AI Article Synopsis
- This study examines how well resting-state functional MRI (rsfMRI) metrics can localize the seizure onset zone (SOZ) in epilepsy patients compared to stereo-electroencephalography (SEEG).
- The researchers analyzed data from 19 patients, focusing on three rsfMRI metrics, particularly the amplitude of low-frequency fluctuations (ALFF), which showed a high spatial overlap with SEEG-defined SOZ in 73.7% of cases.
- The findings suggest that ALFF is a useful noninvasive tool for better localizing brain areas involved in seizures, potentially improving presurgical evaluations for patients with difficult-to-treat focal epilepsies.
Article Abstract
Objective: To examine the individual-patient-level localization value of resting-state functional MRI (rsfMRI) metrics for the seizure onset zone (SOZ) defined by stereo-electroencephalography (SEEG) in patients with medically intractable focal epilepsies.
Methods: We retrospectively included 19 patients who underwent SEEG implantation for epilepsy presurgical evaluation. Voxel-wise whole-brain analysis was performed on 3.0 T rsfMRI to generate clusters for amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo) and degree centrality (DC), which were co-registered with the SEEG-defined SOZ to evaluate their spatial overlap. Subgroup and correlation analyses were conducted for various clinical characteristics.
Results: ALFF demonstrated concordant clusters with SEEG-defined SOZ in 73.7% of patients, with 93.3% sensitivity and 77.8% PPV. The concordance rate showed no significant difference when subgrouped by lesional/non-lesional MRI, SOZ location, interictal epileptiform discharges on scalp EEG, pathology or seizure outcomes. No significant correlation was seen between ALFF concordance rate and epilepsy duration, seizure-onset age, seizure frequency or number of antiseizure medications. ReHo and DC did not achieve favorable concordance results (10.5% and 15.8%, respectively). All concordant clusters showed regional activation, representing increased neural activities.
Conclusion: ALFF had high concordance rate with SEEG-defined SOZ at individual-patient level.
Significance: ALFF activation on rsfMRI can add localizing information for the noninvasive presurgical workup of intractable focal epilepsies.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629929 | PMC |
| http://dx.doi.org/10.1016/j.clinph.2021.07.028 | DOI Listing |
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Article Synopsis
- This study examines how well resting-state functional MRI (rsfMRI) metrics can localize the seizure onset zone (SOZ) in epilepsy patients compared to stereo-electroencephalography (SEEG).
- The researchers analyzed data from 19 patients, focusing on three rsfMRI metrics, particularly the amplitude of low-frequency fluctuations (ALFF), which showed a high spatial overlap with SEEG-defined SOZ in 73.7% of cases.
- The findings suggest that ALFF is a useful noninvasive tool for better localizing brain areas involved in seizures, potentially improving presurgical evaluations for patients with difficult-to-treat focal epilepsies.
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