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Dive into the research topics where Ioana Mindruta is active.

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Featured researches published by Ioana Mindruta.


Stereotactic and Functional Neurosurgery | 2014

A personalized stereotactic fixture for implantation of depth electrodes in stereoelectroencephalography.

Bogdan Balanescu; Ronald Franklin; Jean Ciurea; Ioana Mindruta; Alin Rasina; Razvan C. Bobulescu; Cristian Donos; Andrei Barborica

Background: The stereoelectroencephalographic (SEEG) implantation procedures still represent a challenge due to the intrinsic complexity of the method and the number of depth electrodes required. Objectives: We aim at designing and evaluating the accuracy of a custom stereotactic fixture based on the StarFix™ technology (FHC Inc., Bowdoin, ME) that significantly simplifies and optimizes the implantation of depth electrodes used in presurgical evaluation of patients with drug-resistant epilepsy. Methods: Fiducial markers that also serve as anchors for the fixture are implanted into the patients skull prior to surgery. A 3D fixture model is designed within the surgical planning software, with the planned trajectories incorporated in its design, aligned with the patients anatomy. The stereotactic fixture is built using 3D laser sintering technology based on the computer-generated model. Bilateral rectangular grids of guide holes orthogonal to the midsagittal plane and centered on the midcommissural point are incorporated in the fixture design, allowing a wide selection of orthogonal trajectories. Up to two additional grids can be accommodated for targeting structures where oblique trajectories are required. The frame has no adjustable parts, this feature reducing the risk of inaccurate coordinate settings while simultaneously reducing procedure time significantly. Results: We have used the fixture for the implantation of depth electrodes for presurgical evaluation of 4 patients with drug-resistant focal epilepsy, with nearly 2-fold reduction in the duration of the implantation procedure. We have obtained a high accuracy with a submillimetric mean positioning error of 0.68 mm for the anchor bolts placed at the trajectory entry point and 1.64 mm at target. Conclusions: The custom stereotactic fixture design greatly simplifies the planning procedure and significantly reduces the time in the operating room, while maintaining a high accuracy.


Seizure-european Journal of Epilepsy | 2013

Current status of epilepsy health care for adult patients from Central and Eastern European Union Countries—A survey of members of the Central Europe Epilepsy Experts Working Group

Joanna Jędrzejczak; Petr Marusic; Sulev Haldre; Beata Majkowska-Zwolińska; Veneta Bojinova-Tchamova; Ruta Mameniskiene; Ioana Mindruta; Igor M. Ravnik; Zoltán Szupera; Pavol Sykora; Aleksandrs Verzbickis; Jerzy Daniluk

PURPOSE The aim of this survey was to review and compare the current approaches to epilepsy management in central and eastern EU (CEEU) countries. METHOD The questionnaire was sent to ten invited experts from Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, and Slovenia. It focused on the treatment of adults. RESULTS The number of neurologists and epilepsy reference centers is highly variable in CEEU countries. None of the analyzed states has a formal specialization in epileptology. No universal state-approved criteria for reference centers exist in Czech Republic, Estonia, Hungary, Latvia, and Slovenia. Generally, the protocols for epilepsy treatment in CEEU countries, including drug-resistant epilepsy, are in accordance with international guidelines; however, most countries have their own national standards of care and some have local clinical guidelines. Also, the reimbursement systems for antiepileptic drugs in CEEU countries are highly variable. Seven countries have epilepsy surgery centers. The costs of epilepsy surgeries are fully reimbursed, procedures performed abroad may also be covered. The length of time spent on waiting lists for surgery following the completion of preoperative investigations varies from two weeks to three years. The fraction of patients who qualified and were operated on within 12 months ranges from 20% to 100%. CONCLUSION The lack of unified procedures pertaining to the evaluation and therapy of epilepsy is reflected by marked differences in access to treatment modalities for patients from CEEU countries.


Seizure-european Journal of Epilepsy | 2015

Diagnostic yield of five minutes compared to three minutes hyperventilation during electroencephalography

Laura Craciun; Edina Varga; Ioana Mindruta; Pirgit Meritam; Zoltán Horváth; Daniella Terney; Elena Gardella; Jørgen Alving; László Vécsei; Sándor Beniczky

