A-511 fMRI in epilepsy

N. Bargalló | Sunday, March 10, 16:00 – 17:30 / Room G/H

Functional MRI (fMRI) is a non-invasive tool that is capable to detect the subtle homodynamic changes produced in regional brain activation. The main fMRI clinical application until now is localization and evaluation of brain eloquent areas in surgical planning of brain pathology. fMRI application in epilepsy patients are language lateralization, memory function assessment and localization of ictal and interictal BOLD changes. There are several factors that can influence the results of a fMRI experiment such as the scan noise for the rest condition, the simplicity of the task performance, the monitoring of the experiment during the exam, how to achieve a real baseline condition and the most important, to use the most specific paradigm that would activate the selected brain areas. In practical approach, one must be aware that sometime fMRI studies are applied in paediatric or impaired cognitive epilepsy population when deciding the language or memory paradigm, and is recommended to use multiple and feasibility tasks to assure the results. fMRI for language lateralization is currently used in the clinical practice and provides comparable results to the intracarotid amobarbital test (IAT). In fMRI studies for memory function assessment, results show changes in epileptic patients, but further studies are required to validate this technique to an individual level. A new application is ictal or interictal fMRI with EEG recorded that provide more detailed information about simultaneously electrographic and homodynamic changes in the seizure process, with encouraging results for epileptogenic area localization and propagation patterns.

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