EEG-fMRI validation studies in comparison with icEEG: a review

Area of Science:

• Neuroscience
• Medical Imaging
• Epileptology

Background:

• Simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) is a non-invasive technique for localizing interictal epileptiform discharges (IEDs) in epilepsy patients.
• The clinical utility of EEG-fMRI in epilepsy presurgical evaluation remains controversial, necessitating further validation.

Purpose of the Study:

• To review EEG-fMRI applications in epilepsy presurgical evaluation.
• To assess EEG-fMRI's utility in seizure focus localization by comparing it with intracranial EEG (icEEG).
• To evaluate the potential of EEG-fMRI to minimize the need for invasive procedures like icEEG.

Main Methods:

• Focused review of validation studies comparing EEG-fMRI with intracranial EEG (icEEG).
• Examination of methodological advancements in EEG-fMRI data analysis.
• Consideration of combined neuroimaging approaches (e.g., MEG/MSI, ESI) with EEG-fMRI.

Main Results:

• EEG-fMRI shows promise in localizing seizure foci, but its clinical utility requires further validation against the gold standard, icEEG.
• Methodological advancements in data analysis are crucial for improving EEG-fMRI accuracy.
• Integration with other neuroimaging modalities may enhance its role.

Conclusions:

• EEG-fMRI is a valuable non-invasive tool for epilepsy presurgical evaluation, though its definitive role is still under investigation.
• Further validation studies are essential to establish EEG-fMRI as a reliable alternative to invasive icEEG.
• Future research should explore multimodal imaging integration to optimize seizure localization.