TY - JOUR
T1 - High-resolution electric source imaging for presurgical evaluation of tuberous sclerosis complex patients
AU - Mouthaan, Brian E.
AU - Jansen, Floor E.
AU - Colon, Albert J.
AU - Huiskamp, Geertjan M.
AU - van Eijsden, Pieter
AU - Leijten, Frans S.S.
AU - Braun, Kees P.J.
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2021 International Federation of Clinical Neurophysiology
PY - 2022/1
Y1 - 2022/1
N2 - Objective: We retrospectively assessed the localizing value of patient-history-based semiology (PHS), video-based semiology (VS), long-term monitoring video electroencephalography (LTM-VEEG) and interictal high resolution electric source imaging (HR-ESI) in the presurgical workup of patients with tuberous sclerosis complex (TSC). Methods: Data from 24 consecutive TSC surgical candidates who underwent both HR-ESI and LTM-VEEG was retrospectively collected. PHS and VS were analyzed to hypothesize the symptomatogenic zone localization. LTM-VEEG and HR-ESI localization results were extracted from the diagnostic reports. Localizing value was compared between modalities, taken the resected/disconnected area of surgical patients in consideration. HR-ESI's impact on the epileptogenic zone hypothesis and surgical workup was evaluated. Results: Semiology, interictal EEG, ictal EEG and HR-ESI were localizing in 25%, 54%, 63% and 79% of patients. Inter-modality concordance ranged between 33–89%. In good surgical outcome patients, PHS, VS, interictal EEG, ictal EEG and HR-ESI showed concordance with resected area in 1/9 (11%), 0/9 (0%), 4/9 (44%), 3/9 (33%) and 6/9 patients (67%). HR-ESI positively impacts clinical management in 50% of patients. Conclusions: In presurgical evaluation of TSC patients, semiology often has limited localizing value. Presurgical work-up benefits from HR-ESI. Significance: Our findings may advice future presurgical epilepsy workup of TSC patients with the ultimate aim to improve outcome.
AB - Objective: We retrospectively assessed the localizing value of patient-history-based semiology (PHS), video-based semiology (VS), long-term monitoring video electroencephalography (LTM-VEEG) and interictal high resolution electric source imaging (HR-ESI) in the presurgical workup of patients with tuberous sclerosis complex (TSC). Methods: Data from 24 consecutive TSC surgical candidates who underwent both HR-ESI and LTM-VEEG was retrospectively collected. PHS and VS were analyzed to hypothesize the symptomatogenic zone localization. LTM-VEEG and HR-ESI localization results were extracted from the diagnostic reports. Localizing value was compared between modalities, taken the resected/disconnected area of surgical patients in consideration. HR-ESI's impact on the epileptogenic zone hypothesis and surgical workup was evaluated. Results: Semiology, interictal EEG, ictal EEG and HR-ESI were localizing in 25%, 54%, 63% and 79% of patients. Inter-modality concordance ranged between 33–89%. In good surgical outcome patients, PHS, VS, interictal EEG, ictal EEG and HR-ESI showed concordance with resected area in 1/9 (11%), 0/9 (0%), 4/9 (44%), 3/9 (33%) and 6/9 patients (67%). HR-ESI positively impacts clinical management in 50% of patients. Conclusions: In presurgical evaluation of TSC patients, semiology often has limited localizing value. Presurgical work-up benefits from HR-ESI. Significance: Our findings may advice future presurgical epilepsy workup of TSC patients with the ultimate aim to improve outcome.
KW - Accuracy
KW - Bourneville
KW - Clinical value
KW - Electroencephalography
KW - Long-term monitoring
KW - Source localization
UR - https://www.scopus.com/pages/publications/85119951005
U2 - 10.1016/j.clinph.2021.09.020
DO - 10.1016/j.clinph.2021.09.020
M3 - Article
C2 - 34844043
SN - 1388-2457
VL - 133
SP - 126
EP - 134
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
ER -