Multimodal MR imaging: functional, diffusion tensor, and chemical shift imaging in a patient with localization-related epilepsy.
OBJECTIVE
To demonstrate the integration of complementary functional and structural data acquired with magnetic resonance imaging (MRI) in a patient with localization-related epilepsy.


METHODS
We studied a patient with partial and secondarily generalized seizures and a hemiparesis due to a malformation of cortical development (MCD) in the right hemisphere by using EEG-triggered functional MRI (fMRI), diffusion tensor imaging (DTI), and chemical shift imaging (CSI).


RESULTS
fMRI revealed significant changes in regional blood oxygenation associated with interictal epileptiform discharges within the MCD. DTI showed a heterogeneous microstructure of the MCD with reduced fractional anisotropy, a high mean diffusivity, and displacement of myelinated tracts. CSI demonstrated low N-acetyl aspartate (NAA) concentrations in parts of the MCD.


CONCLUSIONS
The applied MR methods described functional, microstructural, and biochemical characteristics of the epileptogenic tissue that cannot be obtained with other noninvasive means and thus improve the understanding of the pathophysiology of epilepsy.
Krakow
K
K
Department of Clinical Neurology, Institute of Neurology, University College London, England, UK. kkrakow@ion.ucl.ac.uk
Wieshmann
U C
UC
Woermann
F G
FG
Symms
M R
MR
McLean
M A
MA
Lemieux
L
L
Allen
P J
PJ
Barker
G J
GJ
Fish
D R
DR
Duncan
J S
JS
D000328:Adult; D016880:Anisotropy; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D002540:Cerebral Cortex / Q000002:abnormalities / Q000737:chemistry / Q000503:physiopathology; D004569:Electroencephalography / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D009421:Nervous System Malformations / Q000175:diagnosis; D010100:Oxygen / Q000097:blood
D001224:Aspartic Acid; C000179:N-acetylaspartate; D010100:Oxygen