title: A multimodal imaging approach to the evaluation of post-traumatic epilepsy.
abstract: OBJECTIVE
  Electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration and high-density EEG (hdEEG) can be combined to map noninvasively abnormal brain activation elicited by epileptic processes. By combining noninvasive imaging techniques in a multimodal approach, we sought to investigate pathophysiological mechanisms underlying epileptic activity in seven patients with severe traumatic brain injury.
  
  
  METHODS
  Standard EEG and fMRI data were acquired during a single scanning session. The EEG-fMRI data were analyzed using the general linear model and independent component analysis. Source localization of interictal epileptiform discharges (IEDs) was performed using 256-channel hdEEG. Blood oxygenation level dependent (BOLD) localizations were then compared to EEG source reconstruction.
  
  
  RESULTS
  On hdEEG, focal source localization was detected in all seven patients; in six out of seven it was concordant with the expected epileptic activity as defined by EEG data and clinical evaluation; and in four out of seven in whom IEDs were recorded, BOLD signal changes were observed. These activities were partially concordant with the source localization.
  
  
  CONCLUSIONS
  Multimodal integration of EEG-fMRI and hdEEG combining two different methods to localize the same epileptic foci appears to be a promising tool to noninvasively map abnormal brain activation in patients with post-traumatic brain injury.
authors.affiliation: Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134, Verona, Italy. silviafrancesca.storti@univr.it
authors.forename: Silvia F
authors.initials: SF
authors.lastname: Storti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Formaggio
authors.forename: Enrica
authors.initials: E
authors.lastname: Franchini
authors.forename: Luigi G
authors.initials: LG
authors.lastname: Bongiovanni
authors.forename: Roberto
authors.initials: R
authors.lastname: Cerini
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiaschi
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Michel
authors.forename: Paolo
authors.initials: P
authors.lastname: Manganotti
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D001931:Brain Mapping / Q000379:methods*; D003952:Diagnostic Imaging / Q000379:methods; D004566:Electrodes; D004569:Electroencephalography / Q000379:methods*; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000473:pathology; D004834:Epilepsy, Post-Traumatic / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism
chemical_list: D010100:Oxygen