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- Ensaio Clínico NCT02844374
Epileptogenic Zone's Cartography by Quantification of EEG's Signal and Intracerebral Stimulation. (EPISTIM)
Epilepsy is a devastating chronic disease due to multiple causes that affect close to 50% of the world's population.
Although effective, epilepsy surgery fails in many cases, the percentage of patients free from crisis on a long term (≥ 5 years) varies from 27% to 66% according to the kind of epilepsy.
It is in this context that EPISTIM is interesting, and its aims isb a better electrophysiology delimiting of cortical networks that imply the genesis of seizures with the aim to improove surgery results.
This study will rely on the intracerebral records and on corticales electrical stimulation as they are currently routinely used by epileptic patients candidates for surgery.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Tipo de estudo
Inscrição (Antecipado)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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La Tronche, França, 38700
- Recrutamento
- UniversityHospitalGrenoble
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Contato:
- Philippe Kahane, Professor
- Número de telefone: 04.76.76.54.48
- E-mail: philippe.kahane@ujf-grenoble.fr
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Contato:
- Lorella Minotti
- Número de telefone: 0476765448
- E-mail: Lminotti@chu-grenoble.fr
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria :
- Patient from 5 to 65 years (L1121-7 L1122 2 CSP), including legally protected or unable to give his consent (L1121-8 CSP).
- Written approval of inclusion in the study from the patient or his legal representative.
- Patients with partial Epilepsy Drug Resistant , justifying a SEEG exploration.
Exclusion Criteria :
- Patient under 5 years.
- Patient over 65 years.
- Pregnant or breastfeeeding women (L1121-5 CSP).
- Patient deprived of liberty as a result of a judicial or administrative decision (L1121-6 CSP).
- Patients over 18 years unable to give their free consent and not subject to a legal protection order.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Outro: Partial Epilepsy Drug Resistant
Patients with partial Epilepsy Drug Resistant , justifying a SEEG exploration.
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Visual analysis : in order to define the level of cortical resections.
Epileptogenic maps : calculated for each crisis and for all crisis in general.
Connectivity maps : calculated for each site stimulated at low-frequency.
Post-operative evaluation : in order to assess the extent of resection.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Visual analysis
Prazo: up to one hour
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Visual analysis : in order to define the level of cortical resections.
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up to one hour
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Epileptogenic maps
Prazo: up to 10 min
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Epileptogenic maps : calculated for each crisis and for all crisis in general.
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up to 10 min
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Connectivity maps
Prazo: up to 10 min
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Connectivity maps : calculated for each site stimulated at low-frequency.
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up to 10 min
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MRI
Prazo: up to one hour
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Post-operative evaluation : in order to assess the extent of resection.
MRI : 3D-T1
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up to one hour
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Philippe Kahane, Professor, Grenoble Hospital University
Publicações e links úteis
Publicações Gerais
- Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9. doi: 10.1056/NEJM200002033420503.
- Tellez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain. 2005 May;128(Pt 5):1188-98. doi: 10.1093/brain/awh449. Epub 2005 Mar 9.
- Alarcon G, Binnie CD, Elwes RD, Polkey CE. Power spectrum and intracranial EEG patterns at seizure onset in partial epilepsy. Electroencephalogr Clin Neurophysiol. 1995 May;94(5):326-37. doi: 10.1016/0013-4694(94)00286-t.
- Allen PJ, Fish DR, Smith SJ. Very high-frequency rhythmic activity during SEEG suppression in frontal lobe epilepsy. Electroencephalogr Clin Neurophysiol. 1992 Feb;82(2):155-9. doi: 10.1016/0013-4694(92)90160-j.
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- Blauwblomme T, Kahane P, Minotti L, Grouiller F, Krainik A, Vercueil L, Chabardes S, Hoffmann D, David O. Multimodal imaging reveals the role of gamma activity in eating-reflex seizures. J Neurol Neurosurg Psychiatry. 2011 Oct;82(10):1171-3. doi: 10.1136/jnnp.2010.212696. Epub 2010 Nov 19.
- Bulacio JC, Jehi L, Wong C, Gonzalez-Martinez J, Kotagal P, Nair D, Najm I, Bingaman W. Long-term seizure outcome after resective surgery in patients evaluated with intracranial electrodes. Epilepsia. 2012 Oct;53(10):1722-30. doi: 10.1111/j.1528-1167.2012.03633.x. Epub 2012 Aug 20.
- Cossu M, Cardinale F, Castana L, Citterio A, Francione S, Tassi L, Benabid AL, Lo Russo G. Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures. Neurosurgery. 2005 Oct;57(4):706-18; discussion 706-18.
