title: Electroencephalographic inverse localization of brain activity in acute traumatic brain injury as a guide to surgery, monitoring and treatment.
abstract: OBJECTIVE
  To inverse-localize epileptiform cortical electrical activity recorded from severe traumatic brain injury (TBI) patients using electroencephalography (EEG).
  
  
  METHODS
  Three acute TBI cases were imaged using computed tomography (CT) and multimodal magnetic resonance imaging (MRI). Semi-automatic segmentation was performed to partition the complete TBI head into 25 distinct tissue types, including 6 tissue types accounting for pathology. Segmentations were employed to generate a finite element method model of the head, and EEG activity generators were modeled as dipolar currents distributed over the cortical surface.
  
  
  RESULTS
  We demonstrate anatomically faithful localization of EEG generators responsible for epileptiform discharges in severe TBI. By accounting for injury-related tissue conductivity changes, our work offers the most realistic implementation currently available for the inverse estimation of cortical activity in TBI.
  
  
  CONCLUSIONS
  Whereas standard localization techniques are available for electrical activity mapping in uninjured brains, they are rarely applied to acute TBI. Modern models of TBI-induced pathology can inform the localization of epileptogenic foci, improve surgical efficacy, contribute to the improvement of critical care monitoring and provide guidance for patient-tailored treatment. With approaches such as this, neurosurgeons and neurologists can study brain activity in acute TBI and obtain insights regarding injury effects upon brain metabolism and clinical outcome.
authors.affiliation: The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, USA.
authors.forename: Andrei
authors.initials: A
authors.lastname: Irimia
authors.forename: S-Y Matthew
authors.initials: SY
authors.lastname: Goh
authors.forename: Carinna M
authors.initials: CM
authors.lastname: Torgerson
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Stein
authors.forename: Micah C
authors.initials: MC
authors.lastname: Chambers
authors.forename: Paul M
authors.initials: PM
authors.lastname: Vespa
authors.forename: John D
authors.initials: JD
authors.lastname: Van Horn
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology* / Q000601:surgery*; D001931:Brain Mapping; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Electroencephalography; Epilepsy; Localization; Monitoring; Outcome; Traumatic brain injury