Storti Silvia F, Del Felice Alessandra, Formaggio Emanuela, Boscolo Galazzo Ilaria, Bongiovanni Luigi G, Cerini Roberto, Fiaschi Antonio, Manganotti Paolo
Department of Neurological and Movement Sciences, Section of Neurology, University of Verona, Verona, Italy
Department of Neurological and Movement Sciences, Section of Neurology, University of Verona, Verona, Italy.
Clin EEG Neurosci. 2015 Jul;46(3):247-52. doi: 10.1177/1550059414523960. Epub 2014 Apr 17.
The combined use of electroencephalography (EEG) and functional magnetic resonance imaging (EEG-fMRI) in epilepsy allows the noninvasive hemodynamic characterization of epileptic discharge-related neuronal activations. The aim of this study was to investigate pathophysiologic mechanisms underlying epileptic activity by exploring the spatial and temporal distribution of fMRI signal modifications during seizure in a single patient with posttraumatic epilepsy. EEG and fMRI data were acquired during two scanning sessions: a spontaneous critical episode was observed during the first, and interictal events were recorded during the second. The EEG-fMRI data were analyzed using the general linear model (GLM). Blood oxygenation level-dependent (BOLD) localization derived from the preictal and artifact-free postictal phase was concordant with the BOLD localization of the interictal epileptiform discharges identified in the second session, pointing to a left perilesional mesiofrontal area. Of note, BOLD signal modifications were already visible several seconds before seizure onset. In brief, BOLD activations from the preictal, postictal, and interictal epileptiform discharge analysis appear to be concordant with the clinically driven localization hypothesis, whereas a widespread network of activations is detected during the ictal phase in a partial seizure.
脑电图（EEG）与功能磁共振成像（EEG-fMRI）联合用于癫痫研究，能够对癫痫放电相关的神经元激活进行无创血流动力学特征分析。本研究旨在通过探究一名创伤后癫痫患者发作期间功能磁共振成像（fMRI）信号改变的时空分布，来研究癫痫活动的病理生理机制。在两次扫描过程中采集了脑电图（EEG）和功能磁共振成像（fMRI）数据：第一次扫描时观察到一次自发的临界发作，第二次扫描记录了发作间期事件。使用一般线性模型（GLM）分析脑电图-功能磁共振成像（EEG-fMRI）数据。发作前和无伪迹发作后期的血氧水平依赖（BOLD）定位与第二次扫描中识别出的发作间期癫痫样放电的BOLD定位一致，指向左侧病变周围内侧额叶区域。值得注意的是，在发作开始前几秒就已经可以看到BOLD信号改变。简而言之，发作前、发作后和发作间期癫痫样放电分析的BOLD激活似乎与临床驱动的定位假设一致，而在部分性发作的发作期检测到广泛的激活网络。