PURPOSE To investigate whether hyperventilation (HV) for 5min increases the diagnostic yield of electroencephalography (EEG) compared to 3min HV. METHODS data were evaluated from 1084 consecutive patients, from three European centres, referred to EEG on suspicion of epilepsy. Seizures and interictal EEG abnormalities precipitated during the first 3min and during the last 2min of the HV period (totally 5min) were determined. RESULTS Eight hundred seventy-seven patients (81%) completed 5min HV. Seizures were precipitated during the first 3min of HV in 21 patients, and during the last 2min in four more patients. Interictal EEG abnormalities were precipitated in the first 3min of HV in 16 patients, and during the last 2min in 7 more patients. Psychogenic nonepileptic seizures occurred in eight patients during the first 3min of HV and in two more patients during the last 2min. No adverse events occurred during the last 2min of HV, but eight patients (1%) stopped HV during the last 2min because they were not able to hyperventilate further. CONCLUSION 16% of seizures and 30% of interictal EEG abnormalities triggered by HV occurred during the last 2min of HV, suggesting the clinical usefulness of prolonged hyperventilation for 5min. The vast majority of patients (99%) who are able to hyperventilate for 3min can complete 5min HV, without additional adverse events.


Clinical Neurophysiology | 2017

High frequency spectral changes induced by single-pulse electric stimulation: Comparison between physiologic and pathologic networks

Mihai Dragos Mălîia; Cristian Donos; Andrei Barborica; Ioana Mindruta; Irina Popa; Mirela Ene; Sándor Beniczky

OBJECTIVE To investigate functional coupling between brain networks using spectral changes induced by single-pulse electric stimulation (SPES). METHOD We analyzed 20 patients with focal epilepsy, implanted with depth electrodes. SPES was applied to each pair of adjacent contacts, and responses were recorded from all other contacts. The mean response amplitude value was quantified in three time-periods after stimulation (10-60, 60-255, 255-500ms) for three frequency-ranges (Gamma, Ripples, Fast-Ripples), and compared to baseline. A total of 30,755 responses were analyzed, taking into consideration three dichotomous pairs: stimulating in primary sensory areas (S1-V1) vs. outside them, to test the interaction in physiologic networks; stimulating in seizure onset zone (SOZ) vs. non-SOZ, to test pathologic interactions; recording in default mode network (DMN) vs. non-DMN. RESULTS Overall, we observed an early excitation (10-60ms) and a delayed inhibition (60-500ms). More specifically, in the delayed period, stimulation in S1-V1 produced a higher gamma-inhibition in the DMN, while stimulation in the SOZ induced a higher inhibition in the epilepsy-related higher frequencies (Ripples and Fast-Ripples). CONCLUSION Physiologic and pathologic interactions can be assessed using spectral changes induced by SPES. SIGNIFICANCE This is a promising method for connectivity studies in patients with drug-resistant focal epilepsy.


Acta Neurologica Scandinavica | 2014

How long shall we record electroencephalography

Laura Craciun; Elena Gardella; Jørgen Alving; Daniella Terney; Ioana Mindruta; Jana Zárubová; Sándor Beniczky

The duration of electroencephalography (EEG) recordings varies widely among laboratories. Although several recommendations had been published, there are no previous studies directly addressing this.


Turkish Neurosurgery | 2015

Presurgical Evaluation and Epilepsy Surgery in MRI Negative Resistant Epilepsy of Childhood with Good Outcome.

Dana Craiu; Andrei Barborica; C Motoescu; Cristian Donos; Jean Ciurea; Ioana Mindruta

Magnetic resonance imaging (MRI)-negative epilepsy may be successfully solved with a multidisciplinary approach using invasive recordings, image and signal analysis. The whole methodology used by the epilepsy surgery team is systematically described based on an resistant epilepsy case with all steps and rationale of choosing different investigation methods from surface electroencephalography (EEG) to invasive recordings. Due to negative MRI and non-concordant ictal surface EEG with clinical semiology, the patient was investigated with stereo- EEG (SEEG), aiming to delimitate epileptogenic and eloquent cerebral areas. Implantation strategy, seizures recordings, stimulation, resection planning using quantitative EEG analysis, and the surgery plan are presented. The patient has been seizure-free for 14 months so far, with improved behavior and daily life quality. Post-operative examination revealed focal cortical dysplasia type II B.


Epileptic Disorders | 2015

Successful epilepsy surgery in frontal lobe epilepsy with startle seizures: a SEEG study.

Ana Ciurea; Irina Popa; Mihai Dragos Maliia; Nagy Csilla-Johanna; Andrei Barborica; Cristian Donos; Jean Ciurea; Ioan Opris; Ioana Mindruta

Pre-surgical assessment and surgical management of frontal epilepsy with normal MRI is often challenging. We present a case of a 33-year-old, right-handed, educated male. During childhood, his seizures presented with mandibular myoclonus and no particular trigger. As a young adult, he developed seizures with a startle component, triggered by unexpected noises. During his ictal episodes, he felt fear and grimaced with sudden head flexion and tonic axial posturing. Similar seizures also occurred without startle. Neuropsychological assessment showed executive dysfunction and verbal memory deficit. The cerebral MRI was normal. Electro-clinical reasoning, investigations performed, the results obtained and follow-up are discussed in detail. [Published with video sequence].


