Download PDF
Klinische Neurophysiologie 2003; 34(4): 169-175
DOI: 10.1055/s-2003-812578
Originalia
© Georg Thieme Verlag Stuttgart · New York

Funktionelle Magnetresonanztomographie in der Epilepsiediagnostik

Functional MRI in EpilepsyF.  G.  Woermann1 , M.  Mertens1
  • 1Abteilung für Kernspintomographie, Klinik Mara I, Epilepsie-Zentrum Bethel, Bielefeld
Further Information

Publication History

Publication Date:
09 January 2004 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die funktionelle Magnetresonanztomographie (fMRT) erlaubt die bildliche Darstellung umschriebener Hirnaktivität. Die dabei auf Hirnschnitte oder die Hirnoberfläche projizierten Aktivitätsmuster bei motorischen, sensorischen oder kognitiven Leistungen können in topografische Beziehungen zu anfallsverursachenden Läsionen gesetzt werden. Inwieweit diese Informationen insbesondere zur präoperativen Abschätzung eines Operationsrisikos klinisch genutzt werden können, ist Gegenstand dieser Übersicht.

Abstract

Functional magnetic resonance imaging (fMRI) allows the visualization of localized brain activation. Localized MR contrast changes associated with sensory-motor or cognitive brain functions are expressed as activation maps and projected onto structural MRI. In patients with epilepsy, fMRI promises to delineate epileptogenic lesions from eloquent cortex. The future clinical use of this method depends highly on its ability to predict postoperative morbidity. Recent fMRI studies on the localization of the motor strip and the lateralization of language and memory are discussed.

