Resting-State Functional MRI/PET Profile as a Potential Alternative to Tri-Modality EEG-MR/PET Imaging: An Exploratory Study in Drug-Refractory Epilepsy

Abstract Objective  The study explores whether the epileptic networks associate with predetermined seizure onset zone (SOZ) identified from other modalities such as electroencephalogram/video electroencephalogram/structural MRI (EEG/VEEG/sMRI) and with the degree of resting-state functional MRI/posi...

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Veröffentlicht in:Asian journal of neurosurgery 2023-03, Vol.18 (1), p.053-061
Hauptverfasser: Mangalore, Sandhya, Peer, Sameer, Khokhar, Sunil Kumar, Bharath, Rose Dawn, Kulanthaivelu, Karthik, Saini, Jitender, Sinha, Sanjib, Kishore, Vyasaraj Kalya, Mundlamuri, Ravindranadh Chowdary, Asranna, Ajay, Lakshminarayanapuram Gopal, Vishwanath, Kenchaiah, Raghavendra, Arimappamagan, Arivazhagan, Sadashiva, Nishanth, Rao, Malla Bhaskara, Mahadevan, Anita, Rajeswaran, Jamuna, Kumar, Keshav, Thennarasu, Kandavel
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Sprache:eng
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Zusammenfassung:Abstract Objective  The study explores whether the epileptic networks associate with predetermined seizure onset zone (SOZ) identified from other modalities such as electroencephalogram/video electroencephalogram/structural MRI (EEG/VEEG/sMRI) and with the degree of resting-state functional MRI/positron emission tomography (RS-fMRI/PET) coupling. Here, we have analyzed the subgroup of patients who reported having a seizure on the day of scan as postictal cases and compared the findings with interictal cases (seizure-free interval). Methods  We performed independent component analysis (ICA) on RS-fMRI and 20 ICA were hand-labeled as large scale, noise, downstream, and epilepsy networks (Epinets) based on their profile in spatial, time series, and power spectrum domains. We had a total of 43 cases, with 4 cases in the postictal group (100%). Of 39 cases, 14 cases did not yield any Epinet and 25 cases (61%) were analyzed for the final study. The analysis was done patient-wise and correlated with predetermined SOZ. Results  The yield of finding Epinets on RS-fMRI is more during the postictal period than in the interictal period, although PET and RS-fMRI spatial, time series, and power spectral patterns were similar in both these subgroups. Overlaps between large-scale and downstream networks were noted, indicating that epilepsy propagation can involve large-scale cognition networks. Lateralization to SOZ was noted as blood oxygen level–dependent activation and correlated with sMRI/PET findings. Postoperative surgical failure cases showed residual Epinet profile. Conclusion  RS-fMRI may be a viable option for trimodality imaging to obtain simultaneous physiological information at the functional network and metabolic level.
ISSN:1793-5482
2248-9614
DOI:10.1055/s-0043-1760852