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Evidence From Meta-Analysis Supports Ictal Magnetoencephalographic Source Imaging as an Accurate Method in Presurgery Evaluation of Patients With Drug-Resistant Epilepsy
Clinical EEG and Neuroscience ( IF 2 ) Pub Date : 2020-05-21 , DOI: 10.1177/1550059420921534
Malthe Brændholt 1, 2 , Mads Jensen 3
Affiliation  

Background. Successful epilepsy surgery relies on localization and removal of the brain area responsible for initializing the seizures called the epileptogenic zone (EZ). Intracranial EEG (icEEG) is gold standard of this localization but has several limitations like invasiveness and limited covered area. A noninvasive method with accurate localization precision is therefore desirable. The aim of this article is to investigate the following hypotheses: (1) Ictal onset zone as localized by magnetic source imaging (iMSI) can reliably localize the EZ in focal epilepsy and (2) this localization is as good as that of icEEG. Methods. Six original studies and a total of 59 unique patients were included in a meta-analysis. Results. Sensitivity and specificity of iMSI based on surgery outcome were 77% (95% CI 60%-90%) and 75% (95% CI 53%-90%), respectively. Specificity of iMSI was statistically higher than that of icEEG. There was no significant difference between sensitivity of iMSI and icEEG. Conclusion. The meta-analysis supports that iMSI is an accurate method, achieving similar sensitivity and higher specificity than icEEG. However, at present the use of the method is limited by short recording times. A limitation that might be overcome in the future using technical advances.

中文翻译:

荟萃分析的证据支持发作性脑磁图源成像作为耐药性癫痫患者术前评估的准确方法

背景。成功的癫痫手术依赖于负责初始化癫痫发作的大脑区域的定位和移除,称为致癫痫区 (EZ)。颅内脑电图 (icEEG) 是这种定位的黄金标准,但有一些局限性,如侵入性和有限的覆盖区域。因此需要一种具有准确定位精度的无创方法。本文的目的是研究以下假设:(1)通过磁源成像(iMSI)定位的发作区可以可靠地定位局灶性癫痫中的 EZ;(2)这种定位与 icEEG 的定位一样好。方法。一项荟萃分析包括了六项原始研究和总共 59 名独特的患者。结果。基于手术结果的 iMSI 敏感性和特异性分别为 77% (95% CI 60%-90%) 和 75% (95% CI 53%-90%)。iMSI 的特异性在统计学上高于 icEEG。iMSI和icEEG的敏感性没有显着差异。结论。荟萃分析支持 iMSI 是一种准确的方法,具有与 icEEG 相似的灵敏度和更高的特异性。然而,目前该方法的使用受到短记录时间的限制。未来可能会通过技术进步克服的限制。
更新日期:2020-05-21
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