title: EEG-fMRI of epileptic spikes: concordance with EEG source localization and intracranial EEG.
abstract: Simultaneous EEG and fMRI recordings permit the non-invasive investigation of the generators of spontaneous brain activity such as epileptic spikes. Despite a growing interest in this technique, the precise relationship between its results and the actual regions of activated cortex is not clear. In this study, we have quantified for the first time the concordance between EEG-fMRI results and stereotaxic EEG (SEEG) recordings in 5 patients with partial epilepsy. We also compared fMRI and SEEG with other non-invasive maps based on scalp EEG alone. We found that SEEG measures largely validated the results of EEG and fMRI. Indeed, when there is an intracranial electrode in the vicinity of an EEG or fMRI peak (in the range 20-40 mm), then it usually includes one active contact. This was the case for both increases ('activations') and decreases ('deactivations') of the fMRI signal: in our patients, fMRI signal decrease could be as important in understanding the complete picture of activity as increase of fMRI signal. The concordance between EEG and fMRI was not as good as the concordance between either of these non-invasive techniques and SEEG. This shows that the two techniques can show different regions of activity: they are complementary for the localization of the areas involved in the generation of epileptic spikes. Moreover, we found that the sign of the fMRI response correlated with the low frequency content of the SEEG epileptic transients, this latter being a reflection of the slow waves. Thus, we observed a higher proportion of energy in the low frequencies for the SEEG recorded in regions with fMRI signal increase compared to the regions with fMRI signal decrease. This could reflect an increase of metabolism linked to the presence of slow waves, which suggests that fMRI is a new source of information on the mechanisms of spike generation.
authors.affiliation: Montreal Neurological Institute, 3801 University Street, Montréal, Québec, Canada H3A 2B4.
authors.forename: Christian-G
authors.initials: CG
authors.lastname: Bénar
authors.forename: Christophe
authors.initials: C
authors.lastname: Grova
authors.forename: Eliane
authors.initials: E
authors.lastname: Kobayashi
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Bagshaw
authors.forename: Yahya
authors.initials: Y
authors.lastname: Aghakhani
authors.forename: François
authors.initials: F
authors.lastname: Dubeau
authors.forename: Jean
authors.initials: J
authors.lastname: Gotman
mesh_terms: D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology* / Q000601:surgery; D004292:Dominance, Cerebral / Q000502:physiology; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004734:Energy Metabolism / Q000502:physiology; D004828:Epilepsies, Partial / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D005071:Evoked Potentials / Q000502:physiology; D005583:Fourier Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013238:Stereotaxic Techniques