Relationship between hemodynamic response by EEG coupled to functional magnetic resonance imaging, surgical lacuna and surgical outcome in extratemporal Epilepsies

• Grant number: 22/04970-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2022
• End date: May 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Cendes
• Grantee: Gabriel Chagas Lutfala Paulino
• Host 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

Epilepsy is a neurological disease that results from the dissonant functioning of the brain, in which the occurrence of disordered stimuli generates interictal epileptiform discharges and epileptic seizures. Epilepsies affect approximately 1% to 2% of the population and a significant portion of these individuals develop a form of the disease that is resistant to treatment with an antiepileptic drug. Respective surgery of the epileptogenic zone is the most recommended procedure in focal epilepsies refractory to drugs. In this scenario, extratemporal epilepsy surgeries with an epileptogenic focus close to or involving eloquent areas (e.g., sensory-motor, visual, and language processing cortex) still yield limited results, as complete resection of the epileptogenic zone would cause significant neurological deficits. The use of the electroencephalogram technique in association with functional magnetic resonance imaging (EEG-fMRI), during the preoperative period, can help in the identification of brain areas with an altered hemodynamic response due to interictal epileptiform discharges, aiding the definition of the epileptogenic zone. The aim of this project is to identify whether the complete resection of the areas with an altered hemodynamic response due to interictal epileptiform discharges during EEG-fMRI may predict seizure control after surgical treatment in patients with extratemporal epilepsies. To that intent, we will analyze the surgical outcome in relation to the agreement of the surgical lacuna determined by postoperative magnetic resonance with the areas of altered hemodynamic response on preoperative EEG-fMRI.(AU)