Identifying the structures involved in seizure generation using sequential analysis of ictal-fMRI data
Identifying the structures involved in seizure generation using sequential analysis of ictal-fMRI data
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DOI：
10.1016/j.neuroimage.2009.03.059
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发表时间：
2009-08-01
期刊：
影响因子：
5.7
通讯作者：
Boget, Teresa
中科院分区：
文献类型：
--
作者：
Donaire, Antonio;Bargallo, Nuria;Boget, Teresa
本研究的目的是调查癫痫发作引起的 BOLD 信号变化的序贯分析是否有助于术前识别耐药局灶性癫痫患者的癫痫发作部位。 方法：我们分析了 5 名局灶性难治性癫痫患者的 BOLD 原始数据，这些患者在 fMRI 期间经历了部分癫痫发作，作为术前评估的一部分。为了对癫痫发作引起的 BOLD 信号变化进行排序，每个癫痫发作时期被分为五个连续图像组（十秒块）。通过比较两组连续的五幅图像，从临床/脑电图癫痫发作前 120 秒开始连续计算 t 地图。每次比较之间的时间间隔为 2 秒。测定了沿癫痫发作时期的连续两组五幅图像之间 BOLD 信号的相对变化。结果与与 MRI (SISCOM) 和颅内 EEG（2 名患者）配准的减法发作 SPECT 的结果进行比较。结果：每位患者均记录到典型的癫痫发作。经过序贯分析后，在每位患者癫痫发作开始时一致发现了定位良好且具有统计显着性（t：7-14）的信号增加区域。该区域总是先于临床/电性癫痫发作几秒（6-52 秒）：与除一名患者外的所有患者的 SISCOM 结果一致：并且与接受侵入性脑电图记录的 2 名患者的颅内脑电图确定的发作区域重叠。完全切除信号增加的初始区域导致癫痫发作缓解。四分之三接受癫痫手术的患者仍然没有癫痫发作。结论：发作性功能磁共振成像数据的顺序分析可能有助于精确且非侵入性地描绘大脑内的发作发作区域；并提供对参与癫痫发作和传播的大脑基质的见解。 (C) 2009 Elsevier Inc. 保留所有权利。
The aim of this study was to investigate if sequential analysis of BOLD signal changes induced by seizures is useful for preoperative identification of the site of seizure onset in patients with pharmaco-resistant focal epilepsy.Method: We analyzed BOLD raw data from 5 patients with focal medically refractory epilepsy who experienced partial seizures during fMRI as part of a preoperative evaluation. To sequence the changes in BOLD signal seizure-induced, each seizure epoch was divided into groups of five consecutive images (ten-second blocks). t-maps were calculated continuously from 120 s before the onset of clinical/EEG seizure onwards by comparing two consecutive groups of five images. Time lag between each comparison was 2 s. Relative changes in BOLD signal between two consecutive groups of five images along the seizure epoch were determined.Results were compared with those Of Subtraction ictal SPECT coregistered with MRI (SISCOM) and intracranial EEG (2 patients). Results: A typical seizure was registered in each patient. After sequential analysis, a well-localized and statistically significant (t: 7-14) area of signal increase was consistently found at seizure initiation in each patient. This area invariably preceded the onset of clinical/electrical seizure by several seconds (6-52 s): was concordant with SISCOM results in all but one patient: and overlapped with the ictal onset zone determined by intracranial EEG in those 2 patients who underwent invasive-EEG recordings. Complete resection of this initial area of signal increase resulted in seizure remission. Three out of Four patients Who Underwent epilepsy surgery remained seizure-free.Conclusion: Sequential analysis of ictal-fMRI data may be Useful to precisely and non-invasively delineate the ictal onset zone within the brain; and provide insights into the cerebral substrates involved in the generation and propagation of seizures. (C) 2009 Elsevier Inc. All rights reserved.