Clinical benefit of presurgical EEG-fMRI in difficult-to-localize focal epilepsy : A single-institution retrospective review.

Journal article


Kowalczyk, Magdalena A., Omidvarnia, Amir, Abbott, David F., Tailby, Chris, Vaughan, David N. and Jackson, Graeme D.. (2019). Clinical benefit of presurgical EEG-fMRI in difficult-to-localize focal epilepsy : A single-institution retrospective review. Epilepsia. 61(1), pp. 49-60. https://doi.org/10.1111/epi.16399
AuthorsKowalczyk, Magdalena A., Omidvarnia, Amir, Abbott, David F., Tailby, Chris, Vaughan, David N. and Jackson, Graeme D.
Abstract

Objective
The aim of this report is to present our clinical experience of electroencephalography–functional magnetic resonance imaging (EEG-fMRI) in localizing the epileptogenic focus, and to evaluate the clinical impact and challenges associated with the use of EEG-fMRI in pharmacoresistant focal epilepsy.

Methods
We identified EEG-fMRI studies (n = 118) in people with focal epilepsy performed at our center from 2003 to 2018. Participants were referred from our Comprehensive Epilepsy Program in an exploratory research effort to address often difficult clinical questions, due to complex and difficult-to-localize epilepsy. We assessed the success of each study, the clinical utility of the result, and when surgery was performed, the postoperative outcome.

Results
Overall, 50% of EEG-fMRI studies were successful, meaning that data were of good quality and interictal epileptiform discharges were recorded. With an altered recruitment strategy since 2012 with increased inclusion of patients who were inpatients for video-EEG monitoring, we found that this patients in this selected group were more likely to have epileptic discharges detected during EEG-fMRI (96% of inpatients vs 29% of outpatients, P<.0001). To date, 48% (57 of 118) of patients have undergone epilepsy surgery. In 10 cases (17% of the 59 successful studies) the EEG-fMRI result had a “critical impact” on the surgical decision. These patients were difficult to localize because of subtle abnormalities, apparently normal MRI, or extensive structural abnormalities. All 10 had a good seizure outcome at 1 year after surgery (mean follow-up 6.5 years).

Significance
EEG-fMRI results can assist identification of the epileptogenic focus in otherwise difficult-to-localize cases of pharmacoresistant focal epilepsy. Surgery determined largely by localization from the EEG-fMRI result can lead to good seizure outcomes. A limitation of this study is its retrospective design with nonconsecutive recruitment. Prospective clinical trials with well-defined inclusion criteria are needed to determine the overall benefit of EEG-fMRI for preoperative localization and postoperative outcome in focal epilepsy.

KeywordsEEG; epilepsy surgery; fMRI; focal epilepsy
Year2019
JournalEpilepsia
Journal citation61 (1), pp. 49-60
PublisherWiley-Blackwell
ISSN0013-9580
Digital Object Identifier (DOI)https://doi.org/10.1111/epi.16399
Scopus EID2-s2.0-85076106670
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online02 Dec 2019
Publication process dates
Accepted06 Nov 2019
Deposited09 Jul 2021
Grant IDNHMRC/1060312
NHMRC/1091593
NHMRC/1081151
Permalink -

https://acuresearchbank.acu.edu.au/item/8w56z/clinical-benefit-of-presurgical-eeg-fmri-in-difficult-to-localize-focal-epilepsy-a-single-institution-retrospective-review

