Papers - ENATSU Rei

Deep learning for the diagnosis of mesial temporal lobe epilepsy.

Kyoya Sakashita, Yukinori Akiyama, Tsukasa Hirano, Ayaka Sasagawa, Masayasu Arihara, Tomoyoshi Kuribara, Satoko Ochi, Rei Enatsu, Takeshi Mikami, Nobuhiro Mikuni

PloS one   18 ( 2 ) e0282082  2023  [International journal]

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OBJECTIVE: This study aimed to enable the automatic detection of the hippocampus and diagnose mesial temporal lobe epilepsy (MTLE) with the hippocampus as the epileptogenic area using artificial intelligence (AI). We compared the diagnostic accuracies of AI and neurosurgical physicians for MTLE with the hippocampus as the epileptogenic area. METHOD: In this study, we used an AI program to diagnose MTLE. The image sets were processed using a code written in Python 3.7.4. and analyzed using Open Computer Vision 4.5.1. The deep learning model, which was a fine-tuned VGG16 model, consisted of several layers. The diagnostic accuracies of AI and board-certified neurosurgeons were compared. RESULTS: AI detected the hippocampi automatically and diagnosed MTLE with the hippocampus as the epileptogenic area on both T2-weighted imaging (T2WI) and fluid-attenuated inversion recovery (FLAIR) images. The diagnostic accuracies of AI based on T2WI and FLAIR data were 99% and 89%, respectively, and those of neurosurgeons based on T2WI and FLAIR data were 94% and 95%, respectively. The diagnostic accuracy of AI was statistically higher than that of board-certified neurosurgeons based on T2WI data (p = 0.00129). CONCLUSION: The deep learning-based AI program is highly accurate and can diagnose MTLE better than some board-certified neurosurgeons. AI can maintain a certain level of output accuracy and can be a reliable assistant to doctors.

DOI PubMed

How do you teach/master Neurosurgicalテクニック?脳波編(第10回) 脳波レポートを作成する!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 6 ) 836 - 846  2022.11

脳マッピング研究の最前線と臨床応用 運動マッピングの臨床応用(Clinical application of motor mapping)

江夏 怜, 山田 奨人, 三國 信啓

臨床神経生理学 ( (一社)日本臨床神経生理学会 )  50 ( 5 ) 283 - 283  2022.10

問題症例のMEG 構造的焦点てんかんを呈した乳児例に対する後頭葉切除と側頭葉切除(Occipital lobe dissection and temporal lobectomy for an infantile case with structural focal epilepsy.)

平松 泰好, 中島 翠, 江川 潔, 江夏 怜, 三國 信啓, 鳴神 雅史, 植田 佑樹, 中久保 佐千子, 木村 修平, 後藤 健, 白石 秀明

臨床神経生理学 ( (一社)日本臨床神経生理学会 )  50 ( 5 ) 344 - 344  2022.10

How do you teach/master Neurosurgicalテクニック?脳波編(第9回) 非てんかん性異常波を読む!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 5 ) 704 - 713  2022.09

遠隔脳波診断を用いたてんかん遠隔診療連携の取り組み

高橋 康弘, 菅野 彩, 江夏 怜, 横山 林太郎, 中村 裕貴, 原口 浩一, 三國 信啓

てんかん研究 ( (一社)日本てんかん学会 )  40 ( 2 ) 433 - 433  2022.08

深部電極植込ロボットに何を求めるか?～精度、安全性からコストまで～ ブレインラボ手術支援ロボットアームCirqシステムを使用した深部電極留置

江夏 怜, 菅野 彩, 三國 信啓

てんかん研究 ( (一社)日本てんかん学会 )  40 ( 2 ) 321 - 321  2022.08

How do you teach/master Neurosurgicalテクニック?脳波編(第8回) てんかん重積脳波を読む!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 4 ) 574 - 581  2022.07

Effect of Early Surgical Intervention for Brain Tumors Associated with Epilepsy on the Improvement in Memory Performance.

