Epileptogenic Tissue Localization using EEG-fMRI

使用 EEG-fMRI 定位致癫痫组织

• 批准号: 7074697
• 负责人: R Todd Constable
• 金额: $ 36.92万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7074697
• 关键词: bioimaging /biomedical imaging; brain circulation; brain electrical activity; clinical research; electroencephalography; epilepsy; functional magnetic resonance imaging; human subject; neurophysiology; oxygen consumption; patient oriented research; tissues

DESCRIPTION (provided by applicant): Each year a significant number of epilepsy patients present to the Yale Epilepsy Center with highly debilitating intractable epilepsy. When epilepsy is refractory to drug therapy, the best outcome occurs if the epileptogenic tissue is removed surgically. However, this approach to curing epilepsy is only effective if the epileptogenic tissue is limited in extent (focal) and identifiable. Many of these patients have no abnormalities visible on MR, PET, or SPECT scanning, or they have discordant findings across several measures, making localization of the epileptogenic tissue that generates the seizures difficult. This proposal is aimed at further developing and understanding combined electroencephalography and functional magnetic resonance imaging (EEG-fMRI). In this approach, EEG monitoring is performed during a functional MRI scanning session. A number of functional imaging approaches including, blood oxygenation level dependent (BOLD) contrast, cerebral blood flow (CBF), and cerebral metabolic rate of oxygen consumption (CMRO2)) will be investigated to identify local tissue regions that exhibit signal changes in synchrony with interictal epileptiform discharges (lEDs). The experiments are designed to improve our understanding of the relationship between MR measures of neuronal activity in the presence of epileptiform activity, and neuronal signatures of activity based on surface or depth recorded EEG. Characteristics of the measured response (peak integration, time-to-peak, amplitude, and duration) for specific tissues will be compared in an F-test with type of epilepsy and concordance with difference SPECT and intracranial recordings. In addition, the EEG-fMRI localization will be directly compared spatially, with the epileptogenic tissue localization obtained using difference SPECT imaging, and with the clinical gold standard of invasive recordings from intracranial implanted electrodes, and finally with surgical outcome. Little is currently known about the neurophysiological response to lEDs, the relationship between EEG and fMRI measures, nor of the relationship between this inter-ictal and ictal activity. The experiments proposed in this work will provide a better understanding of these issues at a basic neuroscience level, while also allowing validation through invasive monitoring. These developments will improve the efficacy of seizure localization, allow for more precise targeting of surgical interventions through better localization, and improve outcomes from surgery. A large epilepsy population exists that could benefit greatly from better mapping techniques and these techniques may ultimately replace invasive methods decreasing health care costs and morbidity.

描述（由申请人提供）：每年都有大量癫痫患者到耶鲁癫痫中心，具有高度衰弱的癫痫病。当癫痫对药物治疗难治时，如果通过手术去除癫痫组织，则会发生最佳结果。但是，这种治疗癫痫的方法只有在癫痫组织的程度有限（局灶性）且可识别的情况下才有效。这些患者中的许多患者在MR，PET或SPECT扫描上没有可见的异常，或者在几种措施中都有不一致的发现，从而使癫痫组织的定位变得难以产生癫痫发作。该建议旨在进一步发展和理解脑电图和功能磁共振成像（EEG-FMRI）。在这种方法中，在功能性MRI扫描过程中进行了脑电图监测。将研究许多功能成像方法，包括血液氧合水平依赖性（BOLD）对比度，脑血流（CBF）和脑消耗的脑代谢率（CMRO2），以识别局部组织区域，这些局部组织区域与伴有互动性高透明样均匀排放的同步变化（LED LED）。该实验旨在提高我们对存在癫痫病活性的神经元活性MR测量的理解，以及基于记录的脑电图表面或深度的活动的神经元特征。在F检验中，将与癫痫类型和与差异SPECT和颅内记录的差异类型进行比较，将比较特定组织的测量响应（峰值整合，峰值，振幅和持续时间）的特征。此外，EEG-FMRI定位将直接与空间进行比较，使用差异化成像的癫痫组织定位，以及颅内植入电极的侵入性记录的临床金标准，最后与外科手术结果。目前，关于对LED的神经生理反应，脑电图与功能磁共振成像措施之间的关系以及这种间歇性和发作活性之间的关系知之甚少。这项工作中提出的实验将在基本的神经科学水平上更好地了解这些问题，同时还可以通过侵入性监测进行验证。这些发展将提高癫痫发作定位的疗效，从而通过更好的定位来更精确地靶向手术干预措施，并改善手术结果。存在大量癫痫的人群，可以从更好的地图技术中受益匪浅，这些技术最终可能取代降低医疗保健成本和发病率的侵入性方法。