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Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time
Intracranial EEG is the current gold standard technique for localizing seizures for surgery, but it can be insensitive to tangential dipole or distant sources. Electrical Impedance Tomography (EIT) offers a novel method to improve coverage and seizure onset localization. The feasibility of EIT has b...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Academic Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204270/ https://www.ncbi.nlm.nih.gov/pubmed/33757909 http://dx.doi.org/10.1016/j.neuroimage.2021.117972 |
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author | Witkowska-Wrobel, Anna Aristovich, Kirill Crawford, Abbe Perkins, Justin D. Holder, David |
author_facet | Witkowska-Wrobel, Anna Aristovich, Kirill Crawford, Abbe Perkins, Justin D. Holder, David |
author_sort | Witkowska-Wrobel, Anna |
collection | PubMed |
description | Intracranial EEG is the current gold standard technique for localizing seizures for surgery, but it can be insensitive to tangential dipole or distant sources. Electrical Impedance Tomography (EIT) offers a novel method to improve coverage and seizure onset localization. The feasibility of EIT has been previously assessed in a computer simulation, which revealed an improved accuracy of seizure detection with EIT compared to intracranial EEG. In this study, slow impedance changes, evoked by cell swelling occurring over seconds, were reconstructed in real time by frequency division multiplexing EIT using depth and subdural electrodes in a swine model of epilepsy. EIT allowed to generate repetitive images of ictal events at similar time course to fMRI but without its significant limitations. EIT was recorded with a system consisting of 32 parallel current sources and 64 voltage recorders. Seizures triggered with intracranial injection of benzylpenicillin (BPN) in five pigs caused a repetitive peak impedance increase of 3.4 ± 1.5 mV and 9.5 ± 3% (N =205 seizures); the impedance signal change was seen already after a single, first seizure. EIT enabled reconstruction of the seizure onset 9 ± 1.5 mm from the BPN cannula and 7.5 ± 1.1 mm from the closest SEEG contact (p<0.05, n =37 focal seizures in three pigs) and it could address problems with sampling error in intracranial EEG. The amplitude of the impedance change correlated with the spread of the seizure on the SEEG (p <<0.001, n =37). The results presented here suggest that combining a parallel EIT system with intracranial EEG monitoring has a potential to improve the diagnostic yield in epileptic patients and become a vital tool in improving our understanding of epilepsy. |
format | Online Article Text |
id | pubmed-8204270 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Academic Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-82042702021-07-01 Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time Witkowska-Wrobel, Anna Aristovich, Kirill Crawford, Abbe Perkins, Justin D. Holder, David Neuroimage Article Intracranial EEG is the current gold standard technique for localizing seizures for surgery, but it can be insensitive to tangential dipole or distant sources. Electrical Impedance Tomography (EIT) offers a novel method to improve coverage and seizure onset localization. The feasibility of EIT has been previously assessed in a computer simulation, which revealed an improved accuracy of seizure detection with EIT compared to intracranial EEG. In this study, slow impedance changes, evoked by cell swelling occurring over seconds, were reconstructed in real time by frequency division multiplexing EIT using depth and subdural electrodes in a swine model of epilepsy. EIT allowed to generate repetitive images of ictal events at similar time course to fMRI but without its significant limitations. EIT was recorded with a system consisting of 32 parallel current sources and 64 voltage recorders. Seizures triggered with intracranial injection of benzylpenicillin (BPN) in five pigs caused a repetitive peak impedance increase of 3.4 ± 1.5 mV and 9.5 ± 3% (N =205 seizures); the impedance signal change was seen already after a single, first seizure. EIT enabled reconstruction of the seizure onset 9 ± 1.5 mm from the BPN cannula and 7.5 ± 1.1 mm from the closest SEEG contact (p<0.05, n =37 focal seizures in three pigs) and it could address problems with sampling error in intracranial EEG. The amplitude of the impedance change correlated with the spread of the seizure on the SEEG (p <<0.001, n =37). The results presented here suggest that combining a parallel EIT system with intracranial EEG monitoring has a potential to improve the diagnostic yield in epileptic patients and become a vital tool in improving our understanding of epilepsy. Academic Press 2021-07-01 /pmc/articles/PMC8204270/ /pubmed/33757909 http://dx.doi.org/10.1016/j.neuroimage.2021.117972 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Witkowska-Wrobel, Anna Aristovich, Kirill Crawford, Abbe Perkins, Justin D. Holder, David Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title | Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title_full | Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title_fullStr | Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title_full_unstemmed | Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title_short | Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time |
title_sort | imaging of focal seizures with electrical impedance tomography and depth electrodes in real time |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204270/ https://www.ncbi.nlm.nih.gov/pubmed/33757909 http://dx.doi.org/10.1016/j.neuroimage.2021.117972 |
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