Abstract

In some cases of pharmaco-resistant and focal epilepsies, intracranial recordings performed epidurally (electrocorticography, ECoG) and/or in depth (stereoelectroencephalography, SEEG) can be required to locate the seizure onset zone and the eloquent cortex before surgical resection. In SEEG, each electrode contact records brain’s electrical activity in a spherical volume of 3 mm diameter approximately. The spatial coverage is around 1% of the brain and differs between patients because the implantation of electrodes is tailored for each case. Group studies thus need a large number of patients to reach a large spatial sampling, which can be achieved more easily using a multicentric approach such as implemented in our F-TRACT project (f-tract.eu). To facilitate group studies, we developed a software—IntrAnat Electrodes—that allows to perform virtual electrode implantation in patients’ neuroanatomy and to overlay results of epileptic and functional mapping, as well as resection masks from the surgery. IntrAnat Electrodes is based on a patient database providing multiple search criteria to highlight various group features. For each patient, the anatomical processing is based on a series of software publicly available. Imaging modalities (Positron Emission Tomography (PET), anatomical MRI pre-implantation, post-implantation and post-resection, functional MRI, diffusion MRI, Computed Tomography (CT) with electrodes) are coregistered. The 3D T1 pre-implantation MRI gray/white matter is segmented and spatially normalized to obtain a series of cortical parcels using different neuroanatomical atlases. On post-implantation images, the user can position 3D models of electrodes defined by their geometry. Each electrode contact is then labeled according to its position in the anatomical atlases, to the class of tissue (gray or white matter, cerebro-spinal fluid) and to its presence inside or outside the resection mask. Users can add more functionally informed labels on contact, such as clinical responses after electrical stimulation, cortico-cortical evoked potentials, gamma band activity during cognitive tasks or epileptogenicity. IntrAnat Electrodes software thus provides a means to visualize multimodal data. The contact labels allow to search for patients in the database according to multiple criteria representing almost all available data, which is to our knowledge unique in current SEEG software. IntrAnat Electrodes will be available in the forthcoming release of BrainVisa software and tutorials can be found on the F-TRACT webpage.

Highlights

  • In some cases of pharmaco-resistant and focal epilepsies, intracranial recordings performed epidurally and/or in depth can be required to locate the seizure onset zone and the eloquent cortex

  • Going further in the automatic detection of false parcellations, we have developed in the groupDisplay interface an approach to automatically find patients for whom the parcellation may be incorrect

  • The software presented here is, to our knowledge, the first SEEG dedicated software based on a database interface to select patients according to many criteria

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Summary

Introduction

In some cases of pharmaco-resistant and focal epilepsies, intracranial recordings performed epidurally (electrocorticography, ECoG; Fernández and Loddenkemper, 2013) and/or in depth (stereoelectroencephalography, SEEG; Kahane and Dubeau, 2014) can be required to locate the seizure onset zone and the eloquent cortex. Each contact records the electrical activity in a spherical volume of 3 mm diameter approximately, leading to a spatial coverage of only around 1% of the brain activity per patient (Halgren et al, 1998; Lachaux et al, 2003). The positioning of electrode contacts on the pre-implantation data is very important (Arnulfo et al, 2015b; Wang et al, 2016; Narizzano et al, 2017; Vakharia et al, 2017). A limited number of electrodes can be implanted, their trajectories being constrained by the blood vessel organization which is patient-specific (Rodionov et al, 2013; Zuluaga et al, 2014) and adapted to the EZ hypothesis from pre-implantation data (Narizzano et al, 2017). The brain is sampled differently between patients, and the final surgical resection may differ, even for similar types of epilepsy

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