Bioimaging and Intervention in Localization-Related Epilepsy

描述(申请人提供)：脑的高分辨率结构、功能和光谱磁共振(MR)成像是研究癫痫的强大技术。影像引导手术切除已被证明是许多内科难治性癫痫的有效治疗方法。然而，在新皮质、双侧或其他弥漫性癫痫中，致痫区域的定位更加困难，而且由于涉及脑功能，通常不可能通过手术移除所有潜在的致痫组织。反应性神经刺激已经成为治疗癫痫的一种很有前途的辅助技术，也可以作为一种强有力的工具来询问大脑功能。我们正在进行一项磁共振成像研究项目，研究定位相关癫痫及其对两种干预措施的反应：手术切除和反应性神经刺激。主要挑战包括开发高场磁共振图像采集技术、改进对致痫区域及其周围组织的生化和功能特征的理解、改进神经刺激的建模以及将这种多模式信息整合到规划和治疗环境中。这些目标将在生物工程研究伙伴关系(BRP)中实现，方法是汇集六个学术合作伙伴和两个产业界合作伙伴，共同实施四个整合的生物工程开发和科学研究计划：1)先进的磁共振成像技术(结构、功能和光谱)，用于研究和治疗定位相关癫痫；2)开发图像分析策略，用于图像制导的规划、建模、干预和评估；3)多模式研究癫痫发作时的变化及其与电连接的关系，从颅内EEG信号看，以及4)根据切除和神经刺激治疗的反应，研究MR量化的脑功能和生化变化。这些研究项目旨在通过使用先进的集成磁共振成像来提高我们对定位相关癫痫患者的理解和治疗。

DESCRIPTION (provided by applicant): High resolution structural, functional and spectroscopic magnetic resonance (MR) imaging of the brain are powerful technologies for the study of epilepsy. Image-guided surgical resection has proven to be an effective treatment for many cases of medically intractable epilepsy. In neocortical, bilateral or otherwise diffuse epilepsy, however, localization of the epileptogenic region is more difficult and it is often impossible to surgically remove all of the potentially epileptogenic tissue due to its involvement in brain function. Responsive neurostimulation has emerged as a promising complementary technique for the treatment of epilepsy which can also serve as a powerful tool for interrogating brain function. We are pursuing a program of MR imaging research on the study of localization-related epilepsy and its response to two interventions: surgical resection and responsive neurostimulation. Key challenges include developing high field MR image acquisition technology, developing an improved understanding of the biochemical and functional signatures of the epileptogenic region and surrounding tissue, improved modeling of neurostimulation and the integration of this multimodal information into the planning and treatment environments. These goals will be achieved in this bioengineering research partnership (BRP) by bringing together six academic and two industrial partners to carry out four integrated programs of bioengineering development and scientific investigation: 1) advanced development of MR imaging technology (structural, functional, and spectroscopic) for the study and treatment of localization-related epilepsy, 2) development of image analysis strategies for image-guided planning, modeling, intervention, and evaluation, 3) multimodal investigation of alterations in the presence of epilepsy and their relationship to electrical connectivity as seen from intracranial EEG signals, and 4) investigation of functional and biochemical changes in the brain, as quantified by MR, in response to resection and neurostimulation therapy. These programs of research are designed to lead to improvement of our understanding and treatment of patients with localization-related epilepsy through the use of advanced integrated magnetic resonance imaging.