Aghakhani Yahya, Beers Craig A, Pittman Daniel J, Gaxiola-Valdez Ismael, Goodyear Bradley G, Federico Paolo
Department of Clinical Neurosciences, University of Calgary.
Department of Clinical Neurosciences, University of Calgary ; Hotchkiss Brain Institute, University of Calgary, Canada ; Seaman Family MR Research Centre, University of Calgary, Canada.
Neuroimage Clin. 2015 Mar 7;7:755-63. doi: 10.1016/j.nicl.2015.03.002. eCollection 2015.
Simultaneous scalp EEG-fMRI can identify hemodynamic changes associated with the generation of interictal epileptiform discharges (IEDs), and it has the potential of becoming a standard, non-invasive technique for pre-surgical assessment of patients with medically intractable epilepsy. This study was designed to assess the BOLD response to focal IEDs recorded via simultaneous intracranial EEG-functional MRI (iEEG-fMRI).
Twelve consecutive patients undergoing intracranial video EEG monitoring were recruited for iEEG-fMRI studies at 3 T. Depth, subdural strip, or grid electrodes were implanted according to our standard clinical protocol. Subjects underwent 10-60 min of continuous iEEG-fMRI scanning. IEDs were marked, and the most statistically significant clusters of BOLD signal were identified (Z-score 2.3, p value < 0.05). We assessed the concordance between the locations of the BOLD response and the IED. Concordance was defined as a distance <1.0 cm between the IED and BOLD response location. Negative BOLD responses were not studied in this project.
Nine patients (7 females) with a mean age of 31 years (range 22-56) had 11 different types of IEDs during fMR scanning. The IEDs were divided based on the location of the active electrode contact into mesial temporal, lateral temporal, and extra-temporal. Seven (5 left) mesial temporal IED types were recorded in 5 patients (110-2092 IEDs per spike location). Six of these IEDs had concordant BOLD response in the ipsilateral mesial temporal structures, <1 cm from the most active contact. One of the two subjects with left lateral temporal IEDs had BOLD responses concordant with the location of the most active contact, as well other ipsilateral and contralateral sites. Notably, the remaining two subjects with extratemporal discharges showed no BOLD signal near the active electrode contact.
iEEG-fMRI is a feasible and low-risk method for assessment of hemodynamic changes of very focal IEDs that may not be recorded by scalp EEG. A high concordance rate between the location of the BOLD response and IEDs was seen for mesial temporal (6/7) IEDs. Significant BOLD activation was also seen in areas distant from the active electrode and these sites exhibited maximal BOLD activation in the majority of cases. This implies that iEEG-fMRI may further describe the areas involved in the generation of IEDs beyond the vicinity of the electrode(s).
同步头皮脑电图-功能磁共振成像（EEG-fMRI）能够识别与发作间期癫痫样放电（IEDs）产生相关的血流动力学变化，并且有潜力成为一种用于药物难治性癫痫患者术前评估的标准非侵入性技术。本研究旨在评估通过同步颅内脑电图-功能磁共振成像（iEEG-fMRI）记录的局灶性IEDs的血氧水平依赖（BOLD）反应。
连续招募12例接受颅内视频脑电图监测的患者进行3T场强的iEEG-fMRI研究。根据我们的标准临床方案植入深部、硬膜下条状或栅格电极。受试者接受10 - 60分钟的连续iEEG-fMRI扫描。标记IEDs，并识别出统计学上最显著的BOLD信号簇（Z分数2.3，p值<0.05）。我们评估了BOLD反应位置与IEDs之间的一致性。一致性定义为IED与BOLD反应位置之间的距离<1.0厘米。本项目未研究负性BOLD反应。
9例患者（7例女性），平均年龄31岁（范围22 - 56岁），在功能磁共振扫描期间出现11种不同类型的IEDs。根据活动电极触点的位置将IEDs分为内侧颞叶、外侧颞叶和颞叶外。在5例患者中记录到7种（5例左侧）内侧颞叶IED类型（每个尖峰位置有110 - 2092次IEDs）。其中6种IEDs在同侧内侧颞叶结构中有一致的BOLD反应，距离最活跃触点<1厘米。2例左侧外侧颞叶IEDs患者中的1例，其BOLD反应与最活跃触点的位置以及同侧和对侧其他部位一致。值得注意的是，其余2例颞叶外放电患者在活动电极触点附近未显示BOLD信号。
iEEG-fMRI是一种可行且低风险的方法，用于评估可能无法被头皮脑电图记录的非常局灶性IEDs的血流动力学变化。内侧颞叶（6/7）IEDs的BOLD反应位置与IEDs之间的一致性较高。在远离活动电极的区域也观察到显著的BOLD激活，并且在大多数情况下这些部位表现出最大的BOLD激活。这意味着iEEG-fMRI可能进一步描述电极附近以外参与IEDs产生的区域。
Zotero 插件