Mayo Clinic researchers have developed a new technique known as STATISCOM to identify seizure origins in the brain. The increased accuracy of STATISCOM over the SISCOM technique, used previously, improves surgical accuracy and increases probability of seizure freedom for patients with epilepsy. The new technique will be described in the January 2010 issue of Neurology.
Epilepsy is a disorder characterized by the occurrence of two or more seizures, and it affects more than 3 million Americans. “About 10 percent of patients with epilepsy have very frequent seizures that are not controlled by medication and adversely affect their quality of life,” says Elson So, M.D., a Mayo Clinic epileptologist and an author of this paper. “These patients should be evaluated for epilepsy surgery. In doing so, it is imperative that we can clearly and distinctively pinpoint seizure location in the brain. In many cases, the standard tests of MRI and EEG cannot do so.”
Mayo Clinic researchers had previously developed SISCOM, or subtraction ictal SPECT coregistered to MRI, as a tool for epilepsy surgery evaluation. In this method, a SPECT, or single-photon emission computerized tomography, scan taken during a seizure is compared with a resting scan. The differences in the two scans are mapped onto an MRI, highlighting the active seizure area(s). Mayo Clinic researchers understood that a limitation of SISCOM is that it does not account for the normal variation in blood flow in a patient’s brain from minute-to-minute. This led to the development of STATISCOM, or statistical ictal SPECT coregistered to MRI. STATISCOM adds the step of considering these normal ariations, and factors this into the subtraction process. The result is a more accurate identification of the active seizure area(s) in a patient’s brain.
“Every individual’s brain waves, blood flow and heart rate vary from minute to minute, even second to second,” says Dr. So. “By recognizing this with STATISCOM, we are able to show a result that is much more distinctive and clear with regard to seizure localization. In fact, the accuracy of the ‘hot spot’ within the temporal lobe is nearly three times better with STATISCOM than with SISCOM.”
In a Mayo Clinic study comparing SISCOM and STATISCOM, the ability of blinded reviewers to detect an abnormality with STATISCOM was two times better than their ability to detect the same abnormality with SISCOM.
“If we are able to pinpoint seizure location with STATISCOM, and if that finding corresponds with the patient’s MRI and EEG studies, the likelihood of that patient benefiting from surgery is about twice greater than if the seizures cannot be localized with these means,” says Dr. So. “Thus, STATISCOM is a powerful tool that will help us improve surgical accuracy and increase the probability of seizure freedom in our patients.”
Below is a link to an edited YouTube video with Dr. So.
? Statiscom availiblity.
Thank you for your question. Mayo is in the development stage of commercializing this technology. Is it not commercially available at this time.
I was wondering if a test like this would be worth having if I have already had invasive testing at John Hopkins? I’m always looking for something that could be better and since my seizures can not be operated on since that would affect my memory I’m hoping this is so much better that it could be something else I would want to do. Thanks for answering.
Candace – Here is a response from Dr. So:
“Thank you for your personal interest in our technique of STATISCOM. The limited information provided in your inquiry would suggest that the likelihood that STATISCOM would help you is small. However, you may wish to consult with your physicians about your inquiry, because they would know your medical condition better than we do. If your physicians should need to discuss with us about your condition, we will be available to consult with them. – E. So
Will Statiscom work if origin of seizures are never in the same place? Hunter is 17 and has had seizures since 5 months old partial brain seperation (2 years ago) did not help. Hunter has seizures everyday with loss of bladder control often. Any info. will be helpful.
Thanks,
Terri
Hi Terri – Here’s a response from Dr. Elson So:
Thank you for your interest in Statiscom. Statiscom could be useful if there is a fair probability that seizures are beginning from a focus or area of the brain. We would encourage you to discuss with Hunter’s doctor regarding the nature of Hunter’s seiziures, whether they are focal or generalized in onset. Your doctor would be able to help in deciding if Statiscom should be considered for Hunter. – E. So
If you are interested in requesting an appointment at Mayo Clinic, you can call 507-322-3555 for our Minnesota campus, 480-422-1646 for the Arizona campus or 904-494-6487 for the Florida campus.