Tsukasa Hirano, Hime Suzuki, Katsuya Komatsu, Aya Kanno, Yuusuke Kimura, Rei Enatsu, Satoko Ochi, Hirofumi Ohnishi, Nobuhiro Mikuni

Neurologia medico-chirurgica   62 ( 6 ) 286 - 293  2022.06  [Domestic journal]

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We evaluated the effect of early surgical intervention on the change in memory performance of patients with low-grade brain tumors associated with epilepsy. Twenty-three adult patients with low-grade brain tumors and epilepsy who underwent surgery at our institution between 2010 and 2019 were included. The Wechsler Memory Scale-Revised (WMS-R) was used to assess cognitive memory performance. Memory performance before and after surgery was retrospectively evaluated. In addition, the relationships among preoperative memory function, postoperative seizure outcome, preoperative seizure control, temporal lobe lesion, and change in memory function were examined. There were statistically significant improvements from median preoperative to postoperative WMS-R subscale scores for verbal memory, general memory, and delayed recall (p<0.001, p<0.001, and p=0.0055, respectively) regardless of preoperative sores and tumor location. Good postsurgical seizure control was associated with significant improvements in postoperative WMS-R performance. Our results indicated that early surgical intervention might improve postoperative memory function in patients with low-grade brain tumors and epilepsy.

DOI PubMed

Comparison of Thresholds between Bipolar and Monopolar Electrical Cortical Stimulation.

Yasuhiro Takahashi, Rei Enatsu, Aya Kanno, Seiichiro Imataka, Shoichi Komura, Tomoaki Tamada, Kyoya Sakashita, Ryohei Chiba, Takuro Saito, Nobuhiro Mikuni

Neurologia medico-chirurgica   62 ( 6 ) 294 - 299  2022.06  [Domestic journal]

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Electrical cortical stimulation is widely performed and is the gold standard for functional mapping in intractable epilepsy patients; however, a standard protocol has not yet been established. With respect to stimulation methods, two techniques can be applied: monopolar and bipolar stimulation. We compared the threshold to induce clinical symptoms between these two stimulation techniques. Twenty patients with intractable epilepsy who underwent electrical cortical stimulation for functional mapping were retrospectively investigated. We evaluated the stimulation intensity thresholds required to induce motor, sensory, and language symptoms. A total of 114 electrodes in 20 patients were used to investigate motor, sensory, and language symptoms. The thresholds required to induce motor (median value, bipolar: 4 mA, monopolar: 5 mA, p < 0.05) and language symptoms (bipolar: 8 mA, monopolar: 10 mA, p < 0.0005) were significantly higher for monopolar stimulation than those for bipolar stimulation. However, for sensory symptoms, no significant differences were found in the required thresholds between monopolar and bipolar stimulation (bipolar: 4 mA, monopolar: 4 mA, p = 0.474). Bipolar cortical stimulation required lower intensities to produce clinical motor and language symptoms and thus would be safe and suitable for screening of the eloquent area in functional mapping.

DOI PubMed

Motor Mapping with Functional Magnetic Resonance Imaging: Comparison with Electrical Cortical Stimulation.

Seiichiro Imataka, Rei Enatsu, Tsukasa Hirano, Ayaka Sasagawa, Masayasu Arihara, Tomoyoshi Kuribara, Satoko Ochi, Nobuhiro Mikuni

Neurologia medico-chirurgica   62 ( 5 ) 215 - 222  2022.05  [Domestic journal]

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The aim of the present study was to evaluate motor area mapping using functional magnetic resonance imaging (fMRI) compared with electrical cortical stimulation (ECS). Motor mapping with fMRI and ECS were retrospectively compared in seven patients with refractory epilepsy in which the primary motor (M1) areas were identified by fMRI and ECS mapping between 2012 and 2019. A right finger tapping task was used for fMRI motor mapping. Blood oxygen level-dependent activation was detected in the left precentral gyrus (PreCG)/postcentral gyrus (PostCG) along the "hand knob" of the central sulcus in all seven patients. Bilateral supplementary motor areas (SMAs) were also activated (n = 6), and the cerebellar hemisphere showed activation on the right side (n = 3) and bilateral side (n = 4). Furthermore, the premotor area (PM) and posterior parietal cortex (PPC) were also activated on the left side (n = 1) and bilateral sides (n = 2). The M1 and sensory area (S1) detected by ECS included fMRI-activated PreCG/PostCG areas with broader extent. This study showed that fMRI motor mapping was locationally well correlated to the activation of M1/S1 by ECS, but the spatial extent was not concordant. In addition, the involvement of SMA, PM/PPC, and the cerebellum in simple voluntary movement was also suggested. Combination analysis of fMRI and ECS motor mapping contributes to precise localization of M1/S1.