Restricted files

Publisher's version

  • 62
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence
Lorenzetti, Valentina, Gaillard, Alexandra, Beyer, Emillie, Kowalczyk, Magdalena, Kamboj, Sunjeev K., Manning, Victoria and Gleeson, John Francis Martin. (2023). Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence. BMC Psychiatry. 23(1), p. Article 407. https://doi.org/10.1186/s12888-023-04789-7
Structural network alterations in focal and generalized epilepsy assessed in a worldwide ENIGMA study follow axes of epilepsy risk gene expression
Larivière, Sara, Royer, Jessica, Rodríguez-Cruces, Raúl, Paquola, Casey, Caligiuri, Maria Eugenia, Gambardella, Antonio, Concha, Luis, Keller, Simon S., Cendes, Fernando, Yasuda, Clarissa L., Bonilha, Leonardo, Gleichgerrcht, Ezequiel, Focke, Niels K., Domin, Martin, von Podewills, Felix, Langner, Soenke, Rummel, Christian, Wiest, Roland, Martin, Pascal, ... Bernhardt, Boris C.. (2022). Structural network alterations in focal and generalized epilepsy assessed in a worldwide ENIGMA study follow axes of epilepsy risk gene expression. Nature Communications. 13(1), p. Article 4320. https://doi.org/10.1038/s41467-022-31730-5
Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy
Park, Bo-yong, Larivière, Sara, Rodríguez-Cruces, Raul, Royer, Jessica, Tavakol, Shahin, Wang, Yezhou, Caciagli, Lorenzo, Caligiuri, Maria Eugenia, Gambardella, Antonio, Concha, Luis, Keller, Simon S, Cendes, Fernando, Alvim, Marina K M, Yasuda, Clarissa, Bonilha, Leonardo, Gleichgerrcht, Ezequiel, Focke, Niels K, Kreilkamp, Barbara A K, Domin, Martin, ... Bernhardt, Boris C. (2022). Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy. Brain. 145(4), pp. 1285-1298. https://doi.org/10.1093/brain/awab417
Brain anatomical alterations in young cannabis users : Is it all hype? A meta-analysis of structural neuroimaging studies
Lorenzetti, Valentina, Kowalczyk, Magdalena, Duehlmeyer, Leonie, Greenwood, Lisa-Marie, Chye, Yann, Yücel, Murat, Whittle, Sarah and Roberts, Carl A.. (2022). Brain anatomical alterations in young cannabis users : Is it all hype? A meta-analysis of structural neuroimaging studies. Cannabis and Cannabinoid Research. 8(1), pp. 184-196. https://doi.org/10.1089/can.2021.0099
A systems-level analysis highlights microglial activation as a modifying factor in common epilepsies
Altmann, Andre, Ryten, Mina, Di Nunzio, Martina, Ravizza, Teresa, Tolomeo, Daniele, Reynolds, Regina H., Somani, Alyma, Bacigaluppi, Marco, Iori, Valentina, Micotti, Edoardo, Di Sapia, Rossella, Cerovic, Milica, Palma, Eleonora, Ruffolo, Gabriele, Botía, Juan A., Absil, Julie, Alhusaini, Saud, Alvim, Marina K. M., Auvinen, Pia, ... Sisodiya, Sanjay M.. (2022). A systems-level analysis highlights microglial activation as a modifying factor in common epilepsies. Neuropathology and Applied Neurobiology. 48(1), p. Article e12758. https://doi.org/10.1111/nan.12758
Patterns of brain function associated with cannabis cue-reactivity in regular cannabis users : A systematic review of fMRI studies
Sehl, Hannah, Terrett, Gill, Greenwood, Lisa-Marie, Kowalczyk, Magdalena, Thomson, Hannah, Poudel, Govinda, Manning, Victoria and Lorenzetti, Valentina. (2021). Patterns of brain function associated with cannabis cue-reactivity in regular cannabis users : A systematic review of fMRI studies. Psychopharmacology. 238(10), pp. 2709-2728. https://doi.org/10.1007/s00213-021-05973-x
Do comorbid personality disorders in cocaine dependence exacerbate neuroanatomical alterations? A structural neuroimaging study
Roberts, Carl A., Lorenzetti, Valentina, Albein-Urios, Natalia, Kowalczyk, Magdalena A., Martinez-Gonzalez, Jose M. and Verdejo-Garcia, Antonio. (2021). Do comorbid personality disorders in cocaine dependence exacerbate neuroanatomical alterations? A structural neuroimaging study. Progress in Neuropsychopharmacology and Biological Psychiatry. 110, p. 110298. https://doi.org/10.1016/j.pnpbp.2021.110298
