|Hiroshi Shigeto||Last modified date：2022.11.09|
Professor / Medical technology / Department of Health Sciences / Faculty of Medical Sciences
|1.||Language related brain region～From an epileptologist’s point of view
Study of the localization of brain language areas started with findings obtained from patients with brain injury, however functional localization studies in epileptology began with findings on brain functional mapping using cortical electrical stimulation during brain surgery. Knowledge of language area identification and knowledge of language sequelae due to brain resection is essential for those engaged in epilepsy surgery. In recent years, many non-invasive examination and analysis methods have been developed, and it has become possible to carry out measurements on not only pathological brains such as epilepsy and cerebrovascular disease but also normal brains. In this educational lecture, I will introduce the language areas related to epilepsy treatment and actual brain functional mapping. In addition, recent findings on the language areas that are becoming clear by use of various examinations and analysis methods will be discussed, that is, the language areas related to vision, the language areas related to hearing, and the white matter tracts that connect cortical language areas. These language areas will be discussed together with some cases..
|2.||EEG and long-term video EEG as clinical tools and research topics in the field of neurology.|
|3.||Toshiki Okadome, MD, 1 Taira Uehara, MD, PhD, 2 Takahiko Mukaino, MD, 1 Jun Yokoyama, MD, 1 Nobutaka Mukae, MD, PhD, 3 Hiroshi Shigeto, MD, 4 Jun-ichi Kira, Interictal epileptic discharges affect functional brain networks: Co-activation pattern analysis of intracranial EEG, 13th Asia Oceania Epilepsy Conference, 2021.06.|
|4.||Hiroshi Shigeto, How to choose AED in newly diagnosed epilepsy, 13th Asia Oceania Epilepsy Conference, 2021.06.|
|5.||Mukaino T, Uehara T1, Yokoyama J, Okadome T, Sakata A, Arakawa T, Yokoyama S, Akamatsu 6, Shigeto H, Kira J-I, Time-dependent functional specialization of hippocampal subfields detected by MRI in patients with temporal lobe epilepsy, American Epilepsy Society Annual Meeting 2019, 2019.12.|
|6.||Hideaki Tanaka, MD; Hiroshi Shigeto, MD, PhD; Shinji Ohara, MD, PhD; Toshio Matsushima, MD, PhD; Tooru Inoue, MD, PhD; Naoki Akamatsu, MD, PhD, Predictors of postsurgical seizure relapse and post-relapse after surgery of temporal lobe epilepsy in the era of new antiepileptic drugs, 33rd International Epilepsy Congress, 2019.06, [URL], Objective:
To assess prognostic factors predicting seizure recurrence after resective surgery for temporal lobe epilepsy patients who had chance to use new antiepileptic drugs (AEDs).
We retrospectively investigated surgical outcomes in patients with neocortical or medial temporal lobe epilepsy who underwent temporal lobe resection between May 2014 and June 2017, and were observed for a minimum of one and half year after the surgery. To identify independent predictors for seizure relapse, we first used the univariate analysis (gender, seizure-onset age, using preoperative AEDs treatment, surgical side, pathology, etc.) to find significance differences and then used Cox’s proportional hazards analyses for multivariate analysis using results of univariate analyses.
A total of 41 consecutive patients were included in this study. Estimated epileptogenic zone in neocortex, existence of inter-ictal epileptiform discharges after operation, and duration of disease before surgery were significantly associated with seizure relapse, whereas preoperative treatment of new AEDs did not change the outcome: (1) Neocortical temporal lobe epilepsy compared to medial temporal lobe epilepsy (hazard ratio [HR] 0.363, 95% confidence interval [CI] 0.162-0.809; p=0.013), (2) Postoperative inter-ictal epileptiform discharges on EEG (HR 0.475, 95% CI 0.240-0.939, p=0.032), (3) Shorter duration of disease (HR 0.965, 95% CI 0.942-0.990, p=0.005).
Our study disclosed that the patients with estimated epileptogenic zone in neocortex, postoperative inter-ictal epileptiform discharges, and shorter duration of disease before surgery are more likely to experience seizure recurrence postoperatively. Our results may be useful for selecting candidates for resective surgery in patients with temporal lobe epilepsy..
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