Key words

Epilepsy - functional MRI - language - memory

Literatur

  • 1 Archer J S, Briellmann R S, Syngeniotis A, Abbott D F, Jackson G D. Spike-triggered fMRI in reading epilepsy: involvement of left frontal cortex working memory area.  Neurology. 2003;  60 415-421
    PubMedGoogle Scholar
  • 2 Archer J S, Briellman R S, Abbott D F, Syngeniotis A, Wellard R M, Jackson G D. Benign epilepsy with centro-temporal spikes: spike triggered fMRI shows somato-sensory cortex activity.  Epilepsia. 2003;  44 200-204
    CrossrefPubMedGoogle Scholar
  • 3 Bahn M M, Lin W, Silbergeld D L, Miller J W, Kuppusamy K, Cook R J, Hammer G, Wetzel R, Cross D. Localization of language cortices by functional MR imaging compared with intracarotid amobarbital hemispheric sedation.  Am J Radiol. 1997;  169 575-579
    PubMedGoogle Scholar
  • 4 Baxendale S. The role of functional MRI in the presurgical investigation of temporal lobe epilepsy patients: a clinical perspective and review.  J Clin Exp Neuropsychol. 2002;  24 664-676
    CrossrefPubMedGoogle Scholar
  • 5 Bellgowan P S, Binder J R, Swanson S J, Hammeke T A, Springer J A, Frost J A, Mueller W M, Morris G L. Side of seizure focus predicts left medial temporal lobe activation during verbal encoding.  Neurology. 1998;  51 479-484
    PubMedGoogle Scholar
  • 6 Benson R R, FitzGerald D B, LeSueur L L, Kennedy D N, Kwong K K, Buchbinder B R, Davis T L, Weisskoff R M, Talavage T M, Logan W J, Cosgrove G R, Belliveau J W, Rosen B R. Language dominance determined by whole brain functional MRI in patients with brain lesions.  Neurology. 1999;  52 798-809
    PubMedGoogle Scholar
  • 7 Binder J R, Swanson S J, Hammeke T A, Morris G L, Mueller W M, Fischer M, Benbadis S, Frost J A, Rao S M, Haughton V M. Determination of language dominance using functional MRI: a comparison with the Wada test.  Neurology. 1996;  46 978-984
    CrossrefPubMedGoogle Scholar
  • 8 Binder J R, Achten E, Constable R T, Detre J A, Gaillard W D, Jack C R, Loring D W. Functional MRI in epilepsy.  Epilepsia. 2002;  43 (Suppl 1) 51-63
    CrossrefPubMedGoogle Scholar
  • 9 Bookheimer S Y. Functional MRI applications in clinical epilepsy.  Neuroimage. 1996;  4 139-146
    CrossrefPubMedGoogle Scholar
  • 10 Bookheimer S Y. Methodological issues in pediatric neuroimaging.  Mental Retardation and Developmental Disabilities Research Reviews. 2000;  6 161-165
    CrossrefPubMedGoogle Scholar
  • 11 Boor S, Vucurevic G, Pfleiderer C, Stoeter P, Kutschke G, Boor R. EEG-related functional MRI in benign childhood epilepsy with centrotemporal spikes.  Epilepsia. 2003;  44 688-692
    CrossrefPubMedGoogle Scholar
  • 12 Bradley W G, Shey R B. MR imaging evaluation of seizures.  Radiology. 2000;  214 651-656
    PubMedGoogle Scholar
  • 13 Carpentier A, Pugh K R, Westerveld M, Studholme C, Skrinjar O, Thompson J L, Spencer D D, Constable R T. Functional MRI of language processing: dependence on input modality and temporal lobe epilepsy.  Epilepsia. 2001;  42 1241-1254
    CrossrefPubMedGoogle Scholar
  • 14 Cendes F, Knowlton R C, Novotny E, Li L M, Antel S, Sawrie S, Laxer K D, Arnold D. Magnetic resonance spectroscopy in epilepsy: clinical issues.  Epilepsia. 2002;  43 (Suppl 1) 32-39
    PubMedGoogle Scholar
  • 15 Dehaene-Lambertz G, Dehaene S, Hertz-Pannier L. Functional neuroimaging of speech perception in infants.  Science. 2002;  298 2013-2015
    CrossrefPubMedGoogle Scholar
  • 16 Desmond J E, Sum J M, Wagner A D, Demb J B, Shear P K, Glover G H, Gabrieli J DE, Morell M J. Functional MRI measurement of language lateralization in Wada-tested patients.  Brain. 1995;  118 1411-1419
    CrossrefPubMedGoogle Scholar
  • 17 Detre J A, Sirven J I, Alsop D C, O'Connor M J, French J A. Localization of subclinical ictal activity by functional magnetic resonance imaging: correlation with invasive monitoring.  Ann Neurol. 1995;  38 618-624
    CrossrefPubMedGoogle Scholar
  • 18 Detre J A, Alsop D C, Aguirre G K, Sperling M A. Coupling of cortical and thalamic ictal activity in human partial epilepsy: demonstration by functional magnetic resonance imaging.  Epilepsia. 1996;  37 657-661
    CrossrefPubMedGoogle Scholar
