The value of magnetoencephalography for stereo-EEG-guided radiofrequency thermocoagulation in MRI-negative epilepsy.

Abstract

OBJECTIVE:

Magnetoencephalography (MEG) is valuable for guiding resective surgery in patients with epilepsy. However, its value for minimally invasive treatment is still unknown. This study aims to evaluate the value of MEG for stereo-electroencephalogram (EEG)-guided radiofrequency thermocoagulation (SEEG-guided RF-TC) in magnetic resonance imaging (MRI)-negative epilepsies.

METHODS:

An observational cohort study was performed and 19 MRI-negative patients who underwent SEEG-guided RF-TC in our epilepsy center were included. In addition, 16 MRI-positive patients were included as a reference group. Semiology, electrophysiology, and imaging information were collected. To evaluate the value of locating the MEG cluster, the proportion of the RF-TC contacts located in the MEG cluster out of all contacts used to perform RF-TC in each patient was calculated. All patients underwent the standard SEEG-guided RF-TC procedure and were followed up after the treatment.

RESULTS:

Nineteen MRI-negative patients were divided into two groups based on the existence of MEG clusters; 10 patients with MEG clusters were in group I and nine patients without any MEG cluster were in group II. No significant difference was observed in terms of age, sex, type of seizures, or number of SEEG electrodes implanted. The median of the proportion of contacts in the MEG cluster was 77.0 % (IQR 57.7-100.0 %). The follow-up results showed that the probability of being seizure-free at one year after RFTC in MRI-negative patients with an MEG cluster was 30.0 % (95 % CI 11.6-77.3 %), significantly (p = 0.014) higher than that in patients without an MEG cluster; there was no significant difference when compared with MRI-positive patients.

CONCLUSION:

This is the first study to evaluate the value of MEG in SEEG-guided RF-TC in MRI-negative epilepsies. MEG is a useful supplement for patients with MRI-negative epilepsy. MEG can be applied in minimally invasive treatment. MEG clusters can help identify better candidates and provide a valuable target for SEEG-guided RF-TC, which leads to better outcomes.

• Authors: Runshi Gao, Tao Yu, Cuiping Xu, Xiating Zhang, Xiaoming Yan, Duanyu Ni, Xiaohua Zhang, Kai Ma, Liang Qiao, Jin Zhu, Xueyuan Wang, Zhiwei Ren, Xi Zhang, Guojun Zhang, Yongjie Li
• Journal: Epilepsy research (Epilepsy Res) Vol. 163 Pg. 106322 (07 2020) ISSN: 1872-6844 [Electronic] Netherlands
• PMID: 32278277 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Adult
• Child
• Cohort Studies
• Electrocoagulation (methods)
• Electroencephalography (methods)
• Epilepsies, Partial (surgery)
• Epilepsy (diagnostic imaging, surgery)
• Female
• Humans
• Magnetic Resonance Imaging (methods)
• Magnetoencephalography (methods)
• Male
• Seizures (surgery)
• Stereotaxic Techniques
• Young Adult