Abstract
Objective Subtotal hemispherectomy involves the resection of multiple lobes in children with drug-resistant epilepsy, skipping the motor area (MA). We determined epileptogenicity using the occurrence rate (OR) of high-frequency oscillations (HFOs) and the modulation index (MI), demonstrating strength of coupling between HFO and slow wave. We hypothesized that epileptogenicity increased over the multiple lobes but skipped the MA. Methods We analyzed 23 children (14 subtotal hemispherectomy; 9 multilobar resections). Scalp video-EEG and magnetoencephalography were performed before surgery. We analyzed the OR(HFO) and MI(5 phases=0.5–8 Hz) on electrodes of total area, resection areas, and MA. We compared the data between good [International League Against Epilepsy (ILAE) class I–II] and poor (III–VI) seizure outcome groups. Results ILAE class Ia outcome was achieved in 18 children. Among the MI(5 phases) in the resection areas, MI(3–4 Hz) was the highest. The OR(HFO) and MI(3–4 Hz) in both total area and resection areas were significantly higher in the good seizure outcome group than in the poor outcome group. The OR(HFO) and MI(3–4 Hz) in resection areas were significantly higher than in the MA. Conclusions Our patients with multilobar drug-resistant epilepsy showed evidence of multifocal epileptogenicity that specifically skipped the MA. Significance This is the first study demonstrating that the electrophysiological phenotype of multifocal epilepsy specifically skips the MA using OR(HFO) and MI(3–4 Hz).
| Original language | English |
|---|---|
| Pages (from-to) | 1197-1205 |
| Number of pages | 9 |
| Journal | Clinical Neurophysiology |
| Volume | 128 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 1 2017 |
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Keywords
- Epileptic spasms
- Modulation index (MI)
- Motor area
- Pathological high-frequency oscillations
- Phase-amplitude coupling
- Subtotal hemispherectomy
ASJC Scopus subject areas
- Sensory Systems
- Neurology
- Clinical Neurology
- Physiology (medical)
Cite this
Epileptogenic high-frequency oscillations skip the motor area in children with multilobar drug-resistant epilepsy. / Iimura, Yasushi; Jones, Kevin; Hattori, Kyoko; Okazawa, Yushi; Noda, Atsuko; Hoashi, Kana; Nonoda, Yutaka; Asano, Eishi; Akiyama, Tomoyuki; Go, Cristina; Ochi, Ayako; Snead, O. Carter; Donner, Elizabeth J.; Rutka, James T.; Drake, James M.; Otsubo, Hiroshi.
In: Clinical Neurophysiology, Vol. 128, No. 7, 01.07.2017, p. 1197-1205.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Epileptogenic high-frequency oscillations skip the motor area in children with multilobar drug-resistant epilepsy
AU - Iimura, Yasushi
AU - Jones, Kevin
AU - Hattori, Kyoko
AU - Okazawa, Yushi
AU - Noda, Atsuko
AU - Hoashi, Kana
AU - Nonoda, Yutaka
AU - Asano, Eishi
AU - Akiyama, Tomoyuki
AU - Go, Cristina
AU - Ochi, Ayako
AU - Snead, O. Carter
AU - Donner, Elizabeth J.
AU - Rutka, James T.
AU - Drake, James M.
AU - Otsubo, Hiroshi
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective Subtotal hemispherectomy involves the resection of multiple lobes in children with drug-resistant epilepsy, skipping the motor area (MA). We determined epileptogenicity using the occurrence rate (OR) of high-frequency oscillations (HFOs) and the modulation index (MI), demonstrating strength of coupling between HFO and slow wave. We hypothesized that epileptogenicity increased over the multiple lobes but skipped the MA. Methods We analyzed 23 children (14 subtotal hemispherectomy; 9 multilobar resections). Scalp video-EEG and magnetoencephalography were performed before surgery. We analyzed the OR(HFO) and MI(5 phases=0.5–8 Hz) on electrodes of total area, resection areas, and MA. We compared the data between good [International League Against Epilepsy (ILAE) class I–II] and poor (III–VI) seizure outcome groups. Results ILAE class Ia outcome was achieved in 18 children. Among the MI(5 phases) in the resection areas, MI(3–4 Hz) was the highest. The OR(HFO) and MI(3–4 Hz) in both total area and resection areas were significantly higher in the good seizure outcome group than in the poor outcome group. The OR(HFO) and MI(3–4 Hz) in resection areas were significantly higher than in the MA. Conclusions Our patients with multilobar drug-resistant epilepsy showed evidence of multifocal epileptogenicity that specifically skipped the MA. Significance This is the first study demonstrating that the electrophysiological phenotype of multifocal epilepsy specifically skips the MA using OR(HFO) and MI(3–4 Hz).
AB - Objective Subtotal hemispherectomy involves the resection of multiple lobes in children with drug-resistant epilepsy, skipping the motor area (MA). We determined epileptogenicity using the occurrence rate (OR) of high-frequency oscillations (HFOs) and the modulation index (MI), demonstrating strength of coupling between HFO and slow wave. We hypothesized that epileptogenicity increased over the multiple lobes but skipped the MA. Methods We analyzed 23 children (14 subtotal hemispherectomy; 9 multilobar resections). Scalp video-EEG and magnetoencephalography were performed before surgery. We analyzed the OR(HFO) and MI(5 phases=0.5–8 Hz) on electrodes of total area, resection areas, and MA. We compared the data between good [International League Against Epilepsy (ILAE) class I–II] and poor (III–VI) seizure outcome groups. Results ILAE class Ia outcome was achieved in 18 children. Among the MI(5 phases) in the resection areas, MI(3–4 Hz) was the highest. The OR(HFO) and MI(3–4 Hz) in both total area and resection areas were significantly higher in the good seizure outcome group than in the poor outcome group. The OR(HFO) and MI(3–4 Hz) in resection areas were significantly higher than in the MA. Conclusions Our patients with multilobar drug-resistant epilepsy showed evidence of multifocal epileptogenicity that specifically skipped the MA. Significance This is the first study demonstrating that the electrophysiological phenotype of multifocal epilepsy specifically skips the MA using OR(HFO) and MI(3–4 Hz).
KW - Epileptic spasms
KW - Modulation index (MI)
KW - Motor area
KW - Pathological high-frequency oscillations
KW - Phase-amplitude coupling
KW - Subtotal hemispherectomy
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UR - http://www.scopus.com/inward/citedby.url?scp=85019183490&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2017.03.031
DO - 10.1016/j.clinph.2017.03.031
M3 - Article
VL - 128
SP - 1197
EP - 1205
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
IS - 7
ER -