- Catenoix H, Magnin M, Guenot M, Isnard J, Mauguiere F, Ryvlin P. Hippocampal-orbitofrontal connectivity in human: an electrical stimulation study. Clin Neurophysiol. 2005 Aug;116(8):1779-84. doi: 10.1016/j.clinph.2005.03.016.
- Catenoix H, Magnin M, Mauguiere F, Ryvlin P. Evoked potential study of hippocampal efferent projections in the human brain. Clin Neurophysiol. 2011 Dec;122(12):2488-97. doi: 10.1016/j.clinph.2011.05.007. Epub 2011 Jun 12.
- David O, Bastin J, Chabardes S, Minotti L, Kahane P. Studying network mechanisms using intracranial stimulation in epileptic patients. Front Syst Neurosci. 2010 Oct 20;4:148. doi: 10.3389/fnsys.2010.00148. eCollection 2010.
- David O, Blauwblomme T, Job AS, Chabardes S, Hoffmann D, Minotti L, Kahane P. Imaging the seizure onset zone with stereo-electroencephalography. Brain. 2011 Oct;134(Pt 10):2898-911. doi: 10.1093/brain/awr238.
- Engel J Jr, Van Ness Paul C, Rasmussen TB, Ojemann LM. Outcome with respect to epileptic seizures. In: Engel J Jr, editor. Surgical treatment of the epilepsies, 2d ed. Philadelphia: Lippincott-Raven; 1996: 609-621.
- Fisher RS, Webber WR, Lesser RP, Arroyo S, Uematsu S. High-frequency EEG activity at the start of seizures. J Clin Neurophysiol. 1992 Jul;9(3):441-8. doi: 10.1097/00004691-199207010-00012.
- Gordon B, Lesser RP, Rance NE, Hart J Jr, Webber R, Uematsu S, Fisher RS. Parameters for direct cortical electrical stimulation in the human: histopathologic confirmation. Electroencephalogr Clin Neurophysiol. 1990 May;75(5):371-7. doi: 10.1016/0013-4694(90)90082-u.
- Jallon P. [Epidemiology of drug-resistant epilepsies]. Rev Neurol (Paris). 2004 Jun;160 Spec No 1:5S22-30. French.
- Jirsch JD, Urrestarazu E, LeVan P, Olivier A, Dubeau F, Gotman J. High-frequency oscillations during human focal seizures. Brain. 2006 Jun;129(Pt 6):1593-608. doi: 10.1093/brain/awl085. Epub 2006 Apr 21.
- Kahane P, Bartolomei F. Traitement neurochirurgical de l'épilepsie. EMC (Elsevier Masson SAS, Paris), Neurologie, 17-045-A-53, 2011.
- Kahane P, Tassi L, Francione S, Hoffmann D, Lo Russo G, Munari C. [Electroclinical manifestations elicited by intracerebral electric stimulation "shocks" in temporal lobe epilepsy]. Neurophysiol Clin. 1993 Jul;23(4):305-26. doi: 10.1016/s0987-7053(05)80123-6. French.
- Kahane P, Minotti L, Hoffmann D, Lachaux JP, Ryvlin P. Invasive EEG in the definition of the seizure onset zone: depth electrodes. In : Rosenow F, Lüders HO, eds. Handbook of Clinical Neurophysiology, Vol.3. Presurgical assessment of the epilepsies with clinical neurophysiology and functional imaging. Amsterdam : Elsevier BV, 2004 : 109-133.
- Kahane P, Ryvlin P, Vercueil L, Hirsch E, Arzimanoglou A. [In this era of value for money what is the place of epilepsy surgery in hospital practice]. Rev Neurol (Paris). 2007 Dec;163(12):1151-6. doi: 10.1016/S0035-3787(07)78399-6. No abstract available. French.
- Koubeissi MZ, Lesser RP, Sinai A, Gaillard WD, Franaszczuk PJ, Crone NE. Connectivity between perisylvian and bilateral basal temporal cortices. Cereb Cortex. 2012 Apr;22(4):918-25. doi: 10.1093/cercor/bhr163. Epub 2011 Jun 29.
- Lacruz ME, Garcia Seoane JJ, Valentin A, Selway R, Alarcon G. Frontal and temporal functional connections of the living human brain. Eur J Neurosci. 2007 Sep;26(5):1357-70. doi: 10.1111/j.1460-9568.2007.05730.x.
- Lee SA, Spencer DD, Spencer SS. Intracranial EEG seizure-onset patterns in neocortical epilepsy. Epilepsia. 2000 Mar;41(3):297-307. doi: 10.1111/j.1528-1157.2000.tb00159.x.
- Matsumoto R, Nair DR, LaPresto E, Najm I, Bingaman W, Shibasaki H, Luders HO. Functional connectivity in the human language system: a cortico-cortical evoked potential study. Brain. 2004 Oct;127(Pt 10):2316-30. doi: 10.1093/brain/awh246. Epub 2004 Jul 21.
