Respective Contribution of Ictal and Inter-ictal Electrical Source Imaging to Epileptogenic Zone Localization

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 val...

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Bibliographic Details
Published in:Brain topography 2020-05, Vol.33 (3), p.384-402
Main Authors: Rikir, Estelle, Maillard, Louis G., Abdallah, Chifaou, Gavaret, Martine, Bartolomei, Fabrice, Vignal, Jean-Pierre, Colnat-Coulbois, Sophie, Koessler, Laurent
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedicine
Cognitive science
Drug Resistant Epilepsy - diagnostic imaging
EEG
Electroencephalography
Epilepsy
Etiology
Humans
Localization
Magnetic Resonance Imaging
Malformations of Cortical Development
Neurology
Neuroscience
Neurosciences
Original Paper
Prospective Studies
Psychiatry
Rhythms
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Summary: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 subsequently 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 
ISSN:0896-0267
1573-6792
DOI:10.1007/s10548-020-00768-3