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Simultaneous electroencephalography and functional magnetic resonance imaging

Part of clinical diagnostics?

Simultane Elektroenzephalographie und funktionelle Magnetresonanztomographie

Teil der klinischen Diagnostik?

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Zeitschrift für Epileptologie Aims and scope Submit manuscript

Abstract

EEG-fMRI has been used in epilepsy as a tool to indentify epileptic networks involved in the generation of spikes and seizures. The method is based on the measure of blood flow changes and allows the high temporal resolution of EEG to be combined with the high spatial resolution of MRI to evaluate brain networks involved in generating intrinsic brain signals. The main focus of research in generalized epilepsies is the understanding of underlying mechanisms, while EEG-fMRI in focal epilepsies has also been evaluated as a method for focus localization in presurgical epilepsy. Despite its extensive use over recent years, EEG-fMRI in epilepsy is still not established as a routine clinical tool, as it faces many methodological challenges which complicate its interpretation. In some patients the sensitivity of the method is low due to a lack of sufficient number of interictal spikes; the correct manner for statistical analysis as well as thresholding are still being debated. The present review gives a short overview of clinical applications of EEG-fMRI in epilepsy and discusses in detail new developments in the field which may allow methodological challenges to be overcome in the future.

Zusammenfassung

In der Epilepsiediagnostik wird die simultane Aufzeichnung von EEG und fMRT verwendet, um epileptogene Netzwerke zu untersuchen, die für die Entstehung von Spikes und Anfällen verantwortlich sind. Die Methode beruht auf der Messung von Veränderungen des Blutflusses, die auf neuronale Aktivitätsänderungen folgen, und ermöglicht die Kombination der hohen zeitlichen Auflösung des EEG mit der hohen räumlichen Auflösung des MRT. Die meisten Untersuchungen bei Patienten mit generalisierten Epilepsien beschäftigen sich hauptsächlich mit der Analyse von Entstehungsmechanismen, während die Methode der EEG-fMRT evaluiert wurde, um bei Patienten mit fokalen Epilepsien im Rahmen der prächirurgischen Diagnostik eine Fokuslokalisation zu erlauben. Trotz zahlreicher Anwendungen ist die EEG-fMRT bis heute kein fester Bestandteil der routinemäßigen klinischen Diagnostik, da viele methodische Schwierigkeiten existieren, die die Interpretation der Ergebnisse erschweren. Bei einigen Patienten ist die Sensitivität der Methode niedrig, v. a. wenn keine ausreichende Anzahl von interiktalen Spikes auftritt, und bisher gibt es keine eindeutige Empfehlung für Auswahl eines Schwellenwerts bei der statistischen Analyse. Die vorliegende Übersichtsarbeit gibt einen Überblick über die Anwendungsmöglichkeiten der EEG-fMRT bei Epilepsie und diskutiert neue Entwicklungen zur Verbesserung der Methode, die in Zukunft mit einer zuverlässigeren klinischen Anwendung einhergehen könnten.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest. The Königsteiner AK receives financial reimbursement for travelling and hotel expenses from Desitin for its annual meeting.

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  1. Klinik für Neuropädiatrie und Muskelerkrankungen, Universitätsklinik Freiburg, Mathildenstr. 1, 79106, Freiburg, Germany

    J. Jacobs & R. Korinthenberg

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  1. J. Jacobs
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  2. R. Korinthenberg
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Correspondence to J. Jacobs.

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Jacobs, J., Korinthenberg, R. Simultaneous electroencephalography and functional magnetic resonance imaging. Z. Epileptol. 26, 10–18 (2013). https://doi.org/10.1007/s10309-012-0294-y

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