ADVANCING EPILEPSY TISSUE BANKING USING IMAGE FUSION AND INTRAOPERATIVE NEURONAVIGATION: A RESOURCE FOR THE FUTURE
Abstract number :
1.205
Submission category :
Year :
2003
Submission ID :
3973
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Edie E. Zusman, Valerie C. Coon, Jeff P. Gregg, Michael S.B. Edwards, Lillian Lee, Nicholas A. Scott Neurological Surgery, Sutter Neuroscience Institute, Sacramento, CA; Stanford University School of Medicine, Stanford, CA; Pathology, UC Davis School of M
Traditionally neurosurgeons have used neuronavigational technology and image fusion to improve the clinical safety and accuracy of surgical procedures. By coupling co-registered anatomic and functional images available intraoperatively with a precise tissue banking protocol, we use neuronavigation to optimize molecular study designs for basic neuroscience research in epilepsy.
Following attainment of informed consent, patients with medically refractory focal epilepsy underwent craniotomy utilizing neuronavigational guidance. Registrations were confirmed within 2 mm accuracy. Image-guided resection was performed based on EEG localization and imaging characteristics. Fused imaging data sets made anatomic and functional information available: MRI T1 +/- Gad, T2, EEG data from electrode localization, brain mapping, and MRS. For each tissue specimen obtained, the precise region of tissue collection was identified. This information was screen-saved and stored superimposed on the pre-operative images. Each specimen was divided evenly with one portion sent [ldquo]fresh[rdquo] to pathology for frozen section as appropriate and routine histopathologic studies. The other portion of each specimen was further subdivided into approximately 6mm portions and flash-frozen in N2(l) within 60 seconds following tissue removal. Specimens remain stored in a -70 Celsius freezer.
For each patient enrolled in the study, specimens were obtained from specifically identified brain regions based on MRI/MRS, functional, or microscopic characteristics. Intraoperative images confirming specimen localization were available for comparison with EEG and imaging data sets. Histopathologic and immunocytochemical analysis were available on most specimens. Gene expression profiling using GeneChip microarrays containing 22,000 genes was performed.
Preliminary analysis is underway to evaluate alterations in gene expression based on electrocorticography, imaging, and histologic characteristics of tissue resected during surgery for epilepsy. This rigorous tissue banking protocol reliably preserves RNA for gene expression profiling and may lead to an improved understanding of the molecular genetic basis for epilepsy. Directions for future research: To identify molecular genetic profiles which correlate with seizure activity as well as those which may be unique to epileptic circuits.
[Supported by: Bronte Epilepsy Research Foundation]