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Journal of Clinical EEG & Neuroscience, July, 2010Noninvasive Multimodal Neuroimaging for Rasmussen Encephalopathy Surgery: Simultaneous EEG-fMRI RecordingE.R. Cuspineda Bravo, Y. Iturria, J.C. Praderes, L. Melie, P.A. Valdés, T. Virues, C. Machado and L. Valdés UrrutiaABSTRACT: Rasmussen syndrome is characterized by continuous partial seizures with progressive neurological / cognitive impairment. Currently the only effective treatment is the surgery (hemispherectomy). The objective of our study is to detect the unerring epileptogenic focus through the analysis of multimodal noninvasive and innocuous functional neuroimaging. The subject is a 5-year-old female patient with Rasmussen encephalopathy diagnosis. Continuous and simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) was recorded. The sources of background and paroxysmal activity of EEG were computed by low resolution electromagnetic tomography (LORETA). Statistical methods for image analysis (SPM: statistic parametric mapping) were obtained for the areas where statistically significant differences in the fMRI BOLD response were computed, and the results from both techniques were compared. The main source of paroxysmal activity by EEG analysis was found in the anterolateral left hemisphere, with a significant increase in absolute and relative energies of the slow frequency bands (theta-delta): Z ≥ 3. The fMRI BOLD signal (basal vs. paroxysmal activity) was significantly different in the same region (t-test ≥ 2.39). The generators of propagated paroxysmal activity were found in similar areas for both techniques. In conclusion, simultaneous EEG-fMRI recording allows the analysis of two harmless functional neuroimaging techniques separately and together in the same time period. In our case, it allowed the accurate delineation of epileptogenic areas and spreading zones with high spatiotemporal resolution complementing their results, which is crucial for epilepsy surgery. |
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