title: Networks involved in seizure initiation. A reading epilepsy case studied with EEG-fMRI and MEG.
abstract: OBJECTIVE
  To define the ictal cortical/subcortical network of reading-induced seizures.
  
  
  METHODS
  We analyzed ictal magnetoencephalography (MEG) and EEG-correlated fMRI (EEG-fMRI) data in a unique patient with reading epilepsy (RE) affected by frequent perioral reflex myocloni triggered by reading silently.
  
  
  RESULTS
  Ictal MEG corroborated EEG localization and revealed activity extending precentrally into Brodmann area (BA) 6. fMRI blood oxygen level-dependent (BOLD) signal changes in the left deep piriform cortex (PFC) and left BA6 preceded seizures and occurred before BOLD changes were observed in thalamus and right inferior frontal gyrus (BA44). Dynamic causal modeling provided evidence of a causal link between hemodynamic changes in the left PFC and reading-evoked seizures.
  
  
  CONCLUSIONS
  Our findings support the important role of deep cortical and subcortical structures, in particular the frontal PFC, as key regions in initiating and modulating seizure activity. In our patient with RE, BA6 appeared to be the area linking cognitive activation and seizure activity.
authors: Department of Neurological Sciences, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy.
authors: Anna E
authors: AE
authors: Vaudano
authors: David W
authors: DW
authors: Carmichael
authors: Afraim
authors: A
authors: Salek-Haddadi
authors: Stefan
authors: S
authors: Rampp
authors: Hermann
authors: H
authors: Stefan
authors: Louis
authors: L
authors: Lemieux
authors: Matthias J
authors: MJ
authors: Koepp
mesh_terms: D001499:Bayes Theorem; D002540:Cerebral Cortex / Q000503:physiopathology; D003071:Cognition / Q000502:physiology; D004569:Electroencephalography; D020195:Epilepsy, Reflex / Q000503:physiopathology*; D005583:Fourier Analysis; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D012640:Seizures / Q000503:physiopathology*; D013788:Thalamus / Q000503:physiopathology; D055815:Young Adult
chemical_list: D010100:Oxygen