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Currently, mapping the epileptogenic zone is based on a comprehensive preoperative assessment involving clinical, imaging and electrophysiological examinations.
To reduce the need for invasive stereoelectroencephalography (SEEG) explorations, electrophysiological and imaging methods have been developed, such as resting-state functional MRI (fMRI) coupled with electroencephalogram and arterial spin-labeling perfusion MRI (ASL-MRI).
It has been published that these new methods enable precise delineation of the epileptogenic zone and better preparation for surgery.
The aim is to determine whether, in children with focal lesional epilepsy, the combination of ASL-MRI-EEG and resting-state fMRI-EEG enables precise identification of the epileptogenic zone to be defined by SEEG, the current reference examination.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Secondary data collection | Other | clinical data |
|
| Measure | Description | Time Frame |
|---|---|---|
| Determine whether, in children with lesional focal epilepsy, the combination of ASL-MRI-EEG and resting-state fMRI-EEG can accurately identify the epileptogenic zone to be defined by SEEG, today's gold standard. | 15 years |
| Measure | Description | Time Frame |
|---|---|---|
| Study the pathophysiology of resistant lesional epilepsies | Measurements of perfusion in ASL-MRI (inter and/or percritical) and the BOLD effect in resting-state fMRI | 15 years |
| Correlate cortical perfusion change on SL-ASMRI and BOLD signal abnormalities on resting-state fMRI |
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Inclusion Criteria:
Be under 18 years of age on the day of inclusion.
Present with one of the following forms of epilepsy:
Present abnormalities (spikes) on the intercritical EEG
Have been selected by the "Epilepsy" multidisciplinary staff.
In the case of refractory lesional epilepsy, be required to perform an EEG-video recording using intracranial electrodes (SEEG) as part of the pre-surgical workup.
Be affiliated to a health insurance scheme.
Exclusion Criteria:
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Children with refractory focal epilepsy, possibly due to lesions
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nathalie Boddaert, Pr | Contact | +33 (0)1 44 49 51 75 | nathalie.boddaert@aphp.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Necker - Enfants Malades Hospital | Recruiting | Paris | 75015 | France |
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| ID | Term |
|---|---|
| D004828 | Epilepsies, Partial |
| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 15 years |
| Compare cortical perfusion abnormalities and resting-state fMRI based on EEG data in MRI. | 15 years |
| Correlate BOLD-MRI perfusion abnormalities with anatomical (DTI (tractography)) and functional (resting-state fMRI) brain connectivity abnormalities. | 15 years |
| Compare ASL-MRI and resting-state fMRI data coupled with EEG to the results of deep electrodes (intracranial EEG - SEEG), which are today's gold standard. | 15 years |
| Evaluate whether these data will eventually make it possible to reduce the frequency of intracranial EEG explorations (stereo EEG, subdural grids), with a view to replacing invasive deep electrodes in the future with multimodal MRI coupled to EEG in MRI. | 15 years |
| Improving understanding of the pathophysiology of rare non-lesional epilepsies | 15 years |