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Updated: Apr 30, 2026

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

Published on: November 13, 2016

Linking MRI postprocessing with magnetic source imaging in MRI-negative epilepsy.

Zhong I Wang¹, Andreas V Alexopoulos, Stephen E Jones

¹Epilepsy Center, Cleveland Clinic, Cleveland, OH.

Annals of Neurology

|April 30, 2014

Summary

This summary is machine-generated.

A novel MRI postprocessing technique, Morphometric Analysis Program (MAP), aids in detecting subtle focal cortical dysplasia in epilepsy patients. Concordant MAP and magnetic source imaging (MSI) results improve seizure-free outcomes after surgery.

Keywords:

MEG MRI MRI-negative epilepsy MSI epilepsy focal cortical dysplasia image processing magnetoencephalography presurgical evaluation voxel-based morphometric MRI postprocessing

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Equipment Setup and Artifact Removal for Simultaneous Electroencephalogram and Functional Magnetic Resonance Imaging for Clinical Review in Epilepsy

Equipment Setup and Artifact Removal for Simultaneous Electroencephalogram and Functional Magnetic Resonance Imaging for Clinical Review in Epilepsy

Published on: June 23, 2023

Area of Science:

Neuroimaging
Epileptology
Surgical Neurology

Background:

Pharmacoresistant focal epilepsy (PFE) presents challenges in surgical management, particularly in MRI-negative cases.
Subtle focal cortical dysplasia (FCD) is often difficult to detect with conventional MRI in these patients.

Purpose of the Study:

To evaluate a voxel-based MRI postprocessing technique, Morphometric Analysis Program (MAP), for detecting subtle FCD in MRI-negative PFE patients.
To assess the concordance between MAP-identified regions and magnetic source imaging (MSI) for improved surgical targeting.

Main Methods:

Retrospective analysis of 25 MRI-negative surgical epilepsy patients.
MAP applied to T1-weighted MRI, compared against a normal database.
MAP findings validated by MSI, surgical outcomes, and histopathology, with analyses performed blinded.

Main Results:

MAP detected subtle abnormalities in 48% (12/25) of patients.
Resection of MAP-identified areas correlated with higher seizure-free rates (p=0.02).
Concordance between MAP and MSI significantly increased the likelihood of a seizure-free outcome (p=0.008).

Conclusions:

MAP demonstrates potential for enhancing the detection of subtle FCD in presurgical evaluations of PFE.
Combined MAP and MSI analyses may enable noninvasive identification of surgically targetable lesions in challenging epilepsy cases.