EPILEPSY.

The scientific objective of the project is the clinical validation of electroencephalography-correlated functional MRI (EEG-fMRI) to enable the use of EEG-fMRI as a first-line, inexpensive, non-invasive clinical investigation tool in the presurgical evaluation of refractory partial epilepsy. Our scientific approach will be to develop a gold-standard image displaying the ictal onset zone, which we will use to validate EEG-fMRI. We will create a database, consisting of a prospective and consecutive series of patients with unifocal refractory partial epilepsy who underwent a full presurgical evaluation and who were rendered seizure free after surgery. The gold standard multimodal image for each patient will be created using all data of the presurgical evaluation, including ictal SPECT/SISCOM and postsurgical MRI. We will not only delineate the ictal onset zone on the gold-standard multimodal image, but also areas of seizure propagation and ictal hypoperfusion, which will improve our understanding and interpretation of EEG-fMRI findings. EEG-fMRI studies will be acquired. For the statistical analysis of the data, we will use reported methods, such as the general linear model to reveal Blood Oxygen Level Dependent (BOLD) signal changes linked to epileptic discharges identified on scalp EEG, and data-driven fMRI analysis that do not require an EEG derived model, such as Independent Component Analysis (ICA) and Parallel Factor Analysis (PARAFAC). The analysis of the EEG-fMRI data will result in a statistical parametric map with regions displaying statistically significant BOLD changes. To interpret this EEG-fMRI statistical parametric map, we will coregister it with the gold standard multimodal image. We will study, describe and interpret EEG-fMRI data as a function of the predefined regions in the gold-standard multimodal image. This study will enable us to formulate new evidence-based guidelines for the use of EEG-fMRI in epilepsy.

Trefwoorden:Epilepsy