EEG–fMRI validation studies in comparison with icEEG: A review

Zhang, Jing; Liu, Weifang; Chen, Hui; Xia, Hong; Zhou, Zhen; Wang, Lei; Mei, Shanshan; Liu, Qingzhu; Li, Yunlin

doi:10.1016/j.ijpsycho.2012.01.021

Cited by 12 publications

(5 citation statements)

References 70 publications

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“…Surgery is potentially curative for refractory focal epilepsy [1]. Rigorous presurgical evaluation is required for the selection of surgical candidates and for identifying the epileptogenic zone (EZ), since the precise localization of the epileptic focus is a prerequisite for good surgical outcome [2,3].…”

Section: Introductionmentioning

confidence: 99%

The impact of mapping interictal discharges using EEG-fMRI on the epilepsy presurgical clinical decision making process: A prospective study

Markoula

Chaudhary

Perani

et al. 2018

Seizure

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Section: Introductionmentioning

confidence: 99%

The impact of mapping interictal discharges using EEG-fMRI on the epilepsy presurgical clinical decision making process: A prospective study

Markoula

Chaudhary

Perani

et al. 2018

Seizure

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“…In patients with focal epilepsy the significant clinical question is how the EEG-fMRI results can contribute to localize the SOZ, the brain region that is thought to be responsible for generating seizures. icEEGs are considered the gold standard for the validation of the EEG-fMRI studies ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Causality within the Epileptic Network: An EEG-fMRI Study Validated by Intracranial EEG

Vaudano

Avanzini

Tassi³

et al. 2013

Front. Neurol.

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Accurate localization of the Seizure Onset Zone (SOZ) is crucial in patients with drug-resistance focal epilepsy. EEG with fMRI recording (EEG-fMRI) has been proposed as a complementary non-invasive tool, which can give useful additional information in the pre-surgical work-up. However, fMRI maps related to interictal epileptiform activities (IED) often show multiple regions of signal change, or “networks,” rather than highly focal ones. Effective connectivity approaches like Dynamic Causal Modeling (DCM) applied to fMRI data potentially offers a framework to address which brain regions drives the generation of seizures and IED within an epileptic network. Here, we present a first attempt to validate DCM on EEG-fMRI data in one patient affected by frontal lobe epilepsy. Pre-surgical EEG-fMRI demonstrated two distinct clusters of blood oxygenation level dependent (BOLD) signal increases linked to IED, one located in the left frontal pole and the other in the ipsilateral dorso-lateral frontal cortex. DCM of the IED-related BOLD signal favored a model corresponding to the left dorso-lateral frontal cortex as driver of changes in the fronto-polar region. The validity of DCM was supported by: (a) the results of two different non-invasive analysis obtained on the same dataset: EEG source imaging (ESI), and “psycho-physiological interaction” analysis; (b) the failure of a first surgical intervention limited to the fronto-polar region; (c) the results of the intracranial EEG monitoring performed after the first surgical intervention confirming a SOZ located over the dorso-lateral frontal cortex. These results add evidence that EEG-fMRI together with advanced methods of BOLD signal analysis is a promising tool that can give relevant information within the epilepsy surgery diagnostic work-up.

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“…BOLD responses related to interictal epileptic discharges (IEDs) can be confined to the region generating the focal IEDs, but sometimes involve a widespread network . EEG/fMRI has shown good concordance with other noninvasive diagnostic tools, as well as iEEG findings . Bénar showed that near the region having BOLD responses, there was at least one “active” iEEG electrode contact.…”

mentioning

confidence: 99%

Electroencephalography/functional magnetic resonance imaging responses help predict surgical outcome in focal epilepsy

et al. 2013

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SUMMARYPurpose: Simultaneous electroencephalography/functional magnetic resonance imaging (EEG/fMRI) recording can noninvasively map in the whole brain the hemodynamic response following an interictal epileptic discharge. EEG/fMRI is gaining interest as a presurgical evaluation tool. This study aims to determine how hemodynamic responses related to epileptic activity can help predict surgical outcome in patients considered for epilepsy surgery. Methods: Thirty-five consecutive patients with focal epilepsy who had significant hemodynamic responses and eventually surgical resection, were studied. The statistical map of hemodynamic responses were generated and coregistered to postoperative anatomic imaging. Patients were classified into four groups defined by the relative relationship between the location of the maximum hemodynamic response and the resection: group 1, fully concordant; group 2, partially concordant; group 3, partially discordant; and group 4, fully discordant. These findings were correlated with surgical outcome with at least 12-month follow-up. Key Findings: Ten patients in group 1 had the maximum t value (t-max) inside the resection; nine in group 2 had the t-max outside but close to the resection and the cluster with t-max overlapped the resection; five in group 3 had the t-max remote from resection, but with another less significant cluster in the resection; and 11 in group 4 had no response in the resection. The degree of concordance correlated largely with surgical outcome: a good surgical outcome (Engel's class I) was found in 7 of 10 patients of group 1, 4 of 9 of group 2, 3 of 5 of group 3, and only 1 of 11 of group 4. These results indicate that the partially concordant and partially discordant groups are best considered as inconclusive. In contrast, in the fully concordant and fully discordant groups, the sensitivity, specificity, positive predictive value, and negative predictive value were high, 87.5%, 76.9%, 70%, and 90.9%, respectively. Significance: This study demonstrates that hemodynamic responses related to epileptic activity can help delineate the epileptogenic region. Full concordance between maximum response and surgical resection is indicative of seizure freedom, whereas a resection leaving the maximum response intact is likely to lead to a poor outcome. EEG/fMRI is noninvasive but is limited to patients in whom interictal epileptic discharges can be recorded during the 60-90 min scan.

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EEG–fMRI validation studies in comparison with icEEG: A review

Cited by 12 publications

References 70 publications

The impact of mapping interictal discharges using EEG-fMRI on the epilepsy presurgical clinical decision making process: A prospective study

The impact of mapping interictal discharges using EEG-fMRI on the epilepsy presurgical clinical decision making process: A prospective study

Causality within the Epileptic Network: An EEG-fMRI Study Validated by Intracranial EEG

Electroencephalography/functional magnetic resonance imaging responses help predict surgical outcome in focal epilepsy

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