Groening Kristina, Brodbeck Verena, Moeller Friederike, Wolff Stephan, van Baalen Andreas, Michel Christoph M, Jansen Olav, Boor Rainer, Wiegand Gert, Stephani Ulrich, Siniatchkin Michael
Neuropaediatric Department, Christian-Albrechts-University, Kiel, Germany.
Neuroimage. 2009 Jul 1;46(3):827-33. doi: 10.1016/j.neuroimage.2009.02.026. Epub 2009 Mar 2.
Simultaneous recording of EEG and functional MRI (EEG-fMRI) is a promising tool that may be applied in patients with epilepsy to investigate haemodynamic changes associated with interictal epileptiform discharges (IED). As the yield of the EEG-fMRI technique in children with epilepsy is still unclear, the aim of this study was to evaluate whether the combination of EEG-fMRI and EEG source analysis could improve localization of epileptogenic foci in children. Six children with an unambiguous focus localization were selected based on the criterion of the consistency of ictal EEG, PET and ictal SPECT. IEDs were taken as time series for fMRI analysis and as averaged sweeps for the EEG source analysis based on the distributed linear local autoregressive average (LAURA) solution. In four patients, the brain area with haemodymanic changes corresponded to the epileptogenic zone. However, additional distant regions with haemodynamic response were observed. Source analysis located the source of the initial epileptic activity in all cases in the presumed epileptogenic zone and revealed propagation in five cases. In three cases there was a good correspondence between haemodynamic changes and source localization at both the beginning and the propagation of IED. In the remaining three cases, at least one area of haemodynamic changes corresponded to either the beginning or the propagation. In most children analysed, EEG-fMRI revealed extended haemodynamic response, which were difficult to interpret without an appropriate reference, i.e. a priori hypothesis about epileptogenic zone. EEG source analysis may help to differentiate brain areas with haemodynamic response.
同步记录脑电图和功能磁共振成像（EEG-fMRI）是一种很有前景的工具，可应用于癫痫患者，以研究与发作间期癫痫样放电（IED）相关的血流动力学变化。由于EEG-fMRI技术在癫痫儿童中的应用效果尚不清楚，本研究的目的是评估EEG-fMRI与脑电图源分析相结合是否能改善儿童癫痫病灶的定位。根据发作期脑电图、PET和发作期SPECT的一致性标准，选择了6例病灶定位明确的儿童。将IED作为功能磁共振成像分析的时间序列，并作为基于分布式线性局部自回归平均（LAURA）算法的脑电图源分析的平均扫描信号。在4例患者中，出现血流动力学变化的脑区与癫痫病灶区相对应。然而，还观察到了其他有血流动力学反应的远处区域。源分析在所有病例中均将初始癫痫活动的源头定位在假定的癫痫病灶区，并在5例中发现了传播现象。在3例患者中，IED开始和传播时的血流动力学变化与源定位之间有很好的对应关系。在其余3例中，至少有一个血流动力学变化区域与IED的开始或传播相对应。在大多数接受分析的儿童中，EEG-fMRI显示出广泛的血流动力学反应，若无适当的参考，即关于癫痫病灶区的先验假设，这些反应很难解释。脑电图源分析可能有助于区分有血流动力学反应的脑区。
