ECD inverse solution method showed the highest performance and could extract the discharge information at the cortex level from noninvasive low-density EEG data. Thus, the accurate preoperative localization of the epileptogenic zone could reduce the number of intracranial electrode implantations required.

Keywords: Epilepsy, epileptogenic zone, realistic head model, functional brain connectivity, ESI

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Received: 04 February 2023
Revised: 19 February 2023
Accepted: 27 February 2023
Published: 31 March 2023
Issue date: March 2023

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