Combined use of non-invasive techniques for improved functional localization for a selected group of epilepsy surgery candidates

被引：52

作者：

Vitikainen, A. -M. ^{[1
,2
,3
]}

Lioumis, P. ^{[1
,4
]}

Paetau, R. ^{[1
,5
]}

Salli, E. ^{[4
]}

Komssi, S. ^{[2
,4
]}

Metsahonkala, L. ^{[5
]}

Paetau, A. ^{[6
,7
]}

Kicic, D. ^{[1
,8
]}

Blomstedt, G. ^{[9
]}

Valanne, L. ^{[4
]}

Makela, J. P. ^{[1
]}

Gaily, E. ^{[5
]}

机构：

[1] Univ Helsinki, Cent Hosp, HUSLAB BioMag Lab, Hosp Dist Helsinki & Uusimaa, FI-00029 Helsinki, Finland

[2] Univ Helsinki, Cent Hosp, HUSLAB Dept Clin Neurophysiol, Hosp Dist Helsinki & Uusimaa, FI-00029 Helsinki, Finland

[3] Univ Helsinki, Dept Phys, FI-00014 Helsinki, Finland

[4] Univ Helsinki, Cent Hosp, HUS Helsinki Med Imaging Ctr, Hosp Dist Helsinki & Uusimaa, FI-00029 Helsinki, Finland

[5] Univ Helsinki, Cent Hosp, Epilepsy Unit, Dept Gynaecol & Pediat,Hosp Dist Helsinki & Uusim, FI-00029 Helsinki, Finland

[6] Univ Helsinki, Hosp Dist Helsinki & Uusimaa, FI-00014 Helsinki, Finland

[7] HUSLAB Dept Pathol, Haartman Inst, FI-00014 Helsinki, Finland

[8] Aalto Univ, Dept Biomed Engn & Computat Sci, FI-02015 Helsinki, Finland

[9] Univ Helsinki, Cent Hosp, Dept Neurosurg, Hosp Dist Helsinki & Uusimaa, FI-00029 Helsinki, Finland

来源：

NEUROIMAGE | 2009年 / 45卷 / 02期

基金：

芬兰科学院;

关键词：

TMS; MEG; Intracranial electrodes; Cortical localization; Preoperative evaluation; Epilepsy surgery; TRANSCRANIAL MAGNETIC STIMULATION; MOTOR CORTEX; SENSORIMOTOR CORTEX; BRAIN; MAGNETOENCEPHALOGRAPHY; MRI; DEFORMATION; THRESHOLDS; FRAMEWORK; PULSE;

D O I：

10.1016/j.neuroimage.2008.12.026

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Invasive cortical mapping is conventionally required for preoperative identification of epileptogenic and eloquent cortical regions before epilepsy surgery. The decision on the extent and exact location of the resection is always demanding and multimodal approach is desired for added certainty. The present study describes two non-invasive preoperative protocols, used in addition to the normal preoperative work-up for localization of the epileptogenic and sensorimotor cortical regions, in two young patients with epilepsy. Magnetoencephalography (MEG) was used to determine the primary somatosensory cortex (S1) and the ictal onset zones. Navigated transcranial magnetic stimulation (nTMS) was used to determine the location and the extent of the primary motor representation areas. The localization results from these non-invasive methods were used for guiding the subdural grid deployment and later compared with the results from electrical cortical stimulation (ECS) via subdural grids, and validated by surgery outcome. The results from MEG and nTMS localizations were consistent with the ECS results and provided improved spatial precision. Consistent results of our study suggest that these non-invasive methods can be added to the standard preoperative work-up and may even hold a potential to replace the ECS in a subgroup of patients with epilepsy who have the suspected epileptogenic zone near the sensorimotor cortex and seizures frequent enough for ictal MEG. (c) 2008 Elsevier Inc. All rights reserved.

引用

页码：342 / 348

页数：7

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