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Seizure onset zone localization from ictal high-density EEG in refractory focal epilepsy

Willeke Staljanssens (UGent) , Gregor Strobbe (UGent) , Roel Van Holen (UGent) , Gwénaël Birot, Markus Gschwind, Margitta Seeck, Stefaan Vandenberghe (UGent) , Serge Vulliémoz and Pieter van Mierlo (UGent)
(2017) BRAIN TOPOGRAPHY. 30(2). p.257-271
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Abstract
Epilepsy surgery is the most efficient treatment option for patients with refractory epilepsy. Before surgery, it is of utmost importance to accurately delineate the seizure onset zone (SOZ). Non-invasive EEG is the most used neuroimaging technique to diagnose epilepsy, but it is hard to localize the SOZ from EEG due to its low spatial resolution and because epilepsy is a network disease, with several brain regions becoming active during a seizure. In this work, we propose and validate an approach based on EEG source imaging (ESI) combined with functional connectivity analysis to overcome these problems. We considered both simulations and real data of patients. Ictal epochs of 204-channel EEG and subsets down to 32 channels were analyzed. ESI was done using realistic head models and LORETA was used as inverse technique. The connectivity pattern between the reconstructed sources was calculated, and the source with the highest number of outgoing connections was selected as SOZ. We compared this algorithm with a more straightforward approach, i.e. selecting the source with the highest power after ESI as the SOZ. We found that functional connectivity analysis estimated the SOZ consistently closer to the simulated EZ/RZ than localization based on maximal power. Performance, however, decreased when 128 electrodes or less were used, especially in the realistic data. The results show the added value of functional connectivity analysis for SOZ localization, when the EEG is obtained with a high-density setup. Next to this, the method can potentially be used as objective tool in clinical settings.
Keywords
High-density electroencephalogram (hd-EEG), EEG source imaging (ESI), Functional connectivity, Granger causality, Refractory epilepsy, TEMPORAL-LOBE EPILEPSY, DIPOLE-SOURCE LOCALIZATION, SPARSE VOLUMETRIC PRIORS, HIGH-RESOLUTION EEG, FUNCTIONAL CONNECTIVITY, SOURCE RECONSTRUCTION, INTERICTAL SPIKES, HEAD MODEL, BRAIN, NETWORKS

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Citation

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MLA
Staljanssens, Willeke, et al. “Seizure Onset Zone Localization from Ictal High-Density EEG in Refractory Focal Epilepsy.” BRAIN TOPOGRAPHY, vol. 30, no. 2, 2017, pp. 257–71, doi:10.1007/s10548-016-0537-8.
APA
Staljanssens, W., Strobbe, G., Van Holen, R., Birot, G., Gschwind, M., Seeck, M., … van Mierlo, P. (2017). Seizure onset zone localization from ictal high-density EEG in refractory focal epilepsy. BRAIN TOPOGRAPHY, 30(2), 257–271. https://doi.org/10.1007/s10548-016-0537-8
Chicago author-date
Staljanssens, Willeke, Gregor Strobbe, Roel Van Holen, Gwénaël Birot, Markus Gschwind, Margitta Seeck, Stefaan Vandenberghe, Serge Vulliémoz, and Pieter van Mierlo. 2017. “Seizure Onset Zone Localization from Ictal High-Density EEG in Refractory Focal Epilepsy.” BRAIN TOPOGRAPHY 30 (2): 257–71. https://doi.org/10.1007/s10548-016-0537-8.
Chicago author-date (all authors)
Staljanssens, Willeke, Gregor Strobbe, Roel Van Holen, Gwénaël Birot, Markus Gschwind, Margitta Seeck, Stefaan Vandenberghe, Serge Vulliémoz, and Pieter van Mierlo. 2017. “Seizure Onset Zone Localization from Ictal High-Density EEG in Refractory Focal Epilepsy.” BRAIN TOPOGRAPHY 30 (2): 257–271. doi:10.1007/s10548-016-0537-8.
Vancouver
1.
Staljanssens W, Strobbe G, Van Holen R, Birot G, Gschwind M, Seeck M, et al. Seizure onset zone localization from ictal high-density EEG in refractory focal epilepsy. BRAIN TOPOGRAPHY. 2017;30(2):257–71.
IEEE
[1]
W. Staljanssens et al., “Seizure onset zone localization from ictal high-density EEG in refractory focal epilepsy,” BRAIN TOPOGRAPHY, vol. 30, no. 2, pp. 257–271, 2017.
@article{8601524,
  abstract     = {{Epilepsy surgery is the most efficient treatment option for patients with refractory epilepsy. Before surgery, it is of utmost importance to accurately delineate the seizure onset zone (SOZ). Non-invasive EEG is the most used neuroimaging technique to diagnose epilepsy, but it is hard to localize the SOZ from EEG due to its low spatial resolution and because epilepsy is a network disease, with several brain regions becoming active during a seizure. In this work, we propose and validate an approach based on EEG source imaging (ESI) combined with functional connectivity analysis to overcome these problems. We considered both simulations and real data of patients. Ictal epochs of 204-channel EEG and subsets down to 32 channels were analyzed. ESI was done using realistic head models and LORETA was used as inverse technique. The connectivity pattern between the reconstructed sources was calculated, and the source with the highest number of outgoing connections was selected as SOZ. We compared this algorithm with a more straightforward approach, i.e. selecting the source with the highest power after ESI as the SOZ. We found that functional connectivity analysis estimated the SOZ consistently closer to the simulated EZ/RZ than localization based on maximal power. Performance, however, decreased when 128 electrodes or less were used, especially in the realistic data. The results show the added value of functional connectivity analysis for SOZ localization, when the EEG is obtained with a high-density setup. Next to this, the method can potentially be used as objective tool in clinical settings.}},
  author       = {{Staljanssens, Willeke and Strobbe, Gregor and Van Holen, Roel and Birot, Gwénaël and Gschwind, Markus and Seeck, Margitta and Vandenberghe, Stefaan and Vulliémoz, Serge and van Mierlo, Pieter}},
  issn         = {{0896-0267}},
  journal      = {{BRAIN TOPOGRAPHY}},
  keywords     = {{High-density electroencephalogram (hd-EEG),EEG source imaging (ESI),Functional connectivity,Granger causality,Refractory epilepsy,TEMPORAL-LOBE EPILEPSY,DIPOLE-SOURCE LOCALIZATION,SPARSE VOLUMETRIC PRIORS,HIGH-RESOLUTION EEG,FUNCTIONAL CONNECTIVITY,SOURCE RECONSTRUCTION,INTERICTAL SPIKES,HEAD MODEL,BRAIN,NETWORKS}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{257--271}},
  title        = {{Seizure onset zone localization from ictal high-density EEG in refractory focal epilepsy}},
  url          = {{http://doi.org/10.1007/s10548-016-0537-8}},
  volume       = {{30}},
  year         = {{2017}},
}
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