DOI PubMed

過去6年間にてんかん外科治療を行った小児てんかん患者11例のまとめ

山本 晃代, 土田 晃輔, 福村 忍, 越智 さと子, 菅野 彩, 江夏 怜, 三國 信啓

脳と発達 ( (一社)日本小児神経学会 )  54 ( Suppl. ) S216 - S216  2022.05

How do you teach/master Neurosurgicalテクニック? 脳波編(第7回) 発作症候を分類する!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 3 ) 420 - 427  2022.05

【脳波の読み方-up to date】特殊な脳波 皮質皮質間誘発電位(CCEP)

江夏 怜

Clinical Neuroscience ( (株)中外医学社 )  40 ( 4 ) 508 - 510  2022.04

How do you teach/master Neurosurgicalテクニック? 脳波編(第6回) 発作時脳波を解析する!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 2 ) 274 - 282  2022.03

How do you teach/master Neurosurgicalテクニック?脳波編(第5回) 発作間欠期てんかん性異常を検出する!!

江夏 怜

脳神経外科速報 ( (株)メディカ出版 )  32 ( 1 ) 135 - 143  2022.01

脳機能マッピングにおける視機能野のDTIを用いた脳機能ネットワーク分析

玉田 智晃, 江夏 怜, 菅野 彩, 越智 さと子, 三國 信啓

てんかん研究 ( (一社)日本てんかん学会 )  39 ( 3 ) 506 - 507  2022.01

Editorial: Magnetoencephalography: Methodological innovation paves the way for scientific discoveries and new clinical applications.

Rafeed Alkawadri, Rei Enatsu, Matti Hämäläinen, Anto Bagić

Frontiers in neurology   13   1056301 - 1056301  2022  [International journal]

DOI PubMed

各検査法と脳磁図の比較 てんかん外科治療における脳磁図と頭蓋内電極の比較

江夏 怜, 菅野 彩, 白石 秀明, 三國 信啓

日本生体磁気学会誌 ( 日本生体磁気学会 )  35 ( 1 ) 68 - 69  2022

Cortical regions and networks of hyperkinetic seizures: Electrocorticography and diffusion tensor imaging study.

Ayaka Sasagawa, Rei Enatsu, Tomoyoshi Kuribara, Masayasu Arihara, Tsukasa Hirano, Satoko Ochi, Nobuhiro Mikuni

Epilepsy & behavior : E&B   125   108405 - 108405  2021.12  [International journal]

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OBJECTIVE: The present study investigated the cortical areas and networks responsible for hyperkinetic seizures by analyzing invasive recordings and diffusion tensor imaging (DTI) tractography. METHODS: Seven patients with intractable focal epilepsy in whom hyperkinetic seizures were recorded during an invasive evaluation at Sapporo Medical University between January 2012 and March 2020 were enrolled in the present study. Intracranial recordings were analyzed to localize seizure-onset zones (SOZs) and symptomatogenic zones (spread areas at clinical onset). DTI was used to identify the subcortical fibers originating from SOZs. RESULTS: Ten SOZs were located in four areas: (1) the inferior parietal lobule (two SOZs in two patients), (2) temporo-occipital junction (three SOZs in two patients), (3) medial temporal area (three SOZs in three patients) and (4) medial/lateral frontal lobe (two SOZs in two patients). Symptomatogenic zones appeared to be the premotor area, basal temporal area, temporo-occipital junction, and the postcentral gyrus/supramarginal gyrus. The tractographic analysis revealed that the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), middle longitudinal fasciculus (MLF), arcuate fasciculus (AF)/superior longitudinal fasciculus (SLF) II, III, and cingulum bundle may be associated with hyperkinetic seizures. CONCLUSION: The present results suggest the cortical areas (the inferior parietal lobule, temporo-occipital junction, medial temporal area, and medial/lateral frontal lobe) and subcortical fibers (IFOF, ILF, MLF, AF/SLFII, III, and the cingulum bundle) responsible for generating hyperkinetic seizures.

DOI PubMed