Localization of focal epileptic discharges using functional connectivity magnetic resonance imaging

Object. In patients with medically refractory epilepsy the accurate localization of the seizure onset zone is critical for successful surgical treatment. The object of this study was to investigate whether the degree of coupling of spontaneous brain activity as measured with functional connectivity MR imaging (fcMR imaging) can accurately identify and localize epileptic discharges. Methods. The authors studied 6 patients who underwent fcMR imaging presurgical mapping and subsequently underwent invasive electroencephalography. Results. Focal regions of statistically significant increases in connectivity were identified in 5 patients when compared with an ad hoc normative sample of 300 controls. The foci identified by fcMR imaging overlapped the epileptogenic areas identified by in encephalography in all 5 patients. Conclusions. These results suggest that fcMR imaging may provide an effective high spatial resolution and noninvasive method of localizing epileptic discharges in patients with refractory epilepsy. (DOI: 10.3171/2011.1.JNS10482)