| Epileptic networks in focal cortical dysplasia revealed using electroencephalography-functional magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 22162063 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: Surgical treatment of focal epilepsy in patients with focal cortical dysplasia (FCD) is most successful if all epileptogenic tissue is resected. This may not be evident on structural magnetic resonance imaging (MRI), so intracranial electroencephalography (icEEG) is needed to delineate the seizure onset zone (SOZ). EEG-functional MRI (fMRI) can reveal interictal discharge (IED)-related hemodynamic changes in the irritative zone (IZ). We assessed the value of EEG-fMRI in patients with FCD-associated focal epilepsy by examining the relationship between IED-related hemodynamic changes, icEEG findings, and postoperative outcome. METHODS: Twenty-three patients with FCD-associated focal epilepsy undergoing presurgical evaluation including icEEG underwent simultaneous EEG-fMRI at 3T. IED-related hemodynamic changes were modeled, and results were overlaid on coregistered T1-weighted MRI scans fused with computed tomography scans showing the intracranial electrodes. IED-related hemodynamic changes were compared with the SOZ on icEEG and postoperative outcome at 1 year. RESULTS: Twelve of 23 patients had IEDs during recording, and 11 of 12 had significant IED-related hemodynamic changes. The fMRI results were concordant with the SOZ in 5 of 11 patients, all of whom had a solitary SOZ on icEEG. Four of 5 had >50% reduction in seizure frequency following resective surgery. The remaining 6 of 11 patients had widespread or discordant regions of IED-related fMRI signal change. Five of 6 had either a poor surgical outcome (<50% reduction in seizure frequency) or widespread SOZ precluding surgery. INTERPRETATION: Comparison of EEG-fMRI with icEEG suggests that EEG-fMRI may provide useful additional information about the SOZ in FCD. Widely distributed discordant regions of IED-related hemodynamic change appear to be associated with a widespread SOZ and poor postsurgical outcome. ANN NEUROL 2011. |
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Authors:
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Rachel Thornton; Serge Vulliemoz; Roman Rodionov; David W Carmichael; Umair J Chaudhary; Beate Diehl; Helmut Laufs; Christian Vollmar; Andrew W McEvoy; Matthew C Walker; Fabrice Bartolomei; Maxime Guye; Patrick Chauvel; John S Duncan; Louis Lemieux |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of neurology Volume: 70 ISSN: 1531-8249 ISO Abbreviation: Ann. Neurol. Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7707449 Medline TA: Ann Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 822-37 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American Neurological Association. |
Affiliation:
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Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, United Kingdom; Epilepsy Society Magnetic Resonance Imaging Unit, Chalfont St Peter, Buckinghamshire, United Kingdom. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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