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| Description
| - Rationale: The irritative zone is an area of the brain that generates interictal epileptiform discharges (IEDs) and is used together with other results when planning epilepsy surgery. Unfortunately, the irritative zone possesses low diagnostic value due to lack of a specific marker, that would identify IEDs generated within the epileptogenic tissue. To increase the diagnostic yield, we examined functional organization of the irritative zone. Methods: Intracranial EEG recordings from 14 patients with refractory neocortical epilepsy were analysed using an algorithm that groups IEDs according to their spatial profile into clusters. Analysis of clusters enabled determination of their properties. The cluster activity defines its percentage contribution to all IEDs in the given recording. The origin represents the contacts where cluster initiates and the active region marks the area of the most common propagation. Results: On average 27,191±26,155 IEDs per patient were analysed. The results demonstrated that in all patients the irritative zone was composed of multiple clusters with an average number of 6.9±3.2 clusters per patient. Comparison of cluster properties with post-surgical outcome revealed that resection of cluster origins with an activity value above 21% was significantly associated with a favourable outcome. Meanwhile, extending the resection to the active regions did not influence the outcome. Conclusion: This study demonstrates the complex organization and multifocal nature of the neocortical irritative zone in epilepsy patients. It can be stratified into functional components, each with distinct pathophysiological and clinical significance. The ability to identify the key components of this network enhances the yield of presurgical investigation and has potential to improve the results of epilepsy surgery.
- Rationale: The irritative zone is an area of the brain that generates interictal epileptiform discharges (IEDs) and is used together with other results when planning epilepsy surgery. Unfortunately, the irritative zone possesses low diagnostic value due to lack of a specific marker, that would identify IEDs generated within the epileptogenic tissue. To increase the diagnostic yield, we examined functional organization of the irritative zone. Methods: Intracranial EEG recordings from 14 patients with refractory neocortical epilepsy were analysed using an algorithm that groups IEDs according to their spatial profile into clusters. Analysis of clusters enabled determination of their properties. The cluster activity defines its percentage contribution to all IEDs in the given recording. The origin represents the contacts where cluster initiates and the active region marks the area of the most common propagation. Results: On average 27,191±26,155 IEDs per patient were analysed. The results demonstrated that in all patients the irritative zone was composed of multiple clusters with an average number of 6.9±3.2 clusters per patient. Comparison of cluster properties with post-surgical outcome revealed that resection of cluster origins with an activity value above 21% was significantly associated with a favourable outcome. Meanwhile, extending the resection to the active regions did not influence the outcome. Conclusion: This study demonstrates the complex organization and multifocal nature of the neocortical irritative zone in epilepsy patients. It can be stratified into functional components, each with distinct pathophysiological and clinical significance. The ability to identify the key components of this network enhances the yield of presurgical investigation and has potential to improve the results of epilepsy surgery. (en)
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| Title
| - Cluster organization of the irritative zone in neocortical epilepsy: implications for pathophysiology, surgery planning and outcome
- Cluster organization of the irritative zone in neocortical epilepsy: implications for pathophysiology, surgery planning and outcome (en)
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| skos:prefLabel
| - Cluster organization of the irritative zone in neocortical epilepsy: implications for pathophysiology, surgery planning and outcome
- Cluster organization of the irritative zone in neocortical epilepsy: implications for pathophysiology, surgery planning and outcome (en)
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| skos:notation
| - RIV/68407700:21230/14:00223588!RIV15-MSM-21230___
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| http://linked.open...avai/riv/aktivita
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| http://linked.open...avai/riv/aktivity
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| http://linked.open...vai/riv/dodaniDat
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| http://linked.open...aciTvurceVysledku
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| http://linked.open.../riv/druhVysledku
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| http://linked.open...iv/duvernostUdaju
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| http://linked.open...titaPredkladatele
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| http://linked.open...dnocenehoVysledku
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| http://linked.open...ai/riv/idVysledku
| - RIV/68407700:21230/14:00223588
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| http://linked.open...riv/jazykVysledku
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| http://linked.open.../riv/klicovaSlova
| - epilepsy; interictal discharges; intracranial electroencephalography; automatic detection; clustering (en)
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| http://linked.open.../riv/klicoveSlovo
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| http://linked.open...ontrolniKodProRIV
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| http://linked.open...in/vavai/riv/obor
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| http://linked.open...ichTvurcuVysledku
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| http://linked.open...cetTvurcuVysledku
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| http://linked.open...UplatneniVysledku
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| http://linked.open...iv/tvurceVysledku
| - Ježdík, Petr
- Čmejla, Roman
- Janča, Radek
- Kršek, P.
- Jiruška, P.
- Marusič, P.
- Jefferys, J.G.R.
- Komárek, V.
- Tomášek, M.
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| http://bibframe.org/vocab/doi
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| http://localhost/t...ganizacniJednotka
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