EEG-fMRI has gained increasing importance in epilepsy pre-surgical diagnosis. However, 40–70% of EEG-fMRI recordings in patients lack interictal epileptiform discharges (IEDs) during the scan, which could be overcome by detecting matching topography maps. We tried to validate this method in clinical settings taking various electroclinical factors into consideration. Eleven patients who had undergone EEG-fMRI during pre-surgical evaluation for drug-resistant epilepsy and who had had clinical long-term video-EEG were studied. Spike-related blood oxygen level-dependent (BOLD) maps were created using IEDs occurring during the EEG-fMRI scan. Separate maps were then generated from IEDs marked on the clinical long-term EEG recordings, which were averaged to produce topographical IED maps and correlated with the EEGs recorded inside the scanner yielding a correlation coefficient time course. Epileptogenic zones were defined by an expert panel during pre-surgical evaluation and validated by an epilepsy surgery resulting in a good outcome. Both techniques’ performance was evaluated according to factors including arousal during IED recording, IED topography and lateralization, lesion type, and localization. Topography-related EEG-fMRI yielded more specific results compared to the spike-related method. Superficial lesion location and ipsilateral IED seem to result in a higher concordance of BOLD maps. The polarity of BOLD responses may be lesion-dependent, and both positive and negative BOLD changes may be associated with the irritative zone. Topography-related EEG-fMRI may show improved specificity especially for superficial lesions producing ipsilateral spikes. This method can be used as an alternative either in the absence of spikes during the simultaneous EEG-fMRI acquisition or to sharpen a diffusely activated BOLD-map.

EEG-fMRI在癫痫的术前诊断中已变得越来越重要。但是，患者的EEG-fMRI记录中有40-70％的扫描过程中缺乏发作间期癫痫样放电（IED），这可以通过检测匹配的地形图来克服。我们尝试在考虑各种电子临床因素的临床环境中验证此方法。研究了11例在术前评估耐药性癫痫的过程中接受过EEG-fMRI检查并具有临床长期视频EEG的患者。使用在EEG-fMRI扫描期间发生的IED，创建了与峰值相关的血氧水平依赖性（BOLD）图。然后从临床长期脑电图记录上标记的IED生成单独的地图，将其平均以生成地形IED图，并将其与扫描仪内部记录的EEG相关联，从而产生相关系数时间过程。由专家小组在手术前评估期间确定癫痫发生区，并通过癫痫手术进行验证，以取得良好的效果。两种技术的性能均根据包括在IED记录过程中的唤醒，IED地形和侧向化，病变类型和定位在内的因素进行评估。与峰值相关的方法相比，与地形相关的EEG-fMRI产生了更具体的结果。浅表病变的位置和同侧IED似乎导致BOLD图的一致性更高。BOLD反应的极性可能取决于病变，并且BOLD的正负变化都可能与刺激性区域相关。与地形有关的EEG-fMRI可能显示出更高的特异性，尤其是对于产生同侧尖峰的浅表病变。在同时进行EEG-fMRI采集过程中不存在尖峰的情况下，该方法可以用作替代方法，也可以使扩散激活的BOLD图更清晰。