Annals of Neurology | 2017

Stereoelectroencephalography and surgical outcome in polymicrogyria-related epilepsy: A multicentric study: SEEG and Epilepsy Surgery in PMG

Louis Maillard; Laura Tassi; Fabrice Bartolomei; Hélène Catenoix; François Dubeau; William Szurhaj; Philippe Kahane; Anca Nica; Petr Marusic; Ioana Mindruta; Francine Chassoux; Georgia Ramantani

We aimed to (1) assess the concordance between various polymicrogyria (PMG) types and the associated epileptogenic zone (EZ), as defined by stereoelectroencephalography (SEEG), and (2) determine the postsurgical seizure outcome in PMG‐related drug‐resistant epilepsy.


Archive | 2017

Connectomics in Patients with Temporal Lobe Epilepsy

Cristian Donos; Andrei Barborica; Ioana Mindruta; Mihai Dragos Maliia; Irina Popa; Jean Ciurea

The human brain is an amazingly complex structure whose functionality, including high-order cognitive functions, is determined by intricate connectivity patterns between tens of billions of neurons (Azevedo et al. 2009). The signaling between neurons is deceivingly simple, using binary-like electrical impulses, such that the multitude of brain functions, that are often performed concurrently, are the result of connectivity patterns across various spatial scales (Bullock et al. 1977; Budd and Kisvarday 2012), that implement a mixed sequential, parallel or hierarchical architecture. The brain regulates breathing and heart rate, collects and processes sensory information, and controls all the voluntary and involuntary movements and actions. While some of these functions are performed by well-defined areas of the brain (i.e. visual stimuli are processed solely by the primary visual cortex), some higher level functions (i.e. speech production, problem solving, music performance) can only be accomplished by various brain areas working together in a serial or, more likely, in a parallel or distributed design (Sigman and Dehaene 2008).


Clinical Neurophysiology | 2017

P241 Insula connectivity during wakefulness and sleep studied through single pulse electrical stimulation during seeg recordings

Anca Arbune; Ioana Mindruta; Mihai Dragos Maliia; Irina Popa; Cristian Donos; Sabina Ene; Jean Ciurea; Andrei Barborica

Objective We aim to study the connections of the posterior insula (pI) and anterior insula (aI) through cortico-cortical evoked potentials (CCEP) by single pulse electrical stimulation (SPES). Method We performed SPES stimulation protocol in a group of 8 refractory epilepsy patients presurgically explored with intracerebral depth electrodes, out of which 6 were operated on and are currently seizure-free. We selected the early responses (ER) obtained from contacts of 24 electrodes that were included in the anterior and posterior insula, when this structure was outside the seizure onset zone (SOZ). Responses were analyzed in terms of amplitude variations during wakefulness and sleep. Effective connectivity betweeen cortical was calculated based on the measured CCEPs. Results The ER amplitudes by SPES stimulation in the insula during wakefulness compared to sleep showed statistically significant ( p 0.05 ) differences in 6 patients. There are constant connections between aI and pI. We identified connectivity of the pI with language-related brain stuctures during wakefulness, and with the temporal mesial structures during sleep, possibly influenced by the SOZ. Right pI stimulation seems to elicit ampler reponses in the rolandic operculum and parietal structures during wakefulness, and in the primary motor and premotor cortex during sleep. Anterior insula has preferential connectivity with anterior cingulate gyrus during wakefulness and with the fusiform gyrus during sleep. Discussions Connectivity of the aI versus pI, as well as right versus left insula during wakefulness and sleep is different, partially supporting previous observations. Conclusion Sleep has been shown to alter the physiological connectivity of the insula. Further investigations are in progress to confirm these results. Significance These findings describe insular connectivity and variability during sleep, with possible implications in epilepsy surgery, sleep disorders understanding and language studies.

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Cristian Donos

University of Texas Health Science Center at Houston

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Irina Popa

Carol Davila University of Medicine and Pharmacy

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Cristian Donos

University of Texas Health Science Center at Houston

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Edouard Hirsch

University of Strasbourg

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François Dubeau

Montreal Neurological Institute and Hospital

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Petr Marusic

Charles University in Prague

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