QUANTITATIVE ICTAL FLOW CHANGES IN LOCALIZING EPILEPSY

描述（申请人摘要）：我们建议，扣押的网站 癫痫发作可以通过对发作和发作间期的新分析来成像 核医学断层灌注扫描。 的成像技术 这里提出的将产生支持假设的数据， 致痫区域在癫痫发作时表现出高灌注; 癫痫发作停止后短时间内，进入过度低灌注状态 短时间 我们认为，通过分析EEG与SPECT的差异， 图像，我们可以支持一个生理模型， 脑电活动和灌注之间的相关性。 通过 了解灌注变化的特点和附近的 控制致痫灶和控制癫痫发作后的注射时间 发病后，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，其中一项新的图像处理分析将 应用于60例癫痫患者。 这些患者将接受SPECT检查 在新的协议下进行成像，该协议定位致癫痫区域， 致力于描述灌注和突触之间的相关性， 活动 通过配准SPECT扫描并应用我们的建议， 处理算法、灌注改变的位置和大小（两者都 阳性和阴性）在癫痫发作时可以显示在 功能图像（差分图像）。 经过适当的标准化， SPECT扫描是一种定量测量局部脑血变化方法， 可以计算流量。 这些定量的功能差异图像是 叠加在由配准的MRI提供的解剖细节上。 小心 对积极和消极区域的这种定量描述的分析 癫痫发作期间的发作血流变化可能有助于准确定义 自发性癫痫发作和传播的区域。 在这个病人 研究将进行颅内深部电极植入和手术， 定位并切除癫痫发作区域。 在此范围内， 我们打算完成以下任务： 从注射时间不同的发作注射获得灌注图像， 癫痫发作后即刻至癫痫发作停止后5分钟。 更新我们的模型，灌注变化与突触活动相关， 根据这些测量结果进行检查。 创建一个时间模型 评价发作周围的灌注变化，以建立最佳成像 议定书

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.