TY - JOUR
T1 - Beyond the double banana
T2 - Improved recognition of temporal lobe seizures in long-term EEG
AU - Rosenzweig, Ivana
AU - Fogarasi, András
AU - Johnsen, Birger
AU - Alving, Jørgen
AU - Fabricius, Martin Ejler
AU - Scherg, Michael
AU - Neufeld, Miri Y.
AU - Pressler, Ronit
AU - Kjaer, Troels W.
AU - Van Emde Boas, Walter
AU - Beniczky, Sándor
PY - 2014/2
Y1 - 2014/2
N2 - PURPOSE: To investigate whether extending the 10-20 array with 6 electrodes in the inferior temporal chain and constructing computed montages increases the diagnostic value of ictal EEG activity originating in the temporal lobe. In addition, the accuracy of computer-assisted spectral source analysis was investigated. METHODS: Forty EEG samples were reviewed by 7 EEG experts in various montages (longitudinal and transversal bipolar, common average, source derivation, source montage, current source density, and reference-free montages) using 2 electrode arrays (10-20 and the extended one). Spectral source analysis used source montage to calculate density spectral array, defining the earliest oscillatory onset. From this, phase maps were calculated for localization. The reference standard was the decision of the multidisciplinary epilepsy surgery team on the seizure onset zone. Clinical performance was compared with the double banana (longitudinal bipolar montage, 10-20 array). RESULTS: Adding the inferior temporal electrode chain, computed montages (reference free, common average, and source derivation), and voltage maps significantly increased the sensitivity. Phase maps had the highest sensitivity and identified ictal activity at earlier time-point than visual inspection. There was no significant difference concerning specificity. CONCLUSIONS: The findings advocate for the use of these digital EEG technology-derived analysis methods in clinical practice.
AB - PURPOSE: To investigate whether extending the 10-20 array with 6 electrodes in the inferior temporal chain and constructing computed montages increases the diagnostic value of ictal EEG activity originating in the temporal lobe. In addition, the accuracy of computer-assisted spectral source analysis was investigated. METHODS: Forty EEG samples were reviewed by 7 EEG experts in various montages (longitudinal and transversal bipolar, common average, source derivation, source montage, current source density, and reference-free montages) using 2 electrode arrays (10-20 and the extended one). Spectral source analysis used source montage to calculate density spectral array, defining the earliest oscillatory onset. From this, phase maps were calculated for localization. The reference standard was the decision of the multidisciplinary epilepsy surgery team on the seizure onset zone. Clinical performance was compared with the double banana (longitudinal bipolar montage, 10-20 array). RESULTS: Adding the inferior temporal electrode chain, computed montages (reference free, common average, and source derivation), and voltage maps significantly increased the sensitivity. Phase maps had the highest sensitivity and identified ictal activity at earlier time-point than visual inspection. There was no significant difference concerning specificity. CONCLUSIONS: The findings advocate for the use of these digital EEG technology-derived analysis methods in clinical practice.
KW - Inferior temporal electrodes
KW - Spectral source analysis
KW - Virtual and source montages
KW - Voltage and phase maps
UR - http://www.scopus.com/inward/record.url?scp=84894132337&partnerID=8YFLogxK
U2 - 10.1097/WNP.0000000000000019
DO - 10.1097/WNP.0000000000000019
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AN - SCOPUS:84894132337
SN - 0736-0258
VL - 31
SP - 1
EP - 9
JO - Journal of Clinical Neurophysiology
JF - Journal of Clinical Neurophysiology
IS - 1
ER -