Zhang Clara Huishi, Lu Yunfeng, Brinkmann Benjamin, Welker Kirk, Worrell Gregory, He Bin
Department of Biomedical Engineering, University of Minnesota, USA.
Department of Neurology, Mayo Clinic, USA; Mayo Systems Electrophysiology Laboratory, Mayo Clinic, USA.
Clin Neurophysiol. 2015 Jan;126(1):27-38. doi: 10.1016/j.clinph.2014.04.011. Epub 2014 Apr 30.
The aim was to develop a method for the purpose of localizing epilepsy related hemodynamic foci for patients suffering intractable focal epilepsy using task-free fMRI alone.
We studied three groups of subjects: patients with intractable focal epilepsy, healthy volunteers performing motor tasks, and healthy volunteers in resting state. We performed spatial independent component analysis (ICA) on the fMRI alone data and developed a set of IC selection criteria to identify epilepsy related ICs. The method was then tested in the two healthy groups.
In seven out of the nine surgery patients, identified ICs were concordant with surgical resection. Our results were also consistent with presurgical evaluation of the remaining one patient without surgery and may explain why she was not suitable for resection treatment. In the motor task study of ten healthy subjects, our method revealed components with concordant spatial and temporal features as expected from the unilateral motor tasks. In the resting state study of seven healthy subjects, the method successfully rejected all components in four out of seven subjects as non-epilepsy related components.
These results suggest the lateralization and localization value of fMRI alone in presurgical evaluation for patients with intractable unilateral focal epilepsy.
The proposed method is noninvasive in nature and easy to implement. It has the potential to be incorporated in current presurgical workup for treating intractable focal epilepsy patients.
旨在开发一种仅使用静息态功能磁共振成像（fMRI）对难治性局灶性癫痫患者进行癫痫相关血流动力学病灶定位的方法。
我们研究了三组受试者：难治性局灶性癫痫患者、执行运动任务的健康志愿者以及静息状态下的健康志愿者。我们仅对fMRI数据进行空间独立成分分析（ICA），并制定了一套IC选择标准以识别与癫痫相关的IC。然后在两组健康受试者中对该方法进行测试。
在9例手术患者中的7例中，识别出的IC与手术切除结果一致。我们的结果也与其余1例未接受手术患者的术前评估结果一致，并且可以解释她为何不适合进行切除治疗。在对10名健康受试者的运动任务研究中，我们的方法揭示了与单侧运动任务预期相符的具有一致空间和时间特征的成分。在对7名健康受试者的静息状态研究中，该方法成功排除了7名受试者中4名受试者的所有非癫痫相关成分。
这些结果表明，仅fMRI在难治性单侧局灶性癫痫患者的术前评估中具有定位和定侧价值。
所提出的方法本质上是非侵入性的且易于实施。它有可能被纳入当前用于治疗难治性局灶性癫痫患者的术前检查中。