- Matsumoto R, Nair DR, LaPresto E, Bingaman W, Shibasaki H, Luders HO. Functional connectivity in human cortical motor system: a cortico-cortical evoked potential study. Brain. 2007 Jan;130(Pt 1):181-97. doi: 10.1093/brain/awl257. Epub 2006 Oct 17.
- Matsumoto R, Nair DR, Ikeda A, Fumuro T, Lapresto E, Mikuni N, Bingaman W, Miyamoto S, Fukuyama H, Takahashi R, Najm I, Shibasaki H, Luders HO. Parieto-frontal network in humans studied by cortico-cortical evoked potential. Hum Brain Mapp. 2012 Dec;33(12):2856-72. doi: 10.1002/hbm.21407. Epub 2011 Sep 19.
- Morris H, Najm I, Kahane P. Epilepsy surgery : patient selection. In: Lüders HO, ed. Textbook of epilepsy surgery. London : Informa Healthcare, 2008: 230-237.
- Munari C, Bancaud J. The role of stereo-electro-encephalography (SEEG) in the evaluation of partial epileptic patients. In: Porter RJ, Morselli PL, eds. The epilepsies. London : Butterworths, 1987 : 267-306.
- Nariai H, Nagasawa T, Juhasz C, Sood S, Chugani HT, Asano E. Statistical mapping of ictal high-frequency oscillations in epileptic spasms. Epilepsia. 2011 Jan;52(1):63-74. doi: 10.1111/j.1528-1167.2010.02786.x. Epub 2010 Nov 18.
- Nathan SS, Sinha SR, Gordon B, Lesser RP, Thakor NV. Determination of current density distributions generated by electrical stimulation of the human cerebral cortex. Electroencephalogr Clin Neurophysiol. 1993 Mar;86(3):183-92. doi: 10.1016/0013-4694(93)90006-h.
- Ochi A, Otsubo H, Donner EJ, Elliott I, Iwata R, Funaki T, Akizuki Y, Akiyama T, Imai K, Rutka JT, Snead OC 3rd. Dynamic changes of ictal high-frequency oscillations in neocortical epilepsy: using multiple band frequency analysis. Epilepsia. 2007 Feb;48(2):286-96. doi: 10.1111/j.1528-1167.2007.00923.x.
- Penfield W, Jasper H, eds. Epilepsy and the functional anatomy of the human brain. Boston: Little, Brown and Company, 1954.
- Picot MC, Baldy-Moulinier M, Daures JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country. Epilepsia. 2008 Jul;49(7):1230-8. doi: 10.1111/j.1528-1167.2008.01579.x.
- Rosenberg DS, Mauguiere F, Catenoix H, Faillenot I, Magnin M. Reciprocal thalamocortical connectivity of the medial pulvinar: a depth stimulation and evoked potential study in human brain. Cereb Cortex. 2009 Jun;19(6):1462-73. doi: 10.1093/cercor/bhn185. Epub 2008 Oct 20.
- Schmidt D, Baumgartner C, Loscher W. The chance of cure following surgery for drug-resistant temporal lobe epilepsy. What do we know and do we need to revise our expectations? Epilepsy Res. 2004 Jul-Aug;60(2-3):187-201. doi: 10.1016/j.eplepsyres.2004.07.004.
- Valentin A, Anderson M, Alarcon G, Seoane JJ, Selway R, Binnie CD, Polkey CE. Responses to single pulse electrical stimulation identify epileptogenesis in the human brain in vivo. Brain. 2002 Aug;125(Pt 8):1709-18. doi: 10.1093/brain/awf187.
- Wendling F, Bartolomei F, Bellanger JJ, Bourien J, Chauvel P. Epileptic fast intracerebral EEG activity: evidence for spatial decorrelation at seizure onset. Brain. 2003 Jun;126(Pt 6):1449-59. doi: 10.1093/brain/awg144.
- Wilson CL, Isokawa M, Babb TL, Crandall PH. Functional connections in the human temporal lobe. I. Analysis of limbic system pathways using neuronal responses evoked by electrical stimulation. Exp Brain Res. 1990;82(2):279-92. doi: 10.1007/BF00231248.
- Worrell GA, Parish L, Cranstoun SD, Jonas R, Baltuch G, Litt B. High-frequency oscillations and seizure generation in neocortical epilepsy. Brain. 2004 Jul;127(Pt 7):1496-506. doi: 10.1093/brain/awh149. Epub 2004 May 20.
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Outros números de identificação do estudo
- 38RC14.079
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Ensaios clínicos em Functional stereotaxic exploration
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New York State Psychiatric InstituteUniversity of Miami; Columbia University; University of Southern California; Feinstein...Ativo, não recrutandoParticipantes SaudáveisEstados Unidos