Voxel based morphometry as technic to improve the detection of focal cortical dysplasia in children with phamacoresistant

• Grant number: 17/07267-3
• Support type: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): August 01, 2017
• Effective date (End): July 31, 2019
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ana Carolina Coan
• Grantee: Sabrina Vechini Gouvêa
• Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Associated research grant: 13/07559-3 - BRAINN - The Brazilian Institute of Neuroscience and Neurotechnology, AP.CEPID

Abstract

The focal cortical dysplasia (FCD) é the most common cause of pharmacoresistant epilepsy in childhood, with a good prognosis of seizure free after surgery when the entire lesion is removed. In some cases, the FCDs can be easily identified in magnetic resonance imaging (MRI) exams, whereas others have negative MRI or MRI with subtle changes. More efficient methods of diagnosis and identification of this abnormality can contribute for a best chirurgical planning in order to improve the prognoses of seizure free in the postoperative. Objectives: Evaluate the use of a post-processing protocol in MRI exams for the improvement of the detection of dysplasic lesions in children with pharmacoresistant epilepsy secondary to FCD. Methods: Children with clinical diagnosis of phamacoresistant epilepsy secondary to FCD, followed in Clinical Hospital of Unicamp, submitted to MRI exams acquired with 3 Tesla equipment, with anatomical sequence, volumetric T1-weighted, will have these images applied to an algorithm using the voxel-based morphometry (VBM) in order to detect, automatically, possible areas suggestive of FCD. This algorithm will be based in grey and white matter individual maps compared to a healthy control group, obtaining, in the final step, an individual map with the possible localization of the dysplasic lesion. The clinical data of the patients will be acquired with questionnaires structured and based in the preoperative investigation. The results of the analyses of the individual maps will be evaluated as for detection of lesion, agreement of the alterations with regard to the epileptogenic zone clinically defined, the agreement with the surgical resection area and the seizures control in the postoperative. Expected results: The MRI post-processing maps should assist in the detection of the FCD in children with pharmacoresistant epilepsy, which que contribute to refinement of the indication of epilepsy surgery in these patients. (AU)