Individual localization value of resting-state fMRI in epilepsy presurgical evaluation: A combined study with stereo-EEG.
Individual localization value of resting-state fMRI in epilepsy presurgical evaluation: A combined study with stereo-EEG.
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DOI：
10.1016/j.clinph.2021.07.028
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Wang ZI
中科院分区：
文献类型：
--
作者：
Tang Y;Choi JY;Alexopoulos A;Murakami H;Daifu-Kobayashi M;Zhou Q;Najm I;Jones SE;Wang ZI
探讨静息态功能MRI（rsfMRI）指标在难治性局灶性癫痫患者中对立体脑电图（SEEG）定义的癫痫发作区（SOZ）的个体患者水平定位价值。我们回顾性纳入了19名接受SEEG植入以进行癫痫术前评估的患者。在3.0T rsfMRI上进行全脑体素分析，以生成低频波动幅度（ALFF），区域均匀性（ReHo）和程度中心性（DC）的聚类，这些聚类与SEEG定义的SOZ共同配准，以评估它们的空间重叠。对不同临床特征进行亚组分析和相关分析。ALFF在73.7%的患者中表现出与SEEG定义的SOZ一致的簇，灵敏度为93.3%，PPV为77.8%。当按病灶/非病灶MRI、SOZ位置、头皮EEG上的发作间期癫痫样放电、病理或癫痫发作结局分组时，一致率无显著差异。ALFF一致率与癫痫持续时间、癫痫发作年龄、癫痫发作频率或抗癫痫药物数量之间无显著相关性。ReHo和DC未获得有利的一致性结果（分别为10.5%和15.8%）。所有一致的集群显示区域激活，代表增加神经活动。ALFF与SEEG定义的SOZ在个体患者水平上具有较高的一致率。rsfMRI上的ALFF激活可以为难治性局灶性癫痫的非侵入性术前检查增加定位信息。
To examine the individual-patient-level localization value of resting-state functional MRI (rsfMRI) metrics for the seizure onset zone (SOZ) defined by stereo-electroencephalography (SEEG) in patients with medically intractable focal epilepsies. We retrospectively included 19 patients who underwent SEEG implantation for epilepsy presurgical evaluation. Voxel-wise whole-brain analysis was performed on 3.0T rsfMRI to generate clusters for amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo) and degree centrality (DC), which were co-registered with the SEEG-defined SOZ to evaluate their spatial overlap. Subgroup and correlation analyses were conducted for different clinical characteristics. ALFF demonstrated concordant clusters with SEEG-defined SOZ in 73.7% of patients, with 93.3% sensitivity and 77.8% PPV. The concordance rate showed no significant difference when subgrouped by lesional/non-lesional MRI, SOZ location, interictal epileptiform discharges on scalp EEG, pathology or seizure outcomes. No significant correlation was seen between ALFF concordance rate and epilepsy duration, seizure-onset age, seizure frequency or number of antiseizure medications. ReHo and DC did not achieve favorable concordance results (10.5% and 15.8%, respectively). All concordant clusters showed regional activation, representing increased neural activities. ALFF had high concordance rate with SEEG-defined SOZ at individual-patient level. ALFF activation on rsfMRI can add localizing information for the noninvasive presurgical workup of intractable focal epilepsies.
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影响因子：
4.8
作者：
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