Evidence map›Paper›PMID 34034087›Full record

ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2021

Source imaging of seizure onset predicts surgical outcome in pediatric epilepsy.

Lorenzo Ricci, Eleonora Tamilia, Michel Alhilani, Aliza Alter, Μ Scott Perry, Joseph R Madsen, Jurriaan M Peters, Phillip L Pearl, Christos Papadelis

Abstract read
In one paragraph

Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Combining interictal and ictal low-density EEG source imaging to delineate the epileptogenic zone in young children.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Article
  3. Article
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  7. Virtual implantation using conventional scalp EEG delineates seizure onset and predicts surgical outcome in children with epilepsy.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2022
    Article
  8. Article
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  10. Localizing the Epileptogenic Zone with Novel Biomarkers.Seminars in pediatric neurology · 2021
    Review
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Lorenzo RicciLaboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy.
Eleonora TamiliaLaboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Michel AlhilaniLaboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; The Hillingdon Hospital NHS Foundation Trust, London, UK.
Aliza AlterDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Μ Scott PerryJane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX, USA.
Joseph R MadsenDivision of Epilepsy Surgery, Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Jurriaan M PetersDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Phillip L PearlDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Christos PapadelisLaboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX, USA; School of Medicine, Texas Christian University and University of North Texas Health Science Center, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA. Electronic address: christos.papadelis@cookchildrens.org.

Funding

Interictal High Frequency Oscillations of Epileptogenecity in Pediatric PatientsR01NS104116 · NINDS · COOK CHILDREN'S MEDICAL CENTER · PI PAPADELIS, CHRISTOS · 2019 to 2024
$2.4M
Interictal High Frequency Oscillations of Epileptogenecity in Pediatric PatientsR21NS101373 · NINDS · COOK CHILDREN'S MEDICAL CENTER · PI PAPADELIS, CHRISTOS, STUFFLEBEAM, STEVEN · 2018 to 2019
$501k
NINDS NIH HHS R01 NS104116NINDS NIH HHS R21 NS101373
6 · The paper itself

Abstract

objectiveTo assess whether ictal electric source imaging (ESI) on low-density scalp EEG can approximate the seizure onset zone (SOZ) location and predict surgical outcome in children with refractory epilepsy undergoing surgery.

methodsWe examined 35 children with refractory epilepsy. We dichotomized surgical outcome into seizure- and non-seizure-free. We identified ictal onsets recorded with scalp and intracranial EEG and localized them using equivalent current dipoles and standardized low-resolution magnetic tomography (sLORETA). We estimated the localization accuracy of scalp EEG as distance of scalp dipoles from intracranial dipoles. We also calculated the distances of scalp dipoles from resection, as well as their resection percentage and compared between seizure-free and non-seizure-free patients. We built receiver operating characteristic curves to test whether resection percentage predicted outcome.

resultsResection distance was lower in seizure-free patients for both dipoles (p = 0.006) and sLORETA (p = 0.04). Resection percentage predicted outcome with a sensitivity of 57.1% (95% CI, 34-78.2%), a specificity of 85.7% (95% CI, 57.2-98.2%) and an accuracy of 68.6% (95% CI, 50.7-83.5%) (p = 0.01).

conclusionIctal ESI performed on low-density scalp EEG can delineate the SOZ and predict outcome. SIGNIFICANCE: Such an application may increase the number of children who are referred for epilepsy surgery and improve their outcome.

Indexed as

AdolescentChildChild, PreschoolCohort StudiesElectroencephalographyEpilepsyFemaleHumansMagnetic Resonance ImagingMalePredictive Value of TestsRetrospective StudiesSeizuresTomography, Emission-Computed, Single-PhotonTreatment OutcomeYoung AdultElectroencephalographyPediatric EpilepsySource Localization

Identifiers

PMID34034087
PMCPMC8202024

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.