Preoperative Interhemispheric Coherence as a Potential Predictive Maker for Seizure Outcome After Total Corpus Callosotomy in Non-lesional, Generalized Epilepsy: A Scalp EEG Study
Abstract number :
3.459
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2024
Submission ID :
68
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Yuta Tanoue, MD, PhD – Osaka Metropolitan University Graduate School of Medicine
Takehiro Uda, MD, PhD – Osaka Metropolitan University Graduate School of Medicine
Vich Yindeedej, MD – Tammasat University Hospital
Shugo Nishijima, MD – Osaka Metropolitan University Graduate School of Medicine
Takeshi Inoue, MD – Osaka City General Hospital
Ichiro Kuki, MD, PhD – Osaka City General Hospital
Masataka Fukuoka, MD – Osaka City General Hospital
Megumi Nukui, MD – Osaka City General Hospital
Shin Okazaki, MD – Osaka City General Hospital, Osaka, Japan
Noritsugu Kunihiro, MD, PhD – Osaka City General Hospital
Ryoko Umaba, MD, PhD – Osaka City General Hospital
Takeo Goto, MD, PhD – Osaka Metropolitan University Graduate School of Medicine
Rationale: Corpus callosotomy (CC) is one of the palliative epilepsy surgeries available for non-lesional, generalized epilepsy, but is more invasive than other palliative surgeries. The main challenge is proper selection of suitable patients for CC. Coherence analysis is a method of evaluating brain connectivity, but the correlation between preoperative coherence and surgical outcomes has not previously been clarified.
Methods: This retrospective study investigated patients with non-lesional, generalized epilepsy who underwent total CC. We collected data for patients with good seizure outcome (Oguni classification A or B) and bad seizure outcome (Oguni classification D). For coherence analysis, we selected a period without interictal discharges. Preoperative interhemispheric coherence values from eight pairs of symmetrically opposite scalp electrodes were computed across five frequency bands. We then evaluated correlations between coherence and surgical outcomes.
Results: Forty patients were included (19 males, 21 females). Mean age at the time of surgery was 5.1 years (range, 1–18 years). Seizure outcomes were good in 15 patients and bad in the other 25 patients. Age at onset of epilepsy, duration of epilepsy before surgery, age at time of surgery and presence of epileptic spasm did not differ significantly between good and bad seizure outcomes (p=0.36, 0.14, 0.10, and 0.20, respectively). Significant correlations were identified between higher Fp1-Fp2 interhemispheric coherence values in the delta, theta, and alpha frequency bands and bad surgical outcomes (p = 0.0397, 0.0322, 0.0476, respectively). Receiver operating characteristic curves of Fp1-Fp2 coherence values in these frequency bands showed areas under the curve of 67%, 69% and 67%, respectively. Optimal cutoff values of Fp1-Fp2 interhemispheric coherence to predict surgical outcomes were 55.6 for delta (66.7% sensitivity, 72.0% specificity), 55.9 for theta (60.0% sensitivity, 76.0% specificity) and 50.3 for alpha (53.3% sensitivity, 84.0% specificity).
Conclusions: This is the first study to identify potential predictive factors for surgical outcomes based on preoperative interhemispheric coherence in non-lesional, generalized epilepsy. Higher coherence between Fp1-Fp2 in the delta, theta and alpha frequencies correlated with bad seizure outcome following CC.
Funding: None
Surgery