Continuous EEG-fMRI in patients with partial epilepsy and focal interictal slow-wave discharges on EEG

Paolo Manganotti, Emanuela Formaggio, Anna Gasparini, Roberto Cerini, Luigi Giuseppe Bongiovanni, Silvia Francesca Storti, Roberto Pozzi Mucelli, Antonio Fiaschi, Mirko Avesani

Research output: Contribution to journalArticle

Abstract

Purpose: To verify whether in patients with partial epilepsy and routine electroenecephalogram (EEG) showing focal interictal slow-wave discharges without spikes combined EEG-functional magnetic resonance imaging (fMRI) would localize the corresponding epileptogenic focus, thus providing reliable information on the epileptic source. Methods: Eight patients with partial epileptic seizures whose routine scalp EEG recordings on presentation showed focal interictal slow-wave activity underwent EEG-fMRI. EEG data were continuously recorded for 24 min (four concatenated sessions) from 18 scalp electrodes, while fMRI scans were simultaneously acquired with a 1.5-Tesla magnetic resonance imaging (MRI) scanner. After recording sessions and MRI artefact removal, EEG data were analyzed offline. We compared blood oxygen level-dependent (BOLD) signal changes on fMRI with EEG recordings obtained at rest and during activation (with and without focal interictal slow-wave discharges). Results: In all patients, when the EEG tracing showed the onset of focal slow-wave discharges on a few lateralized electrodes, BOLD-fMRI activation in the corresponding brain area significantly increased. We detected significant concordance between focal EEG interictal slow-wave discharges and focal BOLD activation on fMRI. In patients with lesional epilepsy, the epileptogenic area corresponded to the sites of increased focal BOLD signal. Conclusions: Even in patients with partial epilepsy whose standard EEGs show focal interictal slow-wave discharges without spikes, EEG-fMRI can visualize related focal BOLD activation thus providing useful information for pre-surgical planning.

Original languageEnglish
Pages (from-to)1089-1100
Number of pages12
JournalMagnetic Resonance Imaging
Volume26
Issue number8
DOIs
Publication statusPublished - Oct 2008

Keywords

  • BOLD
  • Coregistration
  • EEG
  • fMRI
  • Partial seizures
  • Symptomatic epilepsy

ASJC Scopus subject areas

  • Biophysics
  • Clinical Biochemistry
  • Structural Biology
  • Radiology Nuclear Medicine and imaging
  • Condensed Matter Physics

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