Sofia Markoula1, Umair J Chaudhary2, Suejen Perani3, Alessio De Ciantis4, Tinonkorn Yadee4, John S Duncan4, Beate Diehl3, Andrew W McEvoy3, Louis Lemieux4. 1. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; MRI Unit, Epilepsy Society, Chalfont St. Peter, Buckinghamshire, UK; Neurology Department, University Hospital of Ioannina, Ioannina, Greece. Electronic address: smarkoula@grads.uoi.gr. 2. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; MRI Unit, Epilepsy Society, Chalfont St. Peter, Buckinghamshire, UK; Department of Clinical Neuroscience, Western General Hospital, Edinburgh, UK. 3. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK. 4. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, UK; MRI Unit, Epilepsy Society, Chalfont St. Peter, Buckinghamshire, UK.
Abstract
PURPOSE: We set out to establish the clinical utility of EEG-correlated fMRI as part of the presurgical evaluation, by measuring prospectively its effects on the clinical decision. METHODS: Patients with refractory extra-temporal focal epilepsy, referred for presurgical evaluation were recruited in a period of 18 months. The EEG-fMRI based localization was presented during a multi-disciplinary meeting after the team had defined the presumed RESULTS: Sixteen patients (six women), with a median age of 28 years, were recruited. Interpretable EEG-fMRI results were available in 13: interictal epileptic discharges (IEDs) were recorded in eleven patients and seizures were recorded in two patients. In three patients, no epileptic activity was captured during EEG-fMRI acquisition and in two of those an IED topographic map correlation was performed (between EEG recorded inside the scanner and long-term video EEG monitoring). EEG-fMRI results presentation had no impact on the initial clinical decision in three patients (23%) of the thirteen and resulted in a modification of the initial surgical plan in ten patients (77%) of the thirteen finally presented in MDT; in eight patients the impact was on the planned placement of invasive electrodes and in two patients the EEG-fMRI led to additional non-invasive tests before proceeding further with surgery. CONCLUSION: The study is a prospective observational cohort study specifically designed to assess the impact of EEG-fMRI on the clinical decision making process, suggesting a significant influence of EEG-fMRI on epilepsy surgery planning.
PURPOSE: We set out to establish the clinical utility of EEG-correlated fMRI as part of the presurgical evaluation, by measuring prospectively its effects on the clinical decision. METHODS: Patients with refractory extra-temporal focal epilepsy, referred for presurgical evaluation were recruited in a period of 18 months. The EEG-fMRI based localization was presented during a multi-disciplinary meeting after the team had defined the presumed RESULTS: Sixteen patients (six women), with a median age of 28 years, were recruited. Interpretable EEG-fMRI results were available in 13: interictal epileptic discharges (IEDs) were recorded in eleven patients and seizures were recorded in two patients. In three patients, no epileptic activity was captured during EEG-fMRI acquisition and in two of those an IED topographic map correlation was performed (between EEG recorded inside the scanner and long-term video EEG monitoring). EEG-fMRI results presentation had no impact on the initial clinical decision in three patients (23%) of the thirteen and resulted in a modification of the initial surgical plan in ten patients (77%) of the thirteen finally presented in MDT; in eight patients the impact was on the planned placement of invasive electrodes and in two patients the EEG-fMRI led to additional non-invasive tests before proceeding further with surgery. CONCLUSION: The study is a prospective observational cohort study specifically designed to assess the impact of EEG-fMRI on the clinical decision making process, suggesting a significant influence of EEG-fMRI on epilepsy surgery planning.
Authors: Andreas Koupparis; Nicolás von Ellenrieder; Hui Ming Khoo; Natalja Zazubovits; Dang Khoa Nguyen; Jeffery A Hall; Roy W R Dudley; Francois Dubeau; Jean Gotman Journal: Neurology Date: 2021-08-16 Impact factor: 11.800
Authors: A E Vaudano; L Mirandola; F Talami; G Giovannini; G Monti; P Riguzzi; L Volpi; R Michelucci; F Bisulli; E Pasini; P Tinuper; L Di Vito; G Gessaroli; M Malagoli; G Pavesi; F Cardinale; L Tassi; L Lemieux; S Meletti Journal: Brain Topogr Date: 2021-06-21 Impact factor: 3.020
Authors: Umair J Chaudhary; Maria Centeno; David W Carmichael; Beate Diehl; Matthew C Walker; John S Duncan; Louis Lemieux Journal: Front Neurol Date: 2021-09-21 Impact factor: 4.086