Summary

England, Mary Jane; Liverman, Catharyn T.; Schultz, Andrea M.; Strawbridge, Larisa M

doi:10.5698/1535-7511-12.6.245

Cited by 39 publications

(10 citation statements)

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“…This existing gap in offering surgical therapy to MRI– PFE cannot be overstated. 65-67 Enhancing the yield of noninvasive testing is paramount given that some MRI– patients, who are found to have concordant MSI/MAP+ results, may eventually be regarded as more favorable candidates and be offered potentially curative epilepsy surgery.…”

Section: Discussionmentioning

confidence: 99%

Linking MRI postprocessing with magnetic source imaging in MRI‐negative epilepsy

Wang

Alexopoulos

Jones

et al. 2014

Annals of Neurology

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Objective MRI-negative (MRI–) pharmacoresistant focal epilepsy (PFE) patients are most challenging for epilepsy surgical management. This study utilizes a voxel-based MRI postprocessing technique, implemented using a morphometric analysis program (MAP), aiming to facilitate detection of subtle focal cortical dysplasia (FCD) in MRI– patients. Furthermore, the study examines the concordance between MAP-identified regions and localization from magnetic source imaging (MSI). Methods Included in this retrospective study were 25 MRI– surgical patients. MAP was performed on T1-weighted MRI, with comparison to a normal database. The pertinence of MAP+ areas was confirmed by MSI, surgical outcome and pathology. Analyses of MAP and MSI were performed blindly from patients' clinical information and independently from each other. Results The detection rate of subtle changes by MAP was 48% (12/25). Once MAP+ areas were resected, patients were more likely to be seizure-free (p = 0.02). There were no false positives in the 25 age-matched normal controls. Seven patients had a concordant MSI correlate. Patients in whom a concordant area was identified by both MAP and MSI had a significantly higher chance of achieving a seizure-free outcome following complete resection of this area (p = 0.008). In the 9 resected MAP+ areas, pathology revealed FCD type IA in 7 and type IIB in 2. Interpretation MAP shows promise in identifying subtle FCD abnormalities and increasing the diagnostic yield of conventional MRI visual analysis in presurgical evaluation of PFE. Concordant MRI postprocessing and MSI analyses may lead to the noninvasive identification of a structurally and electrically abnormal subtle lesion that can be surgically targeted.

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Section: Discussionmentioning

confidence: 99%

Linking MRI postprocessing with magnetic source imaging in MRI‐negative epilepsy

Wang

Alexopoulos

Jones

et al. 2014

Annals of Neurology

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“…Epilepsy is one of the most common neurological diseases, with a new case diagnosed every 3.5 min on average in the USA alone ( 1 ). Partly due to substantially increased risk of premature death ( 2 ), epilepsy reportedly accounts for a worldwide loss of 13 million disability-adjusted life years ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Can REM Sleep Localize the Epileptogenic Zone? A Systematic Review and Analysis

McLeod

Ghassemi

2020

Front. Neurol.

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Epilepsy is a common and debilitating neurological disease. When medication cannot control seizures in up to 40% of cases, surgical resection of epileptogenic tissue is a clinically and cost- effective therapy to achieve seizure freedom. To simultaneously resect minimal yet sufficient cortex, exquisite localization of the epileptogenic zone (EZ) is crucial. However, localization is not straightforward, given relative difficulty of capturing seizures, constraints of the inverse problem in source localization, and possible disparate locations of symptomatogenic vs. epileptogenic regions. Thus, attention has been paid to which state of vigilance best localizes the EZ, in the hopes that one or another sleep-wake state may hold the key to improved accuracy of localization. Studies investigating this topic have employed diverse methodologies and produced diverse results. Nonetheless, rapid eye movement sleep (REM) has emerged as a promising sleep-wake state, as epileptic phenomena captured in REM may spatially correspond more closely to the EZ. Cortical neuronal asynchrony in REM may spatially constrain epileptic phenomena to reduce propagation away from the source generator, rendering them of high localizing value. However, some recent work demonstrates best localization in sleep-wake states other than REM, and there are reports of REM providing clearly false localization. Moreover, synchronistic properties and basic mechanisms of human REM remain to be fully characterized. Amidst these uncertainties, there is an urgent need for recording and analytical techniques to improve accuracy of localization. Here we present a systematic review and quantitative analysis of pertinent literature on whether and how REM may help localize epileptogenic foci. To help streamline and accelerate future work on the intriguing anti-epileptic properties of REM, we also introduce a simple, conceptually clear set-theoretic framework to conveniently and rigorously describe the spatial properties of epileptic phenomena in the brain.

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“…Epilepsy not-otherwise-specified (ENOS) is one of the most common chronic disorders impacting human health, and the third most common serious neurological disorder, following stroke and Alzheimer's disease [1,2]. In 2015, 1.2% of the total US population had active epilepsy.…”

Section: Introductionmentioning

confidence: 99%

The Biochemical Profile of Post-Mortem Brain from People Who Suffered from Epilepsy Reveals Novel Insights into the Etiopathogenesis of the Disease

et al. 2020

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Epilepsy not-otherwise-specified (ENOS) is one of the most common causes of chronic disorders impacting human health, with complex multifactorial etiology and clinical presentation. Understanding the metabolic processes associated with the disorder may aid in the discovery of preventive and therapeutic measures. Post-mortem brain samples were harvested from the frontal cortex (BA8/46) of people diagnosed with ENOS cases (n = 15) and age- and sex-matched control subjects (n = 15). We employed a targeted metabolomics approach using a combination of proton nuclear magnetic resonance (1H-NMR) and direct injection/liquid chromatography tandem mass spectrometry (DI/LC-MS/MS). We accurately identified and quantified 72 metabolites using 1H-NMR and 159 using DI/LC-MS/MS. Among the 212 detected metabolites, 14 showed significant concentration changes between ENOS cases and controls (p < 0.05; q < 0.05). Of these, adenosine monophosphate and O-acetylcholine were the most commonly selected metabolites used to develop predictive models capable of discriminating between ENOS and unaffected controls. Metabolomic set enrichment analysis identified ethanol degradation, butyrate metabolism and the mitochondrial beta-oxidation of fatty acids as the top three significantly perturbed metabolic pathways. We report, for the first time, the metabolomic profiling of postmortem brain tissue form patients who died from epilepsy. These findings can potentially expand upon the complex etiopathogenesis and help identify key predictive biomarkers of ENOS.

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Summary

Cited by 39 publications

References 0 publications

Linking MRI postprocessing with magnetic source imaging in MRI‐negative epilepsy

Linking MRI postprocessing with magnetic source imaging in MRI‐negative epilepsy

Can REM Sleep Localize the Epileptogenic Zone? A Systematic Review and Analysis

The Biochemical Profile of Post-Mortem Brain from People Who Suffered from Epilepsy Reveals Novel Insights into the Etiopathogenesis of the Disease

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