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Intraoperative epileptogenic network visualization using gamma oscillation regularity correlation analysis in

Yuta Kobayashi1, Yosuke Sato1, Tatsuya Sugiyama1

  • 1Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan.

Surgical Neurology International
|July 5, 2021
PubMed
Summary

Gamma oscillation regularity (GOR) correlation analysis effectively identified dual epileptogenic foci and networks in epilepsy surgery. This method precisely mapped seizure origins, leading to a seizure-free outcome for a patient with complex temporal lobe epilepsy.

Keywords:
CavernomaDual pathologyEpileptogenic networkGamma oscillation regularitySample entropyTemporal lobe epilepsy

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Area of Science:

  • Neuroscience
  • Epileptology
  • Surgical Neurology

Background:

  • Gamma oscillation regularity (GOR) analysis previously localized epileptogenic foci using intraoperative electrocorticography.
  • Assessing GOR correlation analysis to map epileptogenic networks intraoperatively is crucial for complex epilepsy cases.
  • Dual foci in temporal lobe epilepsy without hippocampal structural abnormalities pose diagnostic challenges.

Observation:

  • A patient with pharmacoresistant focal impaired awareness seizures and a temporal lobe cavernoma underwent simultaneous GOR correlation analysis.
  • High GORs indicating epileptogenicity were detected in both the lateral temporal lobe and the hippocampus.
  • GOR correlation networks connected the identified epileptogenic regions.

Findings:

  • Intraoperative GOR correlation analysis successfully visualized dual epileptogenic foci and their interconnected networks.
  • Surgical removal of the cavernoma and subsequent hippocampal transection eliminated high GORs and networks.
  • The patient achieved seizure freedom post-surgery, confirming the efficacy of the targeted approach.

Implications:

  • GOR correlation analysis demonstrates potential as a powerful tool for intraoperative evaluation of epileptogenic networks.
  • This technique may improve surgical outcomes for patients with complex epilepsy, including those with dual foci.
  • Intraoperative network mapping using GOR correlation could refine surgical strategies in epilepsy surgery.