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Individualized targeting and optimization of multi-channel transcranial direct current stimulation in drug-resistant epilepsy

文献类型： 会议论文

第一作者： Marios Antonakakis

作者： Marios Antonakakis 1 ; Stefan Rampp 2 ; Christoph Kellinghaus 3 ; Carsten H. Wolters 4 ; Gabriel Moeddel 5 ;

作者机构： 1.Institute for Biomagnetism and Biosignal Analysis University of Muenster

2.Department of Neurosurgery University Hospital Erlangen

3.Epilepsy Center Muenster-Osnabrueck Department of Neurology Klinikum Osnabrueck

4.Institute for Biomagnetism and Biosignal Analysis, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience University of Muenster

5.Epilepsy Center Muenster-Osnabrueck Department of Neurology with Institute of Translational Neurology - Epileptology University Hospital Muenster

关键词： Focal epilepsy;Brain stimulation;EEG;MEG;Finite element method

会议名称： IEEE International Conference on Bioinformatics and Bioengineering

主办单位：

页码： 871-876

摘要： The principle of epilepsy surgery in patients with drug-resistant focal epilepsy is to localize and then to resect the epileptogenic zone. However, epilepsy surgery might not be feasible if a cortical malformation or focal cortical dysplasia (FCD), is located very close to eloquent areas of the brain. Non-invasive brain stimulation is a promising technique for modulating brain activity and may become a neurotherapeutic approach for suppressing long term epileptic seizures. In the present study, we optimize a multi-channel transcranial direct current stimulation (tDCS) montage based on Electro- (EEG) and Magneto-Encephalography (MEG) source analysis for the therapeutic stimulation of a patient with drug-resistant epilepsy due to an FCD located very close to Broca's area. We first construct a realistic volume conductor Finite Element Method (FEM) model of the patient's head, including skull defects, calibrated skull conductivities and white matter conductivity anisotropy. Single modality (EEG or MEG) and combined EEG/MEG (EMEG) source analysis is performed for localizing the irritative zone that caused interictal epileptic discharges (IEDs). We then adopt a novel optimization algorithm, Alternating Direction Method of Multipliers (ADMM), in order to optimize the multichannel tDCS montage for distributing the injected currents in the target brain region. The patient's source analysis indicates localizations on the FCD and orientations to a different cortical side depending on the used measurement modality. The resulting tDCS optimized montage is based on one of those source reconstructions and the occurred stimulation montage is focal over the detected FCD. The combination of individual source analysis for targeting and optimization algorithms for the estimation of a tDCS montage is a promising neurotherapeutic approach of suppressing long term epileptic seizures.

分类号： Q811.4-53

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