Anna E Vaudano | Scalp EEG-fMRI in epilepsy, beyond the epileptogenic zone definition

INS Seminar Room, Campus Timone, Red Wing, 5th Floor.

Abstract : The view of the epileptogenic process in the brain has evolved from the historical concept of “epileptic focus” to a more complex description of “epileptogenic networks” involved in the genesis and propagation of epileptic activities. Simultaneous scalp recording of EEG and functional MRI (EEGfMRI) is a technique capable of revealing the brain regions engaged during the epileptic discharge based on local blood oxygenation level–dependent (BOLD) signal variations. Compared to resting-state fMRI studies, the presence of electrophysiological data during fMRI provide the indubitable advantage to know in real time the ongoing cerebral activity of the patient, including the level of vigilance and its oscillations. First applications of EEG-fMRI in epilepsy were mainly oriented to the identification of the epileptogenic zone in focal epilepsies. After almost 20 years of experience, this technique has been shown to be extremely valid to show, more than the single focus, the complex epileptogenic networks both in focal and in generalized epilepsies. This could represent a limitation for the surgical prospective while instead highlights the applicability of the EEG-fMRI method for increasing the knowledge on the epileptogenesis, identify bio-markers of well-defined epileptic syndrome and discover the cognitive effect of epileptic activity. These aspects will be discussed in the light of speaker’s personal experiences and publications and the latest progresses of fMRI and EEG data analyses. With more than 400 patients scanned with EEG-fMRI, the Modena’s University Hospital, where Dr. Vaudano works as clinical neurologist, is one greatest national and international hub for the acquisition, setting and analysis of EEG-fMRI data in epilepsy.

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