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首页> 外文期刊>NeuroImage >EEG-fMRI correlation patterns in the presurgical evaluation of focal epilepsy: A comparison with electrocorticographic data and surgical outcome measures
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EEG-fMRI correlation patterns in the presurgical evaluation of focal epilepsy: A comparison with electrocorticographic data and surgical outcome measures

机译：局灶性癫痫的术前评估中的EEG-fMRI相关模式：与脑电图数据和手术结果指标的比较

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EEG-correlated functional MRI (EEG-fMRI) visualizes brain regions associated with interictal epileptiform discharges (IEDs). This technique images the epileptiform network, including multifocal, superficial and deeply situated cortical areas. To understand the role of EEG-fMRI in presurgical evaluation, its results should be validated relative to a gold standard. For that purpose, EEG-fMRI data were acquired for a heterogeneous group of surgical candidates (n = 16) who were later implanted with subdural grids and strips (ECoG). The EEG-fMRI correlation patterns were systematically compared with brain areas involved in IEDs ECoG, using a semi-automatic analysis method, as well as to the seizure onset zone, resected area, and degree of seizure freedom. In each patient at least one of the EEG-fMRI areas was concordant with an interictally active ECoG area, always including the early onset area of IEDs in the ECoG data. This confirms that EEG-fMRI reflects a pattern of onset and propagation of epileptic activity. At group level, 76% of the BOLD regions that were covered with subdural grids, were concordant with interictally active ECoG electrodes. Due to limited spatial sampling, 51% of the BOLD regions were not covered with electrodes and could, therefore, not be validated. From an ECoG perspective it appeared that 29% of the interictally active ECoG regions were missed by EEG-fMRI and that 68% of the brain regions were correctly identified as inactive with EEG-fMRI. Furthermore, EEG-fMRI areas included the complete seizure onset zone in 83% and resected area in 93% of the data sets. No clear distinction was found between patients with a good or poor surgical outcome: in both patient groups, EEG-fMRI correlation patterns were found that were either focal or widespread. In conclusion, by comparison of EEG-fMRI with interictal invasive EEG over a relatively large patient population we were able to show that the EEG-fMRI correlation patterns are spatially accurate at the level of neurosurgical units (i.e. anatomical brain regions) and reflect the underlying network of IEDs. Therefore, we expect that EEG-fMRI can play an important role for the determination of the implantation strategy.
机译：脑电图相关的功能性MRI（EEG-fMRI）可视化与发作性癫痫样放电（IED）相关的大脑区域。该技术对癫痫样网络成像，包括多灶，浅表和深层皮层区域。为了了解脑电图功能磁共振成像在术前评估中的作用，应相对于金标准验证其结果。为了这个目的，获取了一组异种的手术候选者（n = 16）的EEG-fMRI数据，这些候选者随后植入了硬膜下网格和条带（ECoG）。使用半自动分析方法，将EEG-fMRI相关模式与IED ECoG所涉及的大脑区域进行系统比较，并与癫痫发作区，切除区域和癫痫发作自由度进行比较。在每位患者中，至少一个EEG-fMRI区域与一个活跃的ECoG区域一致，在ECoG数据中始终包括IED的早期发作区域。这证实了EEG-fMRI反映了癫痫活动的发作和传播方式。在组水平上，被硬膜下网格覆盖的BOLD区域的76％与充满刺激性的ECoG电极一致。由于有限的空间采样，BOLD区域的51％没有被电极覆盖，因此无法验证。从ECoG的角度看来，EEG-fMRI会漏掉29％的活跃的ECoG区域，而EEG-fMRI正确地将68％的大脑区域识别为无效。此外，EEG-fMRI区域包括83％的完全癫痫发作区和93％的切除区域。手术结果好与差的患者之间没有明确的区别：在两个患者组中，均发现脑电图与功能磁共振成像的相关性模式为局灶性或广泛性。总之，通过在相对较大的患者人群中比较EEG-fMRI与发作间期EEG，我们能够证明EEG-fMRI相关模式在神经外科单位（即大脑解剖区域）的水平上在空间上准确，并反映出潜在的简易爆炸装置网络。因此，我们期望EEG-fMRI可以在确定植入策略中发挥重要作用。

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