Network-based atrophy modeling in the common epilepsies: A worldwide ENIGMA study
Larivière, Sara, Rodríguez-Cruces, Raúl, Royer, Jessica, Caligiuri, Maria Eugenia, Gambardella, Antonio, Concha, Luis, Keller, Simon S., Cendes, Fernando, Yasuda, Clarissa, Bonilha, Leonardo, Gleichgerrcht, Ezequiel, Focke, Niels K., Domin, Martin, von Podewills, Felix, Langner, Soenke, Rummel, Christian, Wiest, Roland, Martin, Pascal, Kotikalapudi, Raviteja, ... Bernhardt, Boris C.. (2020). Network-based atrophy modeling in the common epilepsies: A worldwide ENIGMA study. Science Advances. 6(47), p. eabc6457. https://doi.org/10.1126/sciadv.abc6457
Dynamic analysis of fMRI activation during epileptic spikes can help identify the seizure origin
Kowalczyk, Magdalena A., Omidvarnia, Amir, Dhollander, Thijs and Jackson, Graeme D.. (2020). Dynamic analysis of fMRI activation during epileptic spikes can help identify the seizure origin. Epilepsia. 61(11), pp. 2558-2571. https://doi.org/10.1111/epi.16695
Towards fast and reliable simultaneous EEG-fMRI analysis of epilepsy with automatic spike detection
Omidvarnia, Amir, Kowalczyk, Magdalena A., Pedersen, Mangor and Jackson, Graeme D.. (2019). Towards fast and reliable simultaneous EEG-fMRI analysis of epilepsy with automatic spike detection. Clinical Neurophysiology. 130(3), pp. 368-378. https://doi.org/10.1016/j.clinph.2018.11.024
Normal cerebral cortical thickness in first-degree relatives of temporal lobe epilepsy patients
Alhusaini, Saud, Kowalczyk, Magdalena A., Yasuda, Clarissa L., Semmelroch, Mira K., Katsurayama, Marilise, Zabin, Matheus, Zanão, Tamires, Nogueira, Mateus H., Alvim, Marina K. M., Ferraz, Victória R., Tsai, Meng-Han, Fitzsimons, Mary, Lopes-Cendes, Iscia, Doherty, Colin P., Cavalleri, Gianpiero L., Cendes, Fernando, Jackson, Graeme D. and Delanty, Norman. (2019). Normal cerebral cortical thickness in first-degree relatives of temporal lobe epilepsy patients. Neurology. 92(4), pp. e351-e358. https://doi.org/10.1212/WNL.0000000000006834
Human GABRG2 generalized epilepsy : Increased somatosensory and striato-thalamic connectivity
Pedersen, Mangor, Kowalczyk, Magdalena, Omidvarnia, Amir, Perucca, Piero, Gooley, Samuel, Petrou, Steven, Scheffer, Ingrid E., Berkovic, Samuel F. and Jackson, Graeme D.. (2019). Human GABRG2 generalized epilepsy : Increased somatosensory and striato-thalamic connectivity. Neurology Genetics. 5(4), p. e340. https://doi.org/10.1212/NXG.0000000000000340
Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study
Whelan, Christopher D., Altmann, Andre, Botía, Juan A., Jahanshad, Neda, Hibar, Derrek P., Absil, Julie, Alhusaini, Saud, Alvim, Marina K. M., Auvinen, Pia, Bartolini, Emanuele, Bergo, Felipe P. G., Bernardes, Tauana, Blackmon, Karen, Braga, Barbara, Caligiuri, Maria Eugenia, Calvo, Anna, Carr, Sarah J., Chen, Jian, Chen, Shuai, ... Sisodiya, Sanjay M.. (2018). Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. Brain: a journal of neurology. 141(2), pp. 391-408. https://doi.org/10.1093/brain/awx341
Cognitive impairment in epilepsy : The role of reduced network flexibility
Tailby, Chris, Kowalczyk, Magdalena A. and Jackson, Graeme D.. (2018). Cognitive impairment in epilepsy : The role of reduced network flexibility. Annals of Clinical and Translational Neurology. 5(1), pp. 29-40. https://doi.org/10.1002/acn3.503
Mapping the verbal semantic memory network before anterior temporal lobectomy using a combination of rTMS and fMRI
Sethi, M., Carney, P., Kowalczyk, M., Pedersen, M., Tailby, C. and Jackosn, G.. (2001). Mapping the verbal semantic memory network before anterior temporal lobectomy using a combination of rTMS and fMRI. Epilepsia. 58(Suppl. 5), p. S182. https://doi.org/10.1111/epi.13944