QUANTITATIVE ICTAL FLOW CHANGES IN LOCALIZING EPILEPSY

局限性癫痫发作时血流的定量变化

• 批准号: 2038512
• 负责人: GEORGE ZUBAL
• 金额: $ 37.4万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 2001-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2038512
• 关键词: brain circulation; brain disorder diagnosis; brain electrical activity; brain imaging /visualization /scanning; clinical research; electroencephalography; epilepsy; human subject; neuroanatomy; neurosurgery; perfusion; single photon emission computed tomography

DESCRIPTION (Applicant's Abstract): We propose that the site of seizure onset in epilepsy can be imaged by novel analysis of ictal and interictal nuclear medicine tomographic perfusion scans. The imaging techniques proposed here will yield data supporting the hypothesis that the epileptogenic region exhibits a hyperperfusion at seizure onset; and after a short time after seizure cessation, enters a state of excess hypoperfusion for a short time. WE believe that by analyzing EEG with SPECT difference images, we can support a physiological model which demonstrates the correlation between brain electrical activity and perfusion. By understanding the perfusion change characteristics at and near the epileptogenic region and by controlling the time of injection after seizure onset, we will be able to better localize seizure regions. This proposal outlines a prospective study in which a new image processing analysis will be applied to 60 epileptic patients. These patients will undergo SPECT imaging under a new protocol which localizes the epileptogenic region and strives to characterize the correlation between perfusion and synaptic activity. By registering the SPECT scans and applying our proposed processing algorithm, the location and size of perfusion alterations (both positive and negative) at the time of epileptic seizures can be shown in a functional image (difference-images). After appropriate normalization of the SPECT scan, a quantitative measure of change in regional brain blood flow can be calculated. These quantitative functional difference-images are superimposed on the anatomical detail provided by registered MRI. Careful analysis of this quantitative depiction of regions of positive and negative ictal blood flow changes during seizures may allow accurate definition of areas of spontaneous seizure onset and propagation. The patients in this study will undergo intracranial depth electrode implantation and surgery to localize and remove the area of seizure onset. Within the scope of this proposal we intend to accomplish the following tasks: Obtain perfusion images from ictal injection whose injection time vary from immediately after seizure onset to 5 minutes after seizure cessation. Update our model of perfusion changes correlated to synaptic activity during seizure based on these measurements. Create a model of the temporal evaluation of perfusion changes peri-ictally to establish an optimal imaging protocol.

描述(申请人摘要)：我们建议扣押的地点 发作期和发作间歇期的新分析可以对癫痫发作进行成像 核医学断层扫描灌注扫描。影像技术 这里提出的将产生数据支持这样的假设 致痫区域在癫痫发作时表现为高灌注区； 癫痫停止后短时间内，进入过度低灌流状态 一小段时间。我们认为，通过分析脑电信号与SPECT的差异 图像，我们可以支持一个生理模型，它演示了 脑电活动与脑血流灌注的相关性。通过 了解动脉及其附近的血流灌注变化特征 致痫部位及控制癫痫发作后注射时间的探讨 发作时，我们将能够更好地定位癫痫发作区域。这项建议 概述了一项前瞻性研究，其中一种新的图像处理分析将 适用于60例癫痫患者。这些患者将接受SPECT检查 根据一种新的方案进行成像，该方案定位致痫区域和 努力描述灌流和突触之间的相关性 活动。通过注册SPECT扫描并应用我们建议的 处理算法、灌注改变的位置和大小(两者 阳性和阴性)在癫痫发作时可在 功能图像(差值图像)。在适当归一化 SPECT扫描，一种定量测量局部脑血液变化的方法 流量是可以计算的。这些定量的功能差异图像是 叠加在注册MRI提供的解剖细节上。小心 分析这种对正负区域的定量刻画 癫痫发作期间的发作期血流变化可以准确地定义 自发性癫痫发作和传播的区域。这里面的病人 研究将接受颅内深部电极植入和手术 定位并移除癫痫发作的区域。在本文件的范围内 提案我们打算完成以下任务： 从注射时间不同的发作期注射获得灌注图像 发作后即刻至发作停止后5分钟。 更新我们的与突触活动相关的血流灌注变化模型 基于这些测量结果的癫痫发作。创建一个时态的模型 评估发作期血流灌注变化以建立最佳成像 协议。