  • 19 Detre J A, Maccotta L, King D, Alsop D C, Glosser G, D'Esposito M, Zarahn E, Aguirre G K, French J A. Functional MRI lateralization of memory in temporal lobe epilepsy.  Neurology. 1998;  50 926-932
    CrossrefPubMedGoogle Scholar
  • 20 Diehl B, Najm I, Ruggieri P. et al . Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy.  Epilepsia. 2001;  42 21-28
    PubMedGoogle Scholar
  • 21 Duncan J S. Neuroimaging methods to evaluate the etiology and consequences of epilepsy.  Epilepsy Res. 2002;  50 131-140
    CrossrefPubMedGoogle Scholar
  • 22 Dupont S, Moortele P F Van de, Samson S, Hasboun D, Poline J B, Adam C, Lehericy S, Bihan D Le, Famson Y, Baulac M. Episodic memory in left temporal lobe epilepsy: a functional MRI study.  Brain. 2000;  123 1722-1732
    CrossrefPubMedGoogle Scholar
  • 23 Dupont S, Samson Y, Moortele P F Van de, Poline J B, Adam C, Lehericy S, Bihan D Le, Baulac M. Delayed verbal memory retrieval: a functional MRI study in epileptic patients with structural lesions of the left medial temporal lobe.  Neuroimage. 2001;  14 995-1003
    CrossrefPubMedGoogle Scholar
  • 24 Fernandez G, Brewer J B, Zhao Z, Glover G H, Gabrieli J D. Level of sustained entorhinal activity at study correlates with subsequent cued-recall performance - a functional magnetic resonance imaging study with high acquisition rate.  Hippocampus. 1999;  9 35-44
    CrossrefPubMedGoogle Scholar
  • 25 Fernandez G, Greiff A de, Oertzen J von, Reuber M, Lun S, Kluver P, Ruhlmann J, Reul J, Elger C E. Language mapping in less than 15 minutes: real time functional MRI during routine clinical investigation.  Neuroimage. 2001;  14 585-594
    CrossrefPubMedGoogle Scholar
  • 26 Fox P T, Raichle M E. Focal physiological uncoupling of cerebral blood flow and oxidative metabolism during somatosensory stimulation in human subjects.  Proc Natl Acad Sci USA. 1986;  83 1140-1144
    PubMedGoogle Scholar
  • 27 Gaillard W D, Balsamo L, Xu B, Grandin C B, Braniecki S H, Papero P H, Weinstein S, Conry J, Pearl P L, Sachs B, Sato S, Jabbari B, Vezina L G, Frattali C, Theodore W. Language dominance in partial epilepsy patients identified with an fMRI reading task.  Neurology. 2002;  59 256-265
    CrossrefPubMedGoogle Scholar
  • 28 Golby A J, Poldrack R A, Illes J, Chen D, Desmond J E, Gabrieli J D. Memory lateralization in medial temporal lobe epilepsy assessed by functional MRI.  Epilepsia. 2002;  43 855-863
    CrossrefPubMedGoogle Scholar
  • 29 Hagemann G, Krakow K, Woermann F G. Funktionelle MR-Verfahren in der Epilepsiediagnostik.  Klin Neurophysiol. 2000;  31 (S1) 49-56
    PubMedGoogle Scholar
  • 30 Hammeke T A, Bellgowan P SF, Binder J R. FMRI: methodology - cognitive function mapping.  Adv Neurol. 2000;  83 221-233
    PubMedGoogle Scholar
  • 31 Helmstaedter C, Kurthen M, Lux S, Reuber M, Elger C E. Chronic epilepsy and cognition: A longitudinal study in temporal lobe epilepsy.  Ann Neurol. 2003;  54 425-432
    CrossrefPubMedGoogle Scholar
  • 32 Hertz-Pannier L, Gaillard W D, Mott S H, Cuenod C A, Bookheimer S Y, Weinstein S, Conry J, Papero P H, Schiff S J, Bihan D Le, Theodore W H. Noninvasive assessment of language dominance in children and adolescents with functional MRI: a preliminary study.  Neurology. 1997;  48 1003-1012
    PubMedGoogle Scholar
  • 33 Hertz-Pannier L, Chiron C, Jambaque I, Renaux-Kieffer V, Moortele P F Van de, Delalande O, Fohlen M, Brunelle F, Bihan D Le. Late plasticity for language in a child's non-dominant hemisphere: a pre- and post-surgery fMRI study.  Brain. 2002;  125 361-372
    CrossrefPubMedGoogle Scholar
  • 34 Hetherington H P, Gadian D G, Ng T C. Magnetic resonance spectroscopy in epilepsy: technical issues.  Epilepsia. 2002;  43 (suppl 1) 25-31
    PubMedGoogle Scholar
  • 35 Hirsch J, Ruge M I, Kim K HS, Correa D D, Victor J D, Relkin N R, Labar D R, Krol G, Bilsky M H, Souweidane M M, Angelis L M De, Gutin P H. An integrated functional magnetic resonance imaging procedure for preoperative mapping of cortical areas associated with tactile, motor, language, and visual functions.  Neurosurgery. 2000;  47 711-722
    PubMedGoogle Scholar
  • 36 Hufnagel A, Weber J, Marks S, Ludwig T, Greiff A De, Leonhardt G, Widmann G, Stolke D, Forsting M. Brain diffusion after single seizures.  Epilepsia. 2003;  44 54-63
