Individual localization value of resting-state fMRI in epilepsy presurgical evaluation: A combined study with stereo-EEG

•First study to examine the localization value of resting-state fMRI metrics for seizure onset zone (SOZ) defined by SEEG at the individual level.•Amplitude of low-frequency fluctuations (ALFF) demonstrated concordant clusters with SEEG-defined SOZ in 73.7% of patients.•All concordant clusters showe...

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Published in:Clinical neurophysiology 2021-12, Vol.132 (12), p.3197-3206
Main Authors: Tang, Yingying, Choi, Joon Yul, Alexopoulos, Andreas, Murakami, Hiroatsu, Daifu-Kobayashi, Masako, Zhou, Qin, Najm, Imad, Jones, Stephen E, Wang, Zhong Irene
Format: Article
Language:English
Subjects:
Adolescent
Adult
Amplitude of low-frequency fluctuations (ALFF)
Anterior Temporal Lobectomy - adverse effects
Anterior Temporal Lobectomy - methods
Electroencephalography - methods
Epilepsy
Epilepsy - diagnostic imaging
Epilepsy - physiopathology
Epilepsy - surgery
Female
Humans
Magnetic Resonance Imaging - methods
Male
Middle Aged
Postoperative Complications - epidemiology
Preoperative Period
Presurgical evaluation
resting-state functional magnetic resonance imaging (rsfMRI)
Stereo-electroencephalography (SEEG)
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Summary:•First study to examine the localization value of resting-state fMRI metrics for seizure onset zone (SOZ) defined by SEEG at the individual level.•Amplitude of low-frequency fluctuations (ALFF) demonstrated concordant clusters with SEEG-defined SOZ in 73.7% of patients.•All concordant clusters showed regional activation, representing increased neural activities.•Results suggest ALFF activation on resting-state fMRI can add localization information for SOZ for individuals with intractable focal epilepsies. To examine the individual-patient-level localization value of resting-state functional MRI (rsfMRI) metrics for the seizure onset zone (SOZ) defined by stereo-electroencephalography (SEEG) in patients with medically intractable focal epilepsies. We retrospectively included 19 patients who underwent SEEG implantation for epilepsy presurgical evaluation. Voxel-wise whole-brain analysis was performed on 3.0 T rsfMRI to generate clusters for amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo) and degree centrality (DC), which were co-registered with the SEEG-defined SOZ to evaluate their spatial overlap. Subgroup and correlation analyses were conducted for various clinical characteristics. ALFF demonstrated concordant clusters with SEEG-defined SOZ in 73.7% of patients, with 93.3% sensitivity and 77.8% PPV. The concordance rate showed no significant difference when subgrouped by lesional/non-lesional MRI, SOZ location, interictal epileptiform discharges on scalp EEG, pathology or seizure outcomes. No significant correlation was seen between ALFF concordance rate and epilepsy duration, seizure-onset age, seizure frequency or number of antiseizure medications. ReHo and DC did not achieve favorable concordance results (10.5% and 15.8%, respectively). All concordant clusters showed regional activation, representing increased neural activities. ALFF had high concordance rate with SEEG-defined SOZ at individual-patient level. ALFF activation on rsfMRI can add localizing information for the noninvasive presurgical workup of intractable focal epilepsies.
ISSN:1388-2457
1872-8952
DOI:10.1016/j.clinph.2021.07.028