Annals of Clinical Neurophysiology

The Korean Society of Clinical Neurophysiology (대한임상신경생리학회)
권호 표지

Interictal Epileptiform Discharges and Background Delta Frequency Bands in Scalp EEGs of Epileptic Patients: Anatomical Correlation between the Current Source Distributions

간질환자 두피뇌파의 발작사이간질모양방전과 배경파 델타영역: 전류원분포의 해부학적 연관성

  • Jung, Seung-Uk (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Kwon, Oh-Young (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Kang, Jong-Soo (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Ha, Eun-Ok (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Jung, Seo-Kwon (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Kang, Kyu-Sik (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Kang, Hee-Young (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Park, Ki-Jong (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Choi, Nack-Cheon (Department of Neurology, Gyeongsang National University School of Medicine) ;
  • Lim, Byeong-Hoon (Department of Neurology, Gyeongsang National University School of Medicine)
  • 정승욱 (경상대학교 의학전문대학원 신경과학교실) ;
  • 권오영 (경상대학교 의학전문대학원 신경과학교실) ;
  • 강종수 (경상대학교 의학전문대학원 신경과학교실) ;
  • 하은옥 (경상대학교 의학전문대학원 신경과학교실) ;
  • 정석원 (경상대학교 의학전문대학원 신경과학교실) ;
  • 강규식 (경상대학교 의학전문대학원 신경과학교실) ;
  • 강희영 (경상대학교 의학전문대학원 신경과학교실) ;
  • 박기종 (경상대학교 의학전문대학원 신경과학교실) ;
  • 최낙천 (경상대학교 의학전문대학원 신경과학교실) ;
  • 임병훈 (경상대학교 의학전문대학원 신경과학교실)
  • Received : 2008.12.31
  • Accepted : 2009.04.08
  • Published : 2009.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The intermittent delta activity in electroencephalographies (EEGs) of patients with focal brain lesions has been reported to be a marker of an epileptogenic focus. This study investigated the concordance between the current source distribution (CSD) of the interictal epileptiform discharges (IEDs) and that of the background delta frequency bands (DFBs) of the scalp EEG. Methods: We collected scalp EEGs of 13 patients with focal epilepsy that contained uniregional IEDs and unilateral delta to theta slow waves. We applied a distributed source model using LORETA$^{(R)}$ to determine the CSD of the peak points of the IEDs and the DFBs of the background activity. Results: The CSDs of the DFBs were ipsilateral to the CSDs of the peak point of the averaged IEDs in ten patients, and bilateral with ipsilateral predominance in three patients. In the cases with an ipsilateral CSD of the DFB, 8 of 10 patients had concordance of the CSD localization between the averaged IED and the DFB. In the cases with bilateral CSD of the DFB, 2 of 3 patients had concordance of the CSD localization between the averaged IED and the DFB. Conclusions: The CSD localization and lateralization appear to be concordant between the IEDs and the DFB of background activity in epileptic patients. Therefore, the CSD of the DFB in EEGs with visually observable slow activities may predict those of IEDs.

