Optimized Intracranial EEG Targeting in Focal Epilepsy Based Upon Neuroimaging Connectomics
University of Pennsylvania
Summary
Upon successful completion of this study, the investigators expect the study's contribution to be the development of noninvasive imaging biomarkers to predict IEEG functional dynamics and epilepsy surgical outcomes. Findings from the present study may inform current and new therapies to map and alter seizure spread, and pave the way for less invasive, better- targeted, patient-specific interventions with improved surgical outcomes. This research is relevant to public health because over 20 million people worldwide suffer from focal drug-resistant epilepsy and are potential candidates for cure with epilepsy surgical interventions.
Description
Despite recent advances in neuroimaging, approximately 2/3 of intractable epilepsy patients that undergo surgical evaluation continue to require intracranial EEG (IEEG), arguably the most invasive diagnostic test in medicine. Clinicians currently lack methods to quantitatively map noninvasive imaging measures of structure and function to IEEG. Specifically, there is a critical need to validate whole-brain noninvasive neuroimaging network- based biomarkers to guide precise placement of electrodes and translate noninvasive network neuroimaging to change the paradigms of clinical care. The long-t…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Patients with medication-refractory epilepsy * Planned intracranial EEG (IEEG) placement * Hypothesized to have temporal lobe epilepsy Exclusion Criteria: * Contraindication to 3T MRI (e.g. metal implants or claustrophobia), clinical features that typically preclude the use of IEEG (e.g. pregnancy), prior intracranial surgery or device, and IEEG findings that are non-diagnostic (e.g. seizure onset zone(s) not identified)
Interventions
- Diagnostic Test3T Magnetic Resonance Imaging
Magnetic resonance imaging acquired at a field strength of 3 Tesla.
- Diagnostic TestIntracranial electroencephalography recordings
Epilepsy patients may undergo implantation of intracranial electroencephalography (iEEG) electrodes for localization of epileptogenic foci, which also provide a means to record localized brain activity during memory or other tasks for research purposes.
- Diagnostic Test7T Magnetic Resonance Imaging
Magnetic resonance imaging acquired at a field strength of 7 Tesla.
Location
- University of PennsylvaniaPhiladelphia, Pennsylvania