Stereo‐EEG–based ictal functional connectivity in patients with periventricular nodular heterotopia–related epilepsy

Nodular heterotopia (NH)–related drug‐resistant epilepsy is challenging due to the deep location of the NH and the complexity of the underlying epileptogenic network. Using ictal stereo‐electroencephalography (SEEG) and functional connectivity (FC) analyses in 14 patients with NH‐related drug‐resist...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2024-04, Vol.65 (4), p.e47-e54
Main Authors: Zanello, Marc, Garnier, Elodie, Carron, Romain, Jegou, Aude, Lagarde, Stanislas, Makhalova, Julia, Medina, Samuel, Bénar, Christian‐G., Bartolomei, Fabrice, Pizzo, Francesca
Format: Article
Language:English
Subjects:
Cerebral Cortex
Convulsions & seizures
Drug Resistant Epilepsy - diagnostic imaging
Drug Resistant Epilepsy - surgery
EEG
Electroencephalography - methods
Epilepsy
Epilepsy - diagnostic imaging
h 2
Humans
IN‐strength
Neurodevelopmental disorders
OUT‐strength
Patients
Periventricular Nodular Heterotopia - complications
Periventricular Nodular Heterotopia - diagnostic imaging
Seizures
Substantia grisea
thermocoagulation
Ventricle (lateral)
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Summary:Nodular heterotopia (NH)–related drug‐resistant epilepsy is challenging due to the deep location of the NH and the complexity of the underlying epileptogenic network. Using ictal stereo‐electroencephalography (SEEG) and functional connectivity (FC) analyses in 14 patients with NH‐related drug‐resistant epilepsy, we aimed to determine the leading structure during seizures. For this purpose, we compared node IN and OUT strength between bipolar channels inside the heterotopia and inside gray matter, at the group level and at the individual level. At seizure onset, the channels within NH belonging to the epileptogenic and/or propagation network showed higher node OUT‐strength than the channels within the gray matter (p = .03), with higher node OUT‐strength than node IN‐strength (p = .03). These results are in favor of a “leading” role of NH during seizure onset when involved in the epileptogenic‐ or propagation‐zone network (50% of patients). However, when looking at the individual level, no significant difference between NH and gray matter was found, except for one patient (in two of three seizures). This result confirms the heterogeneity and the complexity of the epileptogenic network organization in NH and the need for SEEG exploration to characterize more precisely patient‐specific epileptogenic network organization.
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.17891