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Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy

Xavier De Tiège, EVELIEN CARRETTE UGent, Benjamin Legros, Kristl Vonck UGent, Marc Op de Beeck, Mathieu Bourguignon, Nicolas Massager, Philippe David, Dirk Van Roost UGent and Alfred Meurs UGent, et al. (2012) JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY. 83(4). p.417-423
abstract
Objective : This prospective, bicentre, blinded, intention to treat study assessed the clinical added value of magnetic source imaging (MSI) in the presurgical evaluation of patients with refractory focal epilepsy (RFE). Methods : 70 consecutive patients with RFE (42 men; mean age 31.5 years, range 3-63) from two Belgian centres were prospectively included. All patients underwent conventional non-invasive presurgical evaluation (CNIPE) and a whole head magnetoencephalography recording (Elekta Neuromag). Equivalent current dipoles corresponding to interictal epileptiform discharges (IED) were fitted in the patients' spherical head model and coregistered on their MRI to produce MSI results. Results of CNIPE were first discussed blinded to the MSI results in respective multidisciplinary epilepsy surgery meetings to determine the presumed localisation of the epileptogenic zone and to set surgical or additional presurgical plans. MSI results were then discussed multidisciplinarily. MSI influence on the initial management plan was assessed. Results : Based on CNIPE, 21 patients had presumed extratemporal epilepsy, 38 had presumed temporal epilepsy and 11 had undetermined localisation epilepsy. MSI showed IED in 52 patients (74.5%) and changed the initial management in 15 patients (21%). MSI related changes were significantly more frequent in patients with presumed extratemporal or undetermined localisation epilepsy compared with patients with presumed temporal epilepsy (p <= 0.001). These changes had a clear impact on clinical management in 13% of all patients. Conclusion : MSI is a clinically relevant, non-invasive neuroimaging technique for the presurgical evaluation of patients with refractory focal epilepsy and, particularly, in patients with presumed extratemporal and undetermined localisation epilepsy.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
SURGERY, INTERFERENCE, ELECTROENCEPHALOGRAPHY, MEG, MAGNETOENCEPHALOGRAPHY, VIDEO-EEG, SPACE SEPARATION METHOD, TEMPORAL-LOBE EPILEPSY, LOCALIZATION, INFORMATION
journal title
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
J. Neurol. Neurosurg. Psychiatry
volume
83
issue
4
pages
417 - 423
Web of Science type
Article
Web of Science id
000301296600018
JCR category
SURGERY
JCR impact factor
4.924 (2012)
JCR rank
4/195 (2012)
JCR quartile
1 (2012)
ISSN
0022-3050
DOI
10.1136/jnnp-2011-301166
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1985049
handle
http://hdl.handle.net/1854/LU-1985049
date created
2012-01-12 16:24:41
date last changed
2012-09-12 14:10:07
@article{1985049,
  abstract     = {Objective : This prospective, bicentre, blinded, intention to treat study assessed the clinical added value of magnetic source imaging (MSI) in the presurgical evaluation of patients with refractory focal epilepsy (RFE). 
Methods : 70 consecutive patients with RFE (42 men; mean age 31.5 years, range 3-63) from two Belgian centres were prospectively included. All patients underwent conventional non-invasive presurgical evaluation (CNIPE) and a whole head magnetoencephalography recording (Elekta Neuromag). Equivalent current dipoles corresponding to interictal epileptiform discharges (IED) were fitted in the patients' spherical head model and coregistered on their MRI to produce MSI results. Results of CNIPE were first discussed blinded to the MSI results in respective multidisciplinary epilepsy surgery meetings to determine the presumed localisation of the epileptogenic zone and to set surgical or additional presurgical plans. MSI results were then discussed multidisciplinarily. MSI influence on the initial management plan was assessed. 
Results : Based on CNIPE, 21 patients had presumed extratemporal epilepsy, 38 had presumed temporal epilepsy and 11 had undetermined localisation epilepsy. MSI showed IED in 52 patients (74.5\%) and changed the initial management in 15 patients (21\%). MSI related changes were significantly more frequent in patients with presumed extratemporal or undetermined localisation epilepsy compared with patients with presumed temporal epilepsy (p {\textlangle}= 0.001). These changes had a clear impact on clinical management in 13\% of all patients. 
Conclusion : MSI is a clinically relevant, non-invasive neuroimaging technique for the presurgical evaluation of patients with refractory focal epilepsy and, particularly, in patients with presumed extratemporal and undetermined localisation epilepsy.},
  author       = {De Ti{\`e}ge, Xavier and CARRETTE, EVELIEN and Legros, Benjamin and Vonck, Kristl and Op de Beeck, Marc  and Bourguignon, Mathieu and Massager, Nicolas and David, Philippe and Van Roost, Dirk and Meurs, Alfred and LAPERE, SAMUEL and Deblaere, Karel and Goldman, Serge and Boon, Paul and Van Bogaert, Patrick},
  issn         = {0022-3050},
  journal      = {JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY},
  keyword      = {SURGERY,INTERFERENCE,ELECTROENCEPHALOGRAPHY,MEG,MAGNETOENCEPHALOGRAPHY,VIDEO-EEG,SPACE SEPARATION METHOD,TEMPORAL-LOBE EPILEPSY,LOCALIZATION,INFORMATION},
  language     = {eng},
  number       = {4},
  pages        = {417--423},
  title        = {Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy},
  url          = {http://dx.doi.org/10.1136/jnnp-2011-301166},
  volume       = {83},
  year         = {2012},
}

Chicago
De Tiège, Xavier, Evelien Carrette, Benjamin Legros, Kristl Vonck, Marc Op de Beeck, Mathieu Bourguignon, Nicolas Massager, et al. 2012. “Clinical Added Value of Magnetic Source Imaging in the Presurgical Evaluation of Refractory Focal Epilepsy.” Journal of Neurology Neurosurgery and Psychiatry 83 (4): 417–423.
APA
De Tiège, X., Carrette, E., Legros, B., Vonck, K., Op de Beeck, M., Bourguignon, M., Massager, N., et al. (2012). Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 83(4), 417–423.
Vancouver
1.
De Tiège X, Carrette E, Legros B, Vonck K, Op de Beeck M, Bourguignon M, et al. Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY. 2012;83(4):417–23.
MLA
De Tiège, Xavier, Evelien Carrette, Benjamin Legros, et al. “Clinical Added Value of Magnetic Source Imaging in the Presurgical Evaluation of Refractory Focal Epilepsy.” JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY 83.4 (2012): 417–423. Print.