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Electroencephalographic Inverse Localization of Brain Activity in Acute Traumatic Brain Injury as a Guide to Surgery, Monitoring and Treatment

Institution:
1The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
2Brain Injury Research Center, Department of Neurosurgery, University of California, Los Angeles, CA, USA.
3Department of Neurology, University of California, Los Angeles, CA, USA.
Publisher:
Elsevier Science
Publication Date:
Oct-2013
Journal:
Clin Neurol Neurosurg
Volume Number:
115
Issue Number:
10
Pages:
2159-65
Citation:
Clin Neurol Neurosurg. 2013 Oct;115(10):2159-65.
PubMed ID:
24011495
PMCID:
PMC3807758
Keywords:
Electroencephalography, Epilepsy, Localization, Monitoring, Outcome, Traumatic brain injury
Appears in Collections:
NA-MIC, SLICER
Sponsors:
P01 NS058489/NS/NINDS NIH HHS/United States
P41 EB015922/EB/NIBIB NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
Generated Citation:
Irimia A., Goh S.Y.M., Torgerson C.M., Stein N.R., Chambers M.C., Vespa P.M., Van Horn J.D. Electroencephalographic Inverse Localization of Brain Activity in Acute Traumatic Brain Injury as a Guide to Surgery, Monitoring and Treatment. Clin Neurol Neurosurg. 2013 Oct;115(10):2159-65. PMID: 24011495. PMCID: PMC3807758.
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OBJECTIVE: To inverse-localize epileptiform cortical electrical activity recorded from severe traumatic brain injury (TBI) patients using electroencephalography (EEG). METHODS: Three acute TBI cases were imaged using computed tomography (CT) and multimodal magnetic resonance imaging (MRI). Semi-automatic segmentation was performed to partition the complete TBI head into 25 distinct tissue types, including 6 tissue types accounting for pathology. Segmentations were employed to generate a finite element method model of the head, and EEG activity generators were modeled as dipolar currents distributed over the cortical surface. RESULTS: We demonstrate anatomically faithful localization of EEG generators responsible for epileptiform discharges in severe TBI. By accounting for injury-related tissue conductivity changes, our work offers the most realistic implementation currently available for the inverse estimation of cortical activity in TBI. CONCLUSION: Whereas standard localization techniques are available for electrical activity mapping in uninjured brains, they are rarely applied to acute TBI. Modern models of TBI-induced pathology can inform the localization of epileptogenic foci, improve surgical efficacy, contribute to the improvement of critical care monitoring and provide guidance for patient-tailored treatment. With approaches such as this, neurosurgeons and neurologists can study brain activity in acute TBI and obtain insights regarding injury effects upon brain metabolism and clinical outcome.

Additional Material
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