van Graan Louis André, Lemieux Louis, Chaudhary Umair Javaid
1 Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; 2 MRI Unit, Epilepsy Society, Chalfont St. Peter SL9 0RJ, UK.
Quant Imaging Med Surg. 2015 Apr;5(2):300-12. doi: 10.3978/j.issn.2223-4292.2015.02.04.
Brain activity data in general and more specifically in epilepsy can be represented as a matrix that includes measures of electrophysiology, anatomy and behaviour. Each of these sub-matrices has a complex interaction depending upon the brain state i.e., rest, cognition, seizures and interictal periods. This interaction presents significant challenges for interpretation but also potential for developing further insights into individual event types. Successful treatments in epilepsy hinge on unravelling these complexities, and also on the sensitivity and specificity of methods that characterize the nature and localization of underlying physiological and pathological networks. Limitations of pharmacological and surgical treatments call for refinement and elaboration of methods to improve our capability to localise the generators of seizure activity and our understanding of the neurobiology of epilepsy. Simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI), by potentially circumventing some of the limitations of EEG in terms of sensitivity, can allow the mapping of haemodynamic networks over the entire brain related to specific spontaneous and triggered epileptic events in humans, and thereby provide new localising information. In this work we review the published literature, and discuss the methods and utility of EEG-fMRI in localising the generators of epileptic activity. We draw on our experience and that of other groups, to summarise the spectrum of information provided by an increasing number of EEG-fMRI case-series, case studies and group studies in patients with epilepsy, for its potential role to elucidate epileptic generators and networks. We conclude that EEG-fMRI provides a multidimensional view that contributes valuable clinical information to localize the epileptic focus with potential important implications for the surgical treatment of some patients with drug-resistant epilepsy, and insights into the resting state and cognitive network dynamics.
一般而言，大脑活动数据，更具体地说是癫痫方面的大脑活动数据，可以表示为一个矩阵，其中包括电生理学、解剖学和行为学的测量指标。这些子矩阵中的每一个都存在复杂的相互作用，具体取决于大脑状态，即休息、认知、癫痫发作期和发作间期。这种相互作用给解释带来了重大挑战，但也为深入了解个体事件类型提供了潜力。癫痫的成功治疗取决于解开这些复杂性，还取决于表征潜在生理和病理网络的性质和定位的方法的敏感性和特异性。药物治疗和手术治疗的局限性要求改进和完善方法，以提高我们定位癫痫发作活动源的能力以及我们对癫痫神经生物学的理解。同步脑电图和功能磁共振成像（EEG-fMRI）通过潜在地规避脑电图在敏感性方面的一些局限性，可以绘制与人类特定自发和触发癫痫事件相关的全脑血流动力学网络，从而提供新的定位信息。在这项工作中，我们回顾了已发表的文献，并讨论了EEG-fMRI在定位癫痫活动源方面的方法和效用。我们借鉴我们自己以及其他研究团队的经验，总结越来越多的癫痫患者EEG-fMRI病例系列、病例研究和组群研究所提供的信息范围，以探讨其在阐明癫痫源和网络方面的潜在作用。我们得出结论，EEG-fMRI提供了一个多维视角，为定位癫痫病灶提供了有价值的临床信息，这对一些耐药性癫痫患者的手术治疗可能具有重要意义，同时也有助于深入了解静息状态和认知网络动力学。
