Combined spike-related functional MRI and multiple source analysis in the non-invasive spike localization of benign rolandic epilepsy

被引:52
作者
Boor, R. [1 ]
Jacobs, J.
Hinzmann, A.
Bauermann, T.
Scherg, M.
Boor, S.
Vucurevic, G.
Pfleiderer, C.
Kutschke, G.
Stoeter, P.
机构
[1] Johannes Gutenberg Univ Mainz, Childrens Hosp, D-6500 Mainz, Germany
[2] Johannes Gutenberg Univ Mainz, Dept Neuroradiol, D-6500 Mainz, Germany
[3] Univ Heidelberg Hosp, Dept Neurol, Heidelberg, Germany
[4] No German Epilepsy Ctr Children & Adolescents, D-24223 Raisdorf, Germany
[5] Univ Hosp Child Neurol, Kiel, Germany
关键词
fMRI; EEG; BECTS; multiple source analysis; dipole localization;
D O I
10.1016/j.clinph.2006.11.272
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To localize the irritative zone in children by combined spike-related fMRI and EEG multiple source analysis (MSA) in children with benign rolandic epilepsy. Methods: Interictal spikes were averaged and localized using MSA, and source locations were displayed in the anatomical 3D-MRI in I I patients (5-12 yrs, median 10). Interictal spikes were additionally recorded during the fMRI acquisition (EEG-fMRI), and the fMRI sequences were correlated off-line with the EEG spikes. Results: MSA revealed an initial central dipole in all patients, including the face or hand area. A second dipolar source was mostly consistent with propagated activity. BOLD activations from EEG-fMRI, consistent with the locations of the initial dipoles, were found in four patients. We found additional large areas of BOLD activations in 3 of these subjects extending into the sylvian fissure and the insula. These were identified as propagated activity by MSA using the short time differences in the source waveforms. Conclusions: MSA provided reliable localization of the spike onset zone in all children with benign rotandic epilepsy. Using the combination of EEG-fMRI and MSA we were able to discriminate the spike onset zone from propagated epileptiform source activity, using the spatial resolution of the EEG-fMRI technique and the temporal resolution of the MSA. However, the sensitivity of the EEG-fMRI technique was low and further improvements of the technique are warranted. Significance: This study shows that a combination of EEG-fMRI and MSA may be a powerful tool to describe the irritative zone of patients with idiopathic focal epilepsies. Clinical studies in patients with non-idiopathic focal epilepsies may clarify whether both techniques can be used as complementary clinical tools to localize the onset of interictal epileptic activity in focal epilepsies. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:901 / 909
页数:9
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