Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Magnetoencephalography Interictal Spike Clustering in Relation with Surgical Outcome of Cortical Dysplasia

  • Jeong, Woorim (MEG Center, Department of Neurosurgery, Seoul National University Hospital) ;
  • Chung, Chun Kee (MEG Center, Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, June Sic (MEG Center, Department of Neurosurgery, Seoul National University Hospital)
  • Received : 2012.05.23
  • Accepted : 2012.11.22
  • Published : 2012.11.28
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Abstract

Objective : The aim of this study was to devise an objective clustering method for magnetoencephalography (MEG) interictal spike sources, and to identify the prognostic value of the new clustering method in adult epilepsy patients with cortical dysplasia (CD). Methods : We retrospectively analyzed 25 adult patients with histologically proven CD, who underwent MEG examination and surgical resection for intractable epilepsy. The mean postoperative follow-up period was 3.1 years. A hierarchical clustering method was adopted for MEG interictal spike source clustering. Clustered sources were then tested for their prognostic value toward surgical outcome. Results : Postoperative seizure outcome was Engel class I in 6 (24%), class II in 3 (12%), class III in 12 (48%), and class IV in 4 (16%) patients. With respect to MEG spike clustering, 12 of 25 (48%) patients showed 1 cluster, 2 (8%) showed 2 or more clusters within the same lobe, 10 (40%) showed 2 or more clusters in a different lobe, and 1 (4%) patient had only scattered spikes with no clustering. Patients who showed focal clustering achieved better surgical outcome than distributed cases (p=0.017). Conclusion : This is the first study that introduces an objective method to classify the distribution of MEG interictal spike sources. By using a hierarchical clustering method, we found that the presence of focal clustered spikes predicts a better postoperative outcome in epilepsy patients with CD.

