Response: Can biomarkers of the epileptogenic zone be characterized in patients rendered seizure free alone?

0572898 - ÚPT 2024 RIV US eng J - Článek v odborném periodiku
Trávníček, Vojtěch - Klimeš, Petr - Cimbálník, J. - Frauscher, B.
Response: Can biomarkers of the epileptogenic zone be characterized in patients rendered seizure free alone?
Epilepsia. Roč. 64, č. 6 (2023), s. 1695. ISSN 0013-9580. E-ISSN 1528-1167
Institucionální podpora: RVO:68081731
Klíčová slova: seizure onset zone * biomarkers * SOZ localization
Obor OECD: Clinical neurology
Impakt faktor: 5.6, rok: 2022
Způsob publikování: Open access
https://onlinelibrary.wiley.com/doi/10.1111/epi.17597

The role of presurgical evaluation with intracranial electroencephalography (iEEG) is to localize the minimal amount of brain tissue which, if resected, will achieve seizure freedom in the treated patient. From the definition of the epileptogenic zone being “the area of cortex that is indispensable for the generation of epileptic seizures,” it is the EZ that we want to localize. At the same time we will only know retrospectively in patients with seizure-free outcome that we were indeed able to identify the EZ. This brings us to the localization dilemma. We either attempt to stick to the primary goal of localization of the EZ and use only good outcome patients or use something else as a localization target that is well defined in both good and poor outcomes. For poor outcome patients the latter remains less clear apart from the fact that at least part of the predicted target, localized by an algorithm, should be outside of the resection cavity. Another issue worth mentioning is that only patients with certain pathologies will reach a high likelihood of becoming seizure-free. This is another issue that can be a hurdle when developing machine/deep learning models that might indeed also identify traits of certain pathologies more likely in good outcome patients. We agree that determining the localization target is one of many problems when evaluating the pre-surgical iEEG. Having a unified strategy for the development of new biomarkers or building new machine/deep learning models for presurgical evaluation of iEEG would be very beneficial for the community. We are open to cooperate on such a strategy and to help to raise this problem in the community.
Trvalý link: https://hdl.handle.net/11104/0344168