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EEG/fMRI study of ictal and interictal epileptic activity: methodological issues and future perspectives in clinical practice.
Epilepsia. 2006; 47 Suppl 5:52-8.E

Abstract

PURPOSE

Electroencephalography/functional magnetic resonance imaging (EEG/fMRI) has been proposed recently as a tool to study electrophysiological activity and, consequently, detect brain regions activated during epileptiform EEG abnormalities. The purpose of the study was to review our two-year experience with studying ictal and interictal activities in patients with epilepsy.

METHODS

Using EEG/fMRI, we studied hemodynamic changes associated with ictal and interictal EEG abnormalities in 43 patients with partial (31 cases) or generalized (12 cases) epilepsy. Using two different paradigms (block design and event-related design), we studied several forms of EEG activity consisting of (i) interictal abnormalities constantly elicitable by specific stimulation (8 cases); (ii) focal and generalized interictal activity, such as focal spikes or typical and atypical generalized spike-and-wave discharges (18 cases); and (iii) focal and generalized ictal electro-clinical activity, such as tonic seizures or pseudo-absences in frontal lobe epilepsy, typical absences in idiopathic generalized epilepsy, complex partial seizures in temporal lobe epilepsy, and perisylvian seizures in special syndromes (17 patients).

RESULTS

EEG/fMRI revealed clear hemodynamic changes related to EEG abnormalities in 21 patients. In 18 of these patients, the changes were highly concordant with electro-clinical findings. In the remaining 22 patients, fMRI analysis data failed to show activation or deactivation clusters, probably owing either to lack or inadequate amount of temporal distribution of abnormal EEG activity, or to intrinsic methodological problems.

CONCLUSIONS

By defining the electro-clinical and hemodynamic correlates of EEG activity, fMRI may shed light on the neurophysiological mechanisms underlying epileptic phenomena. However, as several methodological issues have yet to be addressed, further studies are warranted to assess the reliability and usefulness of EEG/fMRI in clinical practice.

Authors+Show Affiliations

Department of Neurological Sciences, University of Rome, La Sapienza, Rome, Italy. c_dibonaventura@yahoo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17239107

Citation

Di Bonaventura, Carlo, et al. "EEG/fMRI Study of Ictal and Interictal Epileptic Activity: Methodological Issues and Future Perspectives in Clinical Practice." Epilepsia, vol. 47 Suppl 5, 2006, pp. 52-8.
Di Bonaventura C, Vaudano AE, Carnì M, et al. EEG/fMRI study of ictal and interictal epileptic activity: methodological issues and future perspectives in clinical practice. Epilepsia. 2006;47 Suppl 5:52-8.
Di Bonaventura, C., Vaudano, A. E., Carnì, M., Pantano, P., Nucciarelli, V., Garreffa, G., Maraviglia, B., Prencipe, M., Bozzao, L., Manfredi, M., & Giallonardo, A. T. (2006). EEG/fMRI study of ictal and interictal epileptic activity: methodological issues and future perspectives in clinical practice. Epilepsia, 47 Suppl 5, 52-8.
Di Bonaventura C, et al. EEG/fMRI Study of Ictal and Interictal Epileptic Activity: Methodological Issues and Future Perspectives in Clinical Practice. Epilepsia. 2006;47 Suppl 5:52-8. PubMed PMID: 17239107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EEG/fMRI study of ictal and interictal epileptic activity: methodological issues and future perspectives in clinical practice. AU - Di Bonaventura,Carlo, AU - Vaudano,Anna E, AU - Carnì,Marco, AU - Pantano,Patrizia, AU - Nucciarelli,Valter, AU - Garreffa,Girolamo, AU - Maraviglia,Bruno, AU - Prencipe,Massimiliano, AU - Bozzao,Luigi, AU - Manfredi,Mario, AU - Giallonardo,Anna T, PY - 2007/1/24/pubmed PY - 2007/6/15/medline PY - 2007/1/24/entrez SP - 52 EP - 8 JF - Epilepsia JO - Epilepsia VL - 47 Suppl 5 N2 - PURPOSE: Electroencephalography/functional magnetic resonance imaging (EEG/fMRI) has been proposed recently as a tool to study electrophysiological activity and, consequently, detect brain regions activated during epileptiform EEG abnormalities. The purpose of the study was to review our two-year experience with studying ictal and interictal activities in patients with epilepsy. METHODS: Using EEG/fMRI, we studied hemodynamic changes associated with ictal and interictal EEG abnormalities in 43 patients with partial (31 cases) or generalized (12 cases) epilepsy. Using two different paradigms (block design and event-related design), we studied several forms of EEG activity consisting of (i) interictal abnormalities constantly elicitable by specific stimulation (8 cases); (ii) focal and generalized interictal activity, such as focal spikes or typical and atypical generalized spike-and-wave discharges (18 cases); and (iii) focal and generalized ictal electro-clinical activity, such as tonic seizures or pseudo-absences in frontal lobe epilepsy, typical absences in idiopathic generalized epilepsy, complex partial seizures in temporal lobe epilepsy, and perisylvian seizures in special syndromes (17 patients). RESULTS: EEG/fMRI revealed clear hemodynamic changes related to EEG abnormalities in 21 patients. In 18 of these patients, the changes were highly concordant with electro-clinical findings. In the remaining 22 patients, fMRI analysis data failed to show activation or deactivation clusters, probably owing either to lack or inadequate amount of temporal distribution of abnormal EEG activity, or to intrinsic methodological problems. CONCLUSIONS: By defining the electro-clinical and hemodynamic correlates of EEG activity, fMRI may shed light on the neurophysiological mechanisms underlying epileptic phenomena. However, as several methodological issues have yet to be addressed, further studies are warranted to assess the reliability and usefulness of EEG/fMRI in clinical practice. SN - 0013-9580 UR - https://www.unboundmedicine.com/medline/citation/17239107/EEG/fMRI_study_of_ictal_and_interictal_epileptic_activity:_methodological_issues_and_future_perspectives_in_clinical_practice_ L2 - https://doi.org/10.1111/j.1528-1167.2006.00878.x DB - PRIME DP - Unbound Medicine ER -