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Review
. 2011 Jul;52 Suppl 4(Suppl 4):38-42.
doi: 10.1111/j.1528-1167.2011.03151.x.

Combining EEG and fMRI in the study of epileptic discharges

Jean Gotman  1 , Francesca Pittau
Affiliations
Review

Combining EEG and fMRI in the study of epileptic discharges

Jean Gotman et al. Epilepsia. 2011 Jul.

Abstract

The combining of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) is a unique noninvasive method for investigating the brain regions involved at the time of epileptic discharges. The neuronal discharges taking place during an interictal spike or spike-wave burst result in an increase in metabolism and blood flow, which is reflected in the blood oxygen-level dependent (BOLD) signal measured by fMRI. This increase is most intense in the region generating the discharge but is also present in regions affected by the discharge. On occasion, epileptic discharges result in decreased metabolism, the origin of which is only partially understood. EEG-fMRI applied to focal epilepsy results in maxima of the BOLD signal most often concordant with other methods of localization and has been shown to help in localizing epileptic foci in nonlesional frontal lobe epilepsy. It has also demonstrated the involvement of the thalamus in generalized epileptic discharges. In patients with new-onset epilepsy it could be used to evaluate the source and extent of the brain structures involved during discharges and their evolution as the disease progresses.

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Figures

Figure 1
Figure 1
Thirty-three-year-old woman with mesial temporal lobe epilepsy and right mesial temporal sclerosis. The marked events were spikes with phase reversal at F8 (bipolar montage, EEG on the left). The BOLD response shows an activation area in the right amygdala. Epilepsia © ILAE
Figure 2
Figure 2
Left temporal spike and wave in EEG with referential montage (FCz as reference). BOLD response reproducibility shown in 1.5T and 3T studies (from Gholipour et al., 2010). Epilepsia © ILAE
See this image and copyright information in PMC

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