Keywords

References

  1. Gloor P. Brain lesions that produce delta waves in the EEG. Neurology 1977;27:326-333. https://doi.org/10.1212/WNL.27.4.326
  2. Reinikainen KJ, Keranen T, Lehtinen JM, Kalviainen R, Saari T, Riekkinen PJ. CT brain scan and EEG in the diagnosis of adult onset seizures. Epilepsy Res 1987;1:178-184. https://doi.org/10.1016/0920-1211(87)90039-8
  3. Nuwer MR. Frequency analysis and topographic mapping of EEG and evoked potentials in epilepsy. Electroencephalogr Clin Neurophysiol 1987;69:118-126.
  4. Gibbs J, Appleton RE, Carty H, Beirne M, Acomb BA. Focal electroencephalographic abnormalities and computerised to-mography findings in children with seizures. J Neurol Neuro-surg Psychiatry 1993;56:369-371. https://doi.org/10.1136/jnnp.56.4.369
  5. Panet-Raymond D, Gotman J. Asymmetry in delta activity in patients with focal epilepsy. Electroencephalogr Clin Neur-ophysiol 1990;75:474-481. https://doi.org/10.1016/0013-4694(90)90134-6
  6. Engel J JR. Recent advances in surgical treatment of temporal lobe epilepsy. Acta Neurol Scand Suppl 1992;86:71-80. https://doi.org/10.1111/j.1600-0404.1992.tb04474.x
  7. Reiher J, Beaudry M, Leduc CP. Temporal intermittent rhyth-mic delta activity (TIRDA) in the diagnosis of complex partial epilepsy: sensitivity, specificity and predictive value. Can J Neurol Sci 1989;16:398-401. https://doi.org/10.1017/S0317167100029450
  8. Di Gennaro G, Quarato PP, Onorati P, et al. Localizing sig-nificance of temporal intermittent rhythmic delta activity (TIRDA) in drug-resistant focal epilepsy. Clinical Neurophysi-ology 2003;114:70-78. https://doi.org/10.1016/S1388-2457(02)00332-2
  9. Koles ZJ. Trends in EEG source localization. Elec-troencephalography and Clin Neurophysiol 1998;106:127-137. https://doi.org/10.1016/S0013-4694(97)00115-6
  10. Kaltenhauser M, Scheler G, Rampp S, Paulini A, Stefan H. Spatial intralobar correlation of spike and slow wave activity localisations in focal epilepsies: A MEG analysis. NeuroImage 2007;34:1466-1472. https://doi.org/10.1016/j.neuroimage.2006.11.002
  11. Huppertz H-J, Hof E, Klisch J, Wagner M, Lucking CH, Kristeva-Feige R. Localization of interictal delta and epilepti-form EEG activity associated with focal epileptogenic brain lesions. NeuroImage 2001;13:15-28.
  12. Gambardella A, Gotman J, Cendes F, Andermann F. Focal in-termittent delta activity in patients with mesiotemporal atro-phy: a reliable marker of the epileptogenic focus. Epilepsia 1995;36:122-129. https://doi.org/10.1111/j.1528-1157.1995.tb00970.x
  13. Anderer P, Saletu B, Pascual-Marqui RD. Effect of the 5-HT1A partial agonist buspirone on regional brain electrical activity in man: a functional neuroimaging study using low-resolution electromagnetic tomography (LORETA). Psychiatry Res: Neuroimaging 2000;100:81-96. https://doi.org/10.1016/S0925-4927(00)00066-4
  14. Abraham K, Marsan CA. Patterns of cortical discharges and their relation to routine scalp electroencephalography. Elec-troencephalogr Clin Neurophysiol 1958;10:447-461. https://doi.org/10.1016/0013-4694(58)90006-3
  15. Marsan CA, Abraham K. Considerations on the use of chroni-cally implanted electrodes in seizure disorders. Confin Neurol (Basel) 1966;27:95-110. https://doi.org/10.1159/000103938
  16. Cooper R, Winter AL, Crow HJ, Walter WG. Comparison of subcortical, cortical and scalp activity using chronically in-dwelling electrodes in man. Electroencephalogr Clin Neuro-physiol 1965;18:217-228. https://doi.org/10.1016/0013-4694(65)90088-X
  17. Tao JX, Ray A, Hawes-Ebersole S, Ebersole JS. Intracranial EEG substrates of scalp EEG interictal spikes. Epilepsia 2005;46:669-676. https://doi.org/10.1111/j.1528-1167.2005.11404.x
  18. de Jongh A, de Munck JC, Baayen JC, Jonkman EJ, Heethaar RM, van Dijk BW. The localization of spontaneous brain ac-tivity: first results in patients with cerebral tumors. Clin Neu-rophysiol 2001;112:378-385. https://doi.org/10.1016/S1388-2457(00)00526-5
  19. Pascual-Marqui RD, Michel CM, Lehmann D. Low resolution electromagnetic tomography: a new method for localizing elec-trical activity in the brain. Int J Psychophysiol 1994;18:49-65. https://doi.org/10.1016/0167-8760(84)90014-X
  20. Ebersole JS. Noninvasive localization of epileptogenic foci by EEG source modeling. Epilepsia 2000;41:24-33. https://doi.org/10.1111/j.1528-1157.2000.tb01500.x
  21. Kobayashi K, Yoshinaga H, Ohtsuka Y, Gotman J. Dipole modeling of epileptic spikes can be accurate or misleading. Epilepsia 2005;46:397-408. https://doi.org/10.1111/j.0013-9580.2005.31404.x
  22. Holmes MD, Brown M, Tucker DM. Are generalized seizures truly generalized? Evidence of localized mesial frontal and frontopolar discharges in absence. Epilepsia 2004;45:1568- 1579. https://doi.org/10.1111/j.0013-9580.2004.23204.x