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Updated: Dec 23, 2025
A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
Published on: November 13, 2016
Additional clinical value of voxel-based morphometric MRI post-processing for MRI-negative epilepsies: a prospective
Riëm El Tahry1, Susana Ferrao Santos1, Pascal Vrielynck2
1Cliniques Universitaires Saint Luc, Department of Neurology; Institute of Neuroscience, Université Catholique de Louvain ; Institute of Neuroscience (IONS), Faculty of Medicine University of Louvain, Brussels.
Voxel-based morphometric analysis program (MAP) improves subtle lesion detection in drug-resistant epilepsy presurgical evaluations. This MRI post-processing technique increased detection rates by 28% in MRI-negative patients, aiding clinical decisions.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Presurgical evaluation is crucial for drug-resistant epilepsy, with lesion detection significantly impacting surgical outcomes.
- Subtle lesions on conventional MRI can be challenging to detect, necessitating advanced imaging techniques.
- Voxel-based morphometry offers a quantitative approach to identify structural abnormalities.
Purpose of the Study:
- To evaluate the detection rate of the voxel-based morphometric analysis program (MAP) in identifying subtle lesions in MRI-negative epilepsy patients.
- To assess the clinical value of MAP findings in the presurgical decision-making process for drug-resistant epilepsy.
Main Methods:
- A prospective trial included 21 patients with visually MRI-negative drug-resistant epilepsy.
- Initial presurgical plans were made blinded to MAP results.
- MAP results were then presented, and changes in clinical management were recorded and reviewed by an epilepsy-expert neuroradiologist.
Main Results:
- MAP identified lesions in 10/21 (47%) patients, with focal cortical dysplasia confirmed in 60% of these cases (28% overall detection rate).
- MAP findings influenced the management plan in 7/10 patients (33% of all patients).
- Management changes included adapting intracranial EEG plans or proceeding directly to surgery.
Conclusions:
- MRI post-processing with MAP significantly increases the detection rate of subtle dysplastic lesions in MRI-negative epilepsy patients.
- MAP demonstrates potential value in optimizing the presurgical evaluation and management of drug-resistant epilepsy.
