1. Spike detected fMRI - SfMRI
Simultaneous EEG recording during fMRI acquisition
Acquire multislice fMRI in blocks of 10 minutes during EEG recording
Post-processing of EEG to identify images where either ictal or interictal abnormalities are present
Interleave with specific cognitive or other functional tasks
Analyze by SPM by comparing images acquired where EEG is normal with those with ictal and interictal abnormalities
November 24, 2018

2. Characteristic EEG Pattern of CAE
November 24, 2018

3. Simultaneous EEG and fMRI
Use of pre- and post-acquisition artifact reduction measures have enabled us to obtain high-quality EEG recordings. ( Negishi M, R. T. Constable, et al., 2004 )
Example of EEG in a 13 year old girl with CAE who had an absence seizure during fMRI (Berman R., and Negishi, M., AES Abstract 2005). The in-magnet EEG data is of sufficient quality to reveal SWD
R Berman, EJ Novotny, M Negishi, RT Constable, H Blumenfeld 2006 .
November 24, 2018

4. Impaired performance during Seizures
Responses
Missed Targets
Example of an absence seizure (EEG artifact removed) in a 12 year old CAE patient during simultaneous EEG and 3T fMRI.
R Berman, EJ Novotny, M Negishi, RT Constable, H Blumenfeld 2006
November 24, 2018

5. BOLD fMRI changes during seizures
Tested 12 patients with CAE, 3 had seizures during scanning
Obtained a total of 11 seizure episodes (4-12 sec) during 4 sessions
Increases
Decreases
Bilateral Thalamus
Dorsolateral Frontal
Lateral parietal
Superior temporal
Occipital
Anterior Cingulate
Dorsal parietal
Retrosplenial
Pons
Cerebellum
p<0.001, k=3
Example of BOLD fMRI changes during a single 12 second absence seizure
in a 12 year old patient with typical CAE.
November 24, 2018

6. Group Analysis of Timecourse of BOLD Signal during Absence S
November 24, 2018

7. Simultaneous EEG/fMRI
Application as part of presurgical evaluation
Interictal Spikes with SfMRI
Preliminary study of > 60 subjects – results are comparable to FDG - PET
November 24, 2018

8. Simultaneous EEG/fMRI
Novel method combining clinical neurophysiological and functional imaging measures of function simultaneously
Investigation of relationship of structure and function noninvasively
Potential areas of study
Epilepsy
Origin of normal EEG patterns/Sleep
Event related potentials
Integration with other imaging modalities – MEG, PET, SPECT, MRSI, DTI, ….
November 24, 2018