    PubMedGoogle Scholar
  • 37 ILAE neuroimaging commission . Recommendations for neuroimaging of patients with epilepsy.  Epilepsia. 1997;  38 (s10) 1-2
    PubMedGoogle Scholar
  • 38 ILAE Commission on diagnostic strategies . Recommendations for functional neuroimaging of persons with epilepsy.  Epilepsia. 2000;  41 1350-1356
    PubMedGoogle Scholar
  • 39 Jack C R, Lee C C, Ward H A, Riederer S J. The role of functional MRI in planning perirolandic surgery. In: Moonen CTW, Bandettini PA Functional MRI. Berlin, Heidelberg; Springer 1999
    Google Scholar
  • 40 Jackson G D, Connelly A, Cross J H, Gordon I, Gadian D G. Functional magnetic resonance imaging of focal seizures.  Neurology. 1994;  44 850-856
    PubMedGoogle Scholar
  • 41 Janszky J, Ebner A, Kruse B, Mertens M, Jokeit H, Seitz R J, Witte O W, Tuxhorn I, Woermann F G. Functional organization of the brain with malformations of cortical development.  Ann Neurol. 2003;  53 759-767
    CrossrefPubMedGoogle Scholar
  • 42 Jokeit H, Okujava M, Woermann F G. Memory fMRI lateralizes temporal lobe epilepsy.  Neurology. 2001;  57 1786-1792
    CrossrefPubMedGoogle Scholar
  • 43 Jokeit H, Okujava M, Woermann F G. Carbamazepine reduces memory induced activation of mesial temporal lobe structures - a pharmacological fMRI-study.  BMC Neurology. 2001b;  1 6, ,  at http//www.biomedcentral.com/1471-2377/1/6
    CrossrefPubMedGoogle Scholar
  • 44 Krainik A, Lehericy S, Duffau H, Capelle L, Chainay H, Cornu P, Cohen L, Boch A L, Mangin J F, Bihan D Le, Marsault C. Postoperative speech disorder after medial frontal surgery: Role of the supplementary motor area.  Neurology. 2003;  60 587-594
    CrossrefPubMedGoogle Scholar
  • 45 Krakow K, Woermann F G, Symms M R, Allen P J, Lemieux L, Barker G J, Duncan J S, Fish D R. EEG-triggered functional MRI of interictal epileptiform activity in patients with partial seizures.  Brain. 1999;  122 1679-1688
    CrossrefPubMedGoogle Scholar
  • 46 Krings T, Schreckenberger M, Rohde V, Foltys H, Spetzger U, Sabri O, Reinges M H, Kemeny S, Meyer P T, Moller-Hartmann W, Korinth M, Gilsbach J M, Buell U, Thron A. Metabolic and electrophysiological validation of functional MRI.  J Neurol Neurosurg Psychiatry. 2001;  71 762-771
    CrossrefPubMedGoogle Scholar
  • 47 Krings T, Topper R, Willmes K, Reinges M H, Gilsbach J M, Thron A. Activation in primary and secondary motor areas in patients with CNS neoplasms and weakness.  Neurology. 2002;  58 381-390
    PubMedGoogle Scholar
  • 48 Laufs H, Krakow K, Sterzer P, Eger E, Beyerle A, Salek-Haddadi A, Kleinschmidt A. Electroencephalographic signatures of attentional and cognitive default modes in spontaneous brain activity fluctuations at rest.  Proc Natl Acad Sci USA. 2003;  100 11053-11058
    CrossrefPubMedGoogle Scholar
  • 49 Lehericy S, Cohen L, Bazin B, Samson S, Giacomini E, Rougetet R, Hertz-Pannier L, Bihan D Le, Marsault C, Baulac M. Functional MR evaluation of temporal and frontal language dominance compared with the Wada test.  Neurology. 2000;  54 1625-1633
    PubMedGoogle Scholar
  • 50 Logothetis N K, Pauls J, Augath M, Trinath T, Oeltermann A. Neurophysiological investigation of the basis of the fMRI signal.  Nature. 2001;  412 150-157
    CrossrefPubMedGoogle Scholar
  • 51 Lux H D, Heinemann U, Dietzel I. Ionic changes and alterations in the size of the extracellular space during epileptic activity.  Adv Neurol. 1986;  44 619-639
    PubMedGoogle Scholar
  • 52 Niendorf T. Methodische Grundlagen moderner Magnet-Resonanz-Bildgebungsverfahren und ihre Anwendung in der Neurologie.  Klin Neurophysiol. 2000;  31 (S 1) 2-17
    PubMedGoogle Scholar
  • 53 Ogawa S, Lee T M, Kay A R, Tank D W. Brain magnetic resonance imaging with contrast dependent on blood oxygenation.  Proc Natl Acad Sci USA. 1990;  87 9868-9872
    CrossrefPubMedGoogle Scholar
  • 54 Penfield W. The evidence for a cerebral vascular mechanism in epilepsy.  Ann Intern Med. 1933;  7 303-310
    PubMedGoogle Scholar
  • 55 Price C J, Friston K J. Cognitive conjunction: a new approach to brain activation experiments.  Neuroimage. 1997;  5 261-270
    CrossrefPubMedGoogle Scholar
  • 56 Rosenow F, Lüders H. Presurgical evaluation of epilepsy.  Brain. 2001;  124 1683-1700
