Informations générales (source: ClinicalTrials.gov)
MEG Versus EEG HR for the Localization of the Epileptogenic Zone As Part of the Pre-surgical Assessment of Epilepsy (EPIMEEG)
Interventional
N/A
Hospices Civils de Lyon (Voir sur ClinicalTrials)
octobre 2019
avril 2027
05 avril 2025
Drug-resistant partial epilepsies are disabling diseases for which surgical treatment may
be indicated. The determination of the area to be operated (or 'epileptogenic zone') is
based on a bundle of clinical arguments and neuroimaging, having a direct impact on
surgical success.
Epileptic patients have electrical abnormalities that can be detected with surface
electrophysiological examinations such as surface EEG or MagnetoEncephalography (MEG).
The intracerebral source of these abnormalities can be localized in the brain using
source modeling techniques from MEG signals or EEG signals if a sufficient number of
electrodes is used (> 100, so-called high EEG technique Resolution = EEG HR). EEG HR and
MEG are two infrequent state-of-the-art techniques.
The independent contribution of EEG HR and MEG for the localization of the epileptogenic
zone has been shown in several studies. However, several modeling studies have shown that
MEG and EEG HR have a different detection capacity and spatial resolution depending on
the cortical generators studied. Modeling studies suggest that MEG has better
localization accuracy than EEG for most cortical sources.
No direct comparison of the locating value of MEG and EEG HR for the localization of the
epileptogenic zone has been performed to date in a large-scale clinical study.
In this prospective study, 100 patients with partial epilepsy who are candidates for
epilepsy surgery, and for some of them with intracranial EEG recording, will benefit from
two advanced electrophysiological examinations including magnetoencephalographic
recording (MEG). ) interictal electrophysiological abnormalities and high-resolution EEG
recording (128 electrodes) in addition to the usual examinations performed as part of the
pre-surgical assessment, prior to cortectomy and / or intracranial EEG recording.
Based on recent work conducted in humans, we postulate:
- that the MEG and the EEG HR make it possible to precisely determine the
epileptogenic zone, by using two approaches of definition of the epileptogenic zone
(zone operated in the cured patients, zone at the origin of the crises during the
intracranial recordings), but that the MEG is a little more precise than the EEG HR
for the determination of the epileptogenic zone (we will try to highlight a
difference of about 10%)
- that the quantitative study of the complementarity between EEG HR and MEG for
modeling sources of epileptic spikes will show an added value in the use of both
methods compared to the use of only one of the two methods
- that it is possible to determine the epileptogenic zone by determining the MEG model
zone having the highest centrality value (hub) within the intercritical network by
studying networks using graph theory.
Etablissements
| Les établissements hors Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Hospices Civils de Lyon - 69500 - Bron - France | Julien JUNG, MD | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- -patients with partial epilepsy for at least 2 years and for whom are decided and
planned: either i) a surgical procedure to resect the epileptogenic zone without
prior intracranial EEG recording either ii) an intracranial EEG record needed before
a possible cortectomy procedure
- Routine scalp EEG revealing known paroxysmal interictal abnormalities (at least 5
points on a 20-minute plot performed less than 1 year before inclusion in the study)
- Patient giving written consent
- -patients with partial epilepsy for at least 2 years and for whom are decided and
planned: either i) a surgical procedure to resect the epileptogenic zone without
prior intracranial EEG recording either ii) an intracranial EEG record needed before
a possible cortectomy procedure
- Routine scalp EEG revealing known paroxysmal interictal abnormalities (at least 5
points on a 20-minute plot performed less than 1 year before inclusion in the study)
- Patient giving written consent
- patient aged over 60 or under 18
- patients with contraindications to brain MRI and MEG
- women of childbearing age for whom a urine pregnancy test performed during the first
visit would detect a pregnancy