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開催日 2014/9/13
時間 10:00 - 11:00
会場 Room I(311+312)
Chairperson(s) 寺田 清人 / Kiyohito Terada (NHO静岡てんかん・神経医療センター / NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan)
三國 信啓 / Nobuhiro Mikuni (札幌医科大学 脳神経外科 / Department of Neurosurgery, Sapporo Medical University, Japan)

TSI(Temporal Spread Imaging)法を用いたMEGによるてんかんスパイク焦点の検索
Reliable MEG spike focus estimation by Temporal Spread Imaging (TSI) with statistical validation

  • O3-I-2-4
  • 松橋 眞生 / Masao Matsuhashi:1,5 芝田 純也 / Sumiya Shibata :1,3 山尾 幸広 / Yukihiro Yamao :1,3 小林 勝哉 / Katsuya Kobayashi :2 國枝 武治 / Takeharu Kunieda:3 松本 理器 / Riki Matsumoto:2 池田 昭夫 / Akio Ikeda :2 三國 信啓 / Nobuhiro Mikuni:4 美馬 達也 / Tatsuya Mima:1 福山 秀直 / Hidenao Fukuyama:1 
  • 1:京大・医・脳機能センター / Hum Brain Res C, Kyoto, Japan 2:京大・医・てんかん・運動異常生理 / Department of Epilepsy, Movement Disorders & Physiology, Kyoto Univ, Kyoto, Japan 3:京大・医・脳外科 / Dept Neurosurg, Kyoto Univ, Kyoto, Japan 4:札幌医大・医・脳外科 / Dept Neurosurg, Sapporo Med Univ, Sapporo, Japan 5:京大・学際融合 / CPIER, Kyoto Univ, Kyoto, Japan 

Here, we propose TSI method in order to improve estimation accuracy and visualize the spatio-temporal spread pattern of the epileptic spike activities especially at spike onset. The activity at spike onset is too small for to estimate source in single event, but averaging many events are not applicable due to the variability and fluctuation. In order to provide the measure of better reliability to this method, we developed random trigger test and demonstrated its performance in epilepsy patient data, and tried to optimize its performance as compared with epileptic focus detection using intracranial recordings.
Materials: Analyzed data were interictal magnetoencephalography (MEG) records from patients with partial epilepsy who had more than 10 spikes identified in MEG and later underwent subdural grid electrode recording before surgery between 2008 and 2013 and showed good postsurgical seizure supression. Location of equivalent current dipoles (ECDs) estimated by conventional least square fitting, the result of seizure onset mapping by subdural electrodes, location of surgical resection of the epileptic focus and surgical outcome were compared with the TSI mapping output while varying following parameters: spatial filter type, source distribution type, and repetition threshold.
Result: MEG data from seven subjects fulfilled the criteria and were analyzed. Of them, TSI with grid and mesh source distribution both showed greater correlation to the resected area than ECD in six patients and the correlation with epileptic foci were highest when sLORETA spatial filter with half to 2/3 repetition threshold were combined.
Conclusion: This result indicates equivalent or superior reliability of TSI analysis for the evaluation of epileptic foci compared to conventional ECD estimates. This method has further advantage to delineate temporal spread pattern of the spike activities, which gives additional information to the spike genesis and to the epileptogenicity behind.

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