Objective

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.

Methods

We retrospectively included 19 patients who underwent SEEG implantation for epilepsy presurgical evaluation. Voxel-wise whole-brain analysis was performed on 3.0T 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 different clinical characteristics.

Results

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.

Conclusion

ALFF had high concordance rate with SEEG-defined SOZ at individual-patient level.

Significance

ALFF activation on rsfMRI can add localizing information for the noninvasive presurgical workup of intractable focal epilepsies.

中文翻译：

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静息态 fMRI 在癫痫术前评估中的个体定位价值：与立体脑电图的联合研究

客观的

检查静息态功能 MRI (rsfMRI) 指标对由立体脑电图 (SEEG) 定义的癫痫发作区 (SOZ) 在医学上难治性局灶性癫痫患者中的个体患者水平定位值。

方法

我们回顾性纳入了 19 名接受 SEEG 植入手术进行癫痫术前评估的患者。在 3.0T rsfMRI 上进行体素全脑分析，以生成低频波动幅度 (ALFF)、区域同质性 (ReHo) 和度中心性 (DC) 的聚类，这些聚类与 SEEG 定义的 SOZ 共同注册评估它们的空间重叠。对不同的临床特征进行亚组和相关分析。

结果

ALFF 在 73.7% 的患者中表现出与 SEEG 定义的 SOZ 一致的簇，敏感性为 93.3%，PPV 为 77.8%。当按病变/非病变 MRI、SOZ 位置、头皮 EEG 发作间期癫痫样放电、病理学或癫痫发作结果进行分组时，一致性率没有显着差异。ALFF 一致率与癫痫持续时间、发作年龄、发作频率或抗癫痫药物数量之间没有显着相关性。ReHo 和 DC 没有取得有利的一致性结果（分别为 10.5% 和 15.8%）。所有一致的集群都显示区域激活，代表神经活动增加。

结论

ALFF 在个体患者水平上与 SEEG 定义的 SOZ 具有很高的一致性。

意义

ALFF activation on rsfMRI can add localizing information for the noninvasive presurgical workup of intractable focal epilepsies.