Burneo J G, Bartha R, Gati J, Parrent A, Steven D A
Epilepsy Program, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Robarts Research Institute, London, Ontario, Canada.
Clin Neurol Neurosurg. 2014 Jul;122:29-33. doi: 10.1016/j.clineuro.2014.03.020. Epub 2014 Mar 26.
Malformations of cortical development (MCD) are an increasingly recognized cause of medically intractable epilepsy. We assessed the role of fMRI in evaluating the motor and somatosensory cortices, as well as if there is possible reorganization of these vital areas in patients with polymicrogyria.
We included 2 patients with polymicrogyria and epilepsy. Somatosensory and motor cortices were assessed with a 4T fMRI. These findings were compared with direct cortical stimulation.
Localization of the sensorimotor cortices was adequately identified by fMRI. These vital areas did not reorganize outside the malformation of cortical development.
fMRI is a tool that can allow identification of these vital areas of the brain in a non-invasive manner.
Adequate localization of the sensorimotor cortices is important for optimal patient selection, surgical strategy, and to determine the maximal extent of the resection. The clinical implications for such understanding are not limited to it; these findings should help researchers understand more of the neurobiology of MCDs and even possibly clues to the mechanisms of epileptogenesis associated with such malformations.
皮质发育畸形（MCD）是药物难治性癫痫日益被认识到的病因。我们评估了功能磁共振成像（fMRI）在评估运动和躯体感觉皮层方面的作用，以及多小脑回患者这些重要区域是否存在可能的重组。
我们纳入了2例多小脑回伴癫痫患者。使用4T功能磁共振成像评估躯体感觉和运动皮层。将这些结果与直接皮质刺激进行比较。
功能磁共振成像能充分识别感觉运动皮层的定位。这些重要区域在皮质发育畸形之外未发生重组。
功能磁共振成像是一种能够以非侵入性方式识别大脑这些重要区域的工具。
感觉运动皮层的充分定位对于优化患者选择、手术策略以及确定切除的最大范围很重要。这种认识的临床意义不仅限于此；这些发现应有助于研究人员更多地了解皮质发育畸形的神经生物学，甚至可能为与此类畸形相关的癫痫发生机制提供线索。
