Utility of Inter-electrode Coherence for Evaluating Efficacy of Corpus Callosotomy
Abstract number :
3.469
Submission category :
9. Surgery / 9C. All Ages
Year :
2024
Submission ID :
62
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Ako Matsuhashi, MD – the University of Tokyo
Seijiro Shimada, MD, PhD – the University of Tokyo
Toshiya Aono, MD – the University of Tokyo
Shigeta Fujitani, MD, PhD – the University of Tokyo
Keisuke Nagata, MD, PhD – the University of Tokyo
Hiroshi Terashima, MD, PhD – the University of Tokyo
Naoto Kunii, MD, PhD – Jichi Medical University
Takeshi Matsuo, MD, PhD – Tokyo Metropolitan Neurological Hospital
Nobuhito Saito, MD, PhD – the University of Tokyo
Rationale: Corpus callosotomy is known as a palliative therapy for generalized seizures, especially generalized atonic seizures. Even though the decline of interhemispheric synchronization due to dissection of commissural fibers is considered to contribute to seizure reduction, its alterations have not been quantitively examined. Here, we applied inter-electrode coherence analysis in patients who underwent callosotomy to evaluate the change of interhemispheric synchronization and verified its relationship with seizure outcome. Furthermore, we investigated predictive factors that can explain differences among good and poor seizure outcome groups.
Methods: All patients who underwent corpus callosotomy at the University of Tokyo Hospital between April 2013 and March 2024, and those at Tokyo Metropolitan Neurological Hospital between April 2009 and March 2020, whose pre and postoperative electroencephalograms (EEGs) were available, were included. Seizure frequency before and after callosotomy was reviewed retrospectively. Changes of inter-electrode coherence between two electrodes in symmetric positions in each frequency band were calculated from 5 minutes of interictal awake pre and postoperative scalp EEGs. Its relationship with seizure outcome was evaluated.
Results: Among 105 patients who underwent callosotomy, 56 patients (52.8%) were male, and mean age at operation was 17.6 years (range: 0-59 years). 60 patients underwent total corpus callosotomy, 12 patients underwent anterior callosotomy, and 33 patients underwent two-staged corpus callosotomy, in which posterior callosotomy was conducted about three to twelve months after anterior callosotomy. Generalized atonic seizures decreased in 83.3% of the patients after operation. Inter-electrode coherence (Figure) in theta and alpha frequency bands between two electrodes in symmetric positions decreased significantly in patients whose generalized seizures decreased after callosotomy (p< 0.05). This is considered to reflect the decrease of interhemispheric functional connectivity after corpus callosotomy. Among patients whose seizure frequency did not decrease after corpus callosotomy, inter-electrode coherence did not decrease.
Surgery