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Delayed effective connectivity characterizes the epileptogenic zone during stereo-EEG.

Odile Feys1, Vincent Wens2, Antonin Rovai2

  • 1Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB) - Hôpital Erasme, Department of Neurology, Bruxelles, Belgium; Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et Neuroimagerie translationnelles (LN(2)T), Bruxelles, Belgium.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|January 6, 2024
PubMed
Summary

Increased distance-corrected cortico-cortical evoked potentials (CCEPs) latency, indicating altered neuronal propagation, characterizes the epileptogenic zone. This finding may help refine surgical planning for epilepsy patients undergoing stereoelectroencephalography (SEEG).

Keywords:
Cortico-cortical evoked potentialsEpileptogenic zoneSingle-pulse electrical stimulation

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Area of Science:

  • Neuroscience
  • Epilepsy Research
  • Electrophysiology

Background:

  • The epileptogenic zone (EZ) in refractory focal epilepsy is challenging to delineate.
  • Single-pulse electrical stimulations (SPES) can elicit responses that may identify the EZ.
  • Cortico-cortical evoked potentials (CCEPs) are one such response studied during stereoelectroencephalography (SEEG).

Purpose of the Study:

  • To investigate the association between SPES-elicited responses and the EZ during SEEG.
  • To compare characteristics of CCEPs, spikes, and ripples within the EZ versus non-involved brain regions.

Main Methods:

  • 28 patients with refractory focal epilepsy undergoing SEEG were studied.
  • CCEP latency (distance-corrected and uncorrected), amplitude, and connectivity index were assessed.
  • Occurrence of spikes and ripples was also evaluated and compared between EZ and non-EZ using ROC curves and ANOVA.

Main Results:

  • Increased distance-corrected CCEPs latency was significantly associated with the epileptogenic zone (AUCs 0.70-0.72).
  • This latency increase suggests altered neuronal propagation velocity within the epileptogenic network.
  • CCEP amplitude, connectivity index, spikes, and ripples did not show significant association with the EZ.

Conclusions:

  • Distance-corrected CCEPs latency is a potential marker for characterizing the epileptogenic zone.
  • This finding may aid in tailoring surgical resection margins following SEEG.
  • Altered effective connectivity, reflected in delayed CCEPs, characterizes the EZ.