title: Multimodal neuroimaging in presurgical evaluation of drug-resistant epilepsy.
abstract: Intracranial EEG (icEEG) monitoring is critical in epilepsy surgical planning, but it has limitations. The advances of neuroimaging have made it possible to reveal epileptic abnormalities that could not be identified previously and improve the localization of the seizure focus and the vital cortex. A frequently asked question in the field is whether non-invasive neuroimaging could replace invasive icEEG or reduce the need for icEEG in presurgical evaluation. This review considers promising neuroimaging techniques in epilepsy presurgical assessment in order to address this question. In addition, due to large variations in the accuracies of neuroimaging across epilepsy centers, multicenter neuroimaging studies are reviewed, and there is much need for randomized controlled trials (RCTs) to better reveal the utility of presurgical neuroimaging. The results of multiple studies indicate that non-invasive neuroimaging could not replace invasive icEEG in surgical planning especially in non-lesional or extratemporal lobe epilepsies, but it could reduce the need for icEEG in certain cases. With technical advances, multimodal neuroimaging may play a greater role in presurgical evaluation to reduce the costs and risks of epilepsy surgery, and provide surgical options for more patients with drug-resistant epilepsy.
authors.affiliation: School of Biomedical Engineering, Capital Medical University, Beijing 100069, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Weifang
authors.initials: W
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Xia
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhou
authors.forename: Shanshan
authors.initials: S
authors.lastname: Mei
authors.forename: Qingzhu
authors.initials: Q
authors.lastname: Liu
authors.forename: Yunlin
authors.initials: Y
authors.lastname: Li
mesh_terms: D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D064847:Multimodal Imaging; D059906:Neuroimaging; D011300:Preoperative Care
keywords: Epilepsy surgery; Focus localization; Multimodal neuroimaging; Presurgical evaluation