    CrossrefPubMedGoogle Scholar
  • 57 Rutten G J, Ramsey N F, Rijen P van C, Noordmans H J, Veelen C W van. Development of a functional magnetic resonance imaging protocol for intraoperative localization of critical temporoparietal language areas.  Ann Neurol. 2002;  51 350-360
    CrossrefPubMedGoogle Scholar
  • 58 Salek-Haddadi A, Lemieux L, Merschhemke M, Friston K J, Duncan J S, Fish D R. Functional magnetic resonance imaging of human absence seizures.  Ann Neurol. 2003;  53 663-667
    CrossrefPubMedGoogle Scholar
  • 59 Seeck M, Lazeyras F, Michel C M, Blanke O, Gericke C A, Ives J, Delavelle J, Golay X, Haenggeli C A, Tribolet N de, Landis T. Non-invasive epileptic focus localization using EEG-triggered functional MRI and electromagnetic tomography.  Electroencephalogr Clin Neurophysiol. 1998;  106 508-512
    CrossrefPubMedGoogle Scholar
  • 60 Semah F, Picot M C, Adam C, Broglin D, Arzimanoglou A, Bazin B, Cavalcanti D, Baulac M. Is the underlying cause of epilepsy a major prognostic factor for recurrence?.  Neurology. 1998;  51 1256-1262
    CrossrefPubMedGoogle Scholar
  • 61 Souweidane M M, Kim K HS, McDowall R, Ruge M I, Lis E, Krol G, Hirsch J. Brain mapping in sedated infants and young children with passive-functional magnetic resonance imaging.  Pediatric Neurosurgery. 1999;  30 86-92
    PubMedGoogle Scholar
  • 62 Spreer J, Arnold S, Quiske A, Wohlfath R, Ziyeh S, Altenmuller D, Herpers M, Kassubek J, Klisch J, Steinhoff B J, Honegger J, Schulze-Bonhage A, Schumacher M. Determination of hemisphere dominance for language: comparison of frontal and temporal fMRI activation with intracarotid amytal testing.  Neuroradiology. 2002;  44 467-474
    CrossrefPubMedGoogle Scholar
  • 63 Springer J A, Binder J R, Hammeke T A, Swanson S J, Frost J A, Bellgowan P SF, Brewer C C, Perry H M, Mueller W M. Language dominance in neurologically normal and epilepsy subjects - a functional MRI study.  Brain. 1999;  122 2033-2045
    CrossrefPubMedGoogle Scholar
  • 64 Staudt M, Grodd W, Gerloff C, Erb M, Stitz J, Krageloh-Mann I. Two types of ipsilateral reorganization in congenital hemiparesis: a TMS and fMRI study.  Brain. 2002;  125 2222-2237
    CrossrefPubMedGoogle Scholar
  • 65 Turner R, Bihan D Le, Moonen C T, Despres D, Frank J. Echo-planar time course MRI of cat brain oxygenation changes.  Magn Reson Med. 1991;  22 159-166
    CrossrefPubMedGoogle Scholar
  • 66 Warach S, Levin J M, Schomer D L, Holman B L, Edelman R R. Hyperperfusion of ictal seizure focus demonstrated by MR perfusion imaging.  Am J Neuroradiol. 1994;  15 965-968
    PubMedGoogle Scholar
  • 67 Warach S, Ives J R, Schlaug G, Patel M R, Darby D G, Thangerej V, Edelman R R, Schomer D L. EEG-triggered echo-planar functional MRI in epilepsy.  Neurology. 1996;  47 89-93
    PubMedGoogle Scholar
  • 68 Wieshmann U C, Symms M R, Shorvon S D. Diffusion changes in status epilepticus.  Lancet. 1997;  350 493-494
    PubMedGoogle Scholar
  • 69 Worthington C, Vincent D J, Bryant A E, Roberts D R, Vera C L, Ross D A, George M S. Comparison of functional magnetic resonance imaging for language localization and intracarotid speech amytal testing in presurgical evaluation for intractable epilepsy - preliminary results.  Stereotact Funct Neurosurg. 1997;  69 197-201
    PubMedGoogle Scholar
  • 70 Woermann F G, Jokeit H, Luerding R, Freitag H, Schulz R, Guertler S, Okujava M, Wolf P, Tuxhorn I, Ebner A. Language lateralization by Wada test and fMRI in 100 patients with epilepsy.  Neurology. 2003;  61 699-701
    CrossrefPubMedGoogle Scholar
  • 71 Wolf R L, Alsop D C, Levy-Reis I, Meyer P T, Maldjian J A, Gonzalez-Atavales J, French J A, Alavi A, Detre J A. Detection of mesial temporal lobe hypoperfusion in patients with temporal lobe epilepsy by use of arterial spin labeled perfusion MR imaging.  AJNR Am J Neuroradiol. 2001;  22 1334-1341
    PubMedGoogle Scholar
  • 72 Yetkin F Z, Swanson S, Fischer M, Akansel G, Morris G, Mueller W, Haughton V. Functional MR of frontal lobe activation: comparison with Wada language results.  AJNR Am J Neuroradiol. 1998;  19 1095-1098
    PubMedGoogle Scholar

Dr. med. Friedrich G. Woermann

MRT · Krankenhaus Mara · Epilepsiezentrum Bethel

Maraweg 21

33617 Bielefeld

Email: fgw@mara.de

      >