EEG-triggered functional MRI of interictal epileptiform activity in patients with partial seizures
EEG-triggered functional MRI of interictal epileptiform activity in patients with partial seizures
复制标题
DOI：
10.1093/brain/122.9.1679
复制
发表时间：
1999-09-01
期刊：
影响因子：
14.5
通讯作者：
Fish, DR
中科院分区：
文献类型：
--
作者：
Krakow, K;Woermann, FG;Fish, DR
脑电图触发的功能性 MRI (fMRI) 提供了使用生物测量而不是仅仅依赖建模技术来定位头皮脑电图事件（例如发作间期癫痫样放电）的发生器的潜力。尽管最近的研究已经在少数患者中证明了这些可能性，但由于对患者安全的担忧、脉冲相关伪影模糊脑电图轨迹导致的严重问题以及缺乏可重复性数据，更广泛的应用受到限制。我们系统地研究并解决了患者安全和脉冲伪影的问题，现在报告了该技术在 10 名患有定位相关性癫痫和频繁发作间期癫痫样放电（尖峰或尖峰波）的连续患者的 24 次实验中的应用，每个患者至少进行两次实验，在每个实验中，在单个典型癫痫样后约 3.5 秒内获取 10 或 20 切片快照梯度回波平面图像放电（激活图像）和没有放电（控制图像）。每个实验中采样了 21 至 50 次癫痫样放电，使用 t 检验以 95% 的置信度逐个像素地测试功能激活的显着性。 10 名患者中的 6 名患者表现出血氧水平依赖性 (BOLD) 信号的可重复局灶性变化，该变化与并发 EEG 中癫痫样放电的最大值存在密切的空间关系。在其余 4 名患者中没有观察到可重复的局灶性 BOLD 信号变化。 总之，LEG 触发的 fMRI 现在是一种充分发展的技术，可以更广泛地应用于临床研究，证明它可以可重复地定位频繁发作间期放电的癫痫患者中参与产生棘波和棘波的大脑区域。
EEG-triggered functional MRI (fMRI) offers the potential to localize the generators of scalp EEG events, such as interictal epileptiform discharges, using a biological measurement as opposed to relying solely on modelling techniques. Although recent studies have demonstrated these possibilities in a small number of patients, wider application has been limited by concerns about patient safety, severe problems due to pulse-related artefact obscuring the EEG trace, and lack of reproducibility data. We have systematically studied and resolved the issues of patient safety and pulse artefact and now report the application of the technique in 24 experiments in 10 consecutive patients with localization-related epilepsy and frequent interictal epileptiform discharges (spikes or spike wave), At least two experiments were performed for each patient, In each experiment, 10- or 20-slice snapshot gradient-echo planar images were acquired similar to 3.5 s after a single typical epileptiform discharge (activation image) and in the absence of discharges (control image). Between 21 and 50 epileptiform discharges were sampled in each experiment, The significance of functional activation was tested using the t test at 95% confidence on a pixel-by-pixel basis, Six of the 10 patients showed reproducible focal changes of the blood oxygen level-dependent (BOLD) signal, which occurred in close spatial relationship to the maximum of the epileptiform discharges in the concurrent EEG. No reproducible focal BOLD signal changes were observed in the remaining four patients, In conclusion, LEG-triggered fMRI is now a sufficiently developed technique to be more widely used in clinical studies, demonstrating that it can reproducibly localize the brain areas involved in the generation of spikes and spike wave in epilepsy patients with frequent interictal discharges.