Specific consistency score for rational selection of epilepsy resection surgery candidates
Maya Tojima
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorAkihiro Shimotake
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorShuichiro Neshige
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
Search for more papers by this authorTadashi Okada
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorKatsuya Kobayashi
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorKiyohide Usami
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorMasao Matsuhashi
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorMasayuki Honda
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorHirofumi Takeyama
Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakefumi Hitomi
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakeshi Yoshida
Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorAtsushi Yokoyama
Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorYasutaka Fushimi
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTsukasa Ueno
Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorYukihiro Yamao
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakayuki Kikuchi
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakao Namiki
Department of Mathematics, Faculty of Science, Hokkaido University, Sapporo, Japan
Search for more papers by this authorYoshiki Arakawa
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorRyosuke Takahashi
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorCorresponding Author
Akio Ikeda
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Correspondence
Akio Ikeda, Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Email: [email protected]
Search for more papers by this authorMaya Tojima
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorAkihiro Shimotake
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorShuichiro Neshige
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
Search for more papers by this authorTadashi Okada
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorKatsuya Kobayashi
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorKiyohide Usami
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorMasao Matsuhashi
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorMasayuki Honda
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorHirofumi Takeyama
Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakefumi Hitomi
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakeshi Yoshida
Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorAtsushi Yokoyama
Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorYasutaka Fushimi
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTsukasa Ueno
Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorYukihiro Yamao
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakayuki Kikuchi
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorTakao Namiki
Department of Mathematics, Faculty of Science, Hokkaido University, Sapporo, Japan
Search for more papers by this authorYoshiki Arakawa
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorRyosuke Takahashi
Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Search for more papers by this authorCorresponding Author
Akio Ikeda
Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Correspondence
Akio Ikeda, Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Email: [email protected]
Search for more papers by this authorAbstract
Objective
Degree of indication for epilepsy surgery is determined by taking multiple factors into account. This study aimed to investigate the usefulness of the Specific Consistency Score (SCS), a proposed score for focal epilepsy to rate the indication for epilepsy focal resection.
Methods
This retrospective cohort study included patients considered for resective epilepsy surgery in Kyoto University Hospital from 2011 to 2022. Plausible epileptic focus was tentatively defined. Cardinal findings were scored based on specificity and consistency with the estimated laterality and lobe. The total points represented SCS. The association between SCS and the following clinical parameters was assessed by univariate and multivariate analysis: (1) probability of undergoing resective epilepsy surgery, (2) good postoperative seizure outcome (Engel I and II or Engel I only), and (3) lobar concordance between the noninvasively estimated focus and intracranial electroencephalographic (EEG) recordings.
Results
A total of 131 patients were evaluated. Univariate analysis revealed higher SCS in the (1) epilepsy surgery group (8.4 [95% confidence interval (CI) = 7.8–8.9] vs. 4.9 [95% CI = 4.3–5.5] points; p < .001), (2) good postoperative seizure outcome group (Engel I and II; 8.7 [95% CI = 8.2–9.3] vs. 6.4 [95% CI = 4.5–8.3] points; p = .008), and (3) patients whose focus defined by intracranial EEG matched the noninvasively estimated focus (8.3 [95% CI = 7.3–9.2] vs. 5.4 [95% CI = 3.5–7.3] points; p = .004). Multivariate analysis revealed areas under the curve of .843, .825, and .881 for Parameters 1, 2, and 3, respectively.
Significance
SCS provides a reliable index of good indication for resective epilepsy surgery and can be easily available in many institutions not necessarily specializing in epilepsy.
CONFLICT OF INTEREST STATEMENT
K.U., M.M., and A.I. are the currently members of the Department of Epilepsy, Movement Disorders, and Physiology. Since June 2018, this department is the Industry-Academia Collaboration Courses supported by Eisai, Nihon Kohden, Otsuka Pharmaceutical, and UCB Japan. H.T. was previously a member of the Department of Respiratory Care and Sleep Control Medicine. This is the department has received donations from Teijin Pharma, Philips Respironics, Fukuda Denshi, and Fukuda Lifetech Keiji. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
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| epi17945-sup-0001-AppendixS1.docxWord 2007 document , 208.8 KB |
Appendix S1. |
| epi17945-sup-0002-AppendixS2.xlsxapplication/excel, 1.5 MB |
Appendix S2. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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