Keywords

References

  1. Berkovic SF, McIntosh AM, Kalnins RM, Jackson GD, Fabinyi GC, Brazenor GA, et al. : Preoperative MRI predicts outcome of temporal lobectomy : an actuarial analysis. Neurology 45 : 1358-1363, 1995 https://doi.org/10.1212/WNL.45.7.1358
  2. Blümcke I, Thom M, Aronica E, Armstrong DD, Vinters HV, Palmini A, et al. : The clinicopathologic spectrum of focal cortical dysplasias : a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia 52 : 158-174, 2011 https://doi.org/10.1111/j.1528-1167.2010.02777.x
  3. Chassoux F, Devaux B, Landré E, Turak B, Nataf F, Varlet P, et al. : Stereoelectroencephalography in focal cortical dysplasia : a 3D approach to delineating the dysplastic cortex. Brain 123 : 1733-1751, 2000 https://doi.org/10.1093/brain/123.8.1733
  4. Chung CK, Lee SK, Kim KJ : Surgical outcome of epilepsy caused by cortical dysplasia. Epilepsia 46 Suppl 1 : 25-29, 2005 https://doi.org/10.1111/j.0013-9580.2005.461008.x
  5. Engel JJ : Outcome with respect to epileptic seizures in Jr JE (ed) : Surgical treatment of the epilepsies. New York : Raven Press, 1993, pp 609-621
  6. Fischer MJ, Scheler G, Stefan H : Utilization of magnetoencephalography results to obtain favourable outcomes in epilepsy surgery. Brain 128 : 153-157, 2005
  7. Hirabayashi S, Binnie CD, Janota I, Polkey CE : Surgical treatment of epilepsy due to cortical dysplasia : clinical and EEG findings. J Neurol Neurosurg Psychiatry 56 : 765-770, 1993 https://doi.org/10.1136/jnnp.56.7.765
  8. Hudgins RJ, Flamini JR, Palasis S, Cheng R, Burns TG, Gilreath CL : Surgical treatment of epilepsy in children caused by focal cortical dysplasia. Pediatr Neurosurg 41 : 70-76, 2005 https://doi.org/10.1159/000085159
  9. Iida K, Otsubo H, Matsumoto Y, Ochi A, Oishi M, Holowka S, et al. : Characterizing magnetic spike sources by using magnetoencephalography-guided neuronavigation in epilepsy surgery in pediatric patients. J Neurosurg 102 : 187-196, 2005 https://doi.org/10.3171/jns.2005.102.2.0187
  10. Kim IM, Son EI : Surgery of intractable epilepsy associated with cortical dysplasia. J Korean Neurosurg Soc 28 : 942-948, 1999
  11. Kloss S, Pieper T, Pannek H, Holthausen H, Tuxhorn I : Epilepsy surgery in children with focal cortical dysplasia (FCD) : results of long-term seizure outcome. Neuropediatrics 33 : 21-26, 2002 https://doi.org/10.1055/s-2002-23595
  12. Kral T, Clusmann H, Blümcke I, Fimmers R, Ostertun B, Kurthen M, et al. : Outcome of epilepsy surgery in focal cortical dysplasia. J Neurol Neurosurg Psychiatry 74 : 183-188, 2003 https://doi.org/10.1136/jnnp.74.2.183
  13. Lee SK, Lee SY, Kim KK, Hong KS, Lee DS, Chung CK : Surgical outcome and prognostic factors of cryptogenic neocortical epilepsy. Ann Neurol 58 : 525-532, 2005 https://doi.org/10.1002/ana.20569
  14. Morioka T, Nishio S, Ishibashi H, Muraishi M, Hisada K, Shigeto H, et al. : Intrinsic epileptogenicity of focal cortical dysplasia as revealed by magnetoencephalography and electrocorticography. Epilepsy Res 33 : 177-187, 1999 https://doi.org/10.1016/S0920-1211(98)00096-5
  15. Oishi M, Kameyama S, Masuda H, Tohyama J, Kanazawa O, Sasagawa M, et al. : Single and multiple clusters of magnetoencephalographic dipoles in neocortical epilepsy : significance in characterizing the epileptogenic zone. Epilepsia 47 : 355-364, 2006 https://doi.org/10.1111/j.1528-1167.2006.00428.x
  16. RamachandranNair R, Otsubo H, Shroff MM, Ochi A, Weiss SK, Rutka JT, et al. : MEG predicts outcome following surgery for intractable epilepsy in children with normal or nonfocal MRI findings. Epilepsia 48 : 149-157, 2007
  17. Rosenow F, Luders H : Presurgical evaluation of epilepsy. Brain 124 : 1683-1700, 2001 https://doi.org/10.1093/brain/124.9.1683
  18. Sisodiya SM : Surgery for malformations of cortical development causing epilepsy. Brain 123 : 1075-1091, 2000 https://doi.org/10.1093/brain/123.6.1075
  19. Spencer SS : Long-term outcome after epilepsy surgery. Epilepsia 37 : 807-813, 1996 https://doi.org/10.1111/j.1528-1157.1996.tb00032.x
  20. Tassi L, Colombo N, Garbelli R, Francione S, Lo Russo G, Mai R, et al. : Focal cortical dysplasia : neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain 125 : 1719-1732, 2002 https://doi.org/10.1093/brain/awf175
  21. Taulu S, Simola J : Spatiotemporal signal space separation method for rejecting nearby interference in MEG measurements. Phys Med Biol 51 : 1759-1768, 2006 https://doi.org/10.1088/0031-9155/51/7/008
  22. Taulu S, Simola J, Kajola M : Applications of the signal space separation method. IEEE Trans Sign Proc 53 : 3359-3372, 2005 https://doi.org/10.1109/TSP.2005.853302
  23. Tonini C, Beghi E, Berg AT, Bogliun G, Giordano L, Newton RW, et al. : Predictors of epilepsy surgery outcome : a meta-analysis. Epilepsy Res 62 : 75-87, 2004 https://doi.org/10.1016/j.eplepsyres.2004.08.006
  24. Widdess-Walsh P, Kellinghaus C, Jeha L, Kotagal P, Prayson R, Bingaman W, et al. : Electro-clinical and imaging characteristics of focal cortical dysplasia : correlation with pathological subtypes. Epilepsy Res 67 : 25-33, 2005 https://doi.org/10.1016/j.eplepsyres.2005.07.013
  25. Widjaja E, Otsubo H, Raybaud C, Ochi A, Chan D, Rutka JT, et al. : Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia : surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasia. Epilepsy Res 82 : 147-155, 2008 https://doi.org/10.1016/j.eplepsyres.2008.07.013
  26. Yun CH, Lee SK, Lee SY, Kim KK, Jeong SW, Chung CK : Prognostic factors in neocortical epilepsy surgery : multivariate analysis. Epilepsia 47 : 574-579, 2006 https://doi.org/10.1111/j.1528-1167.2006.00470.x

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