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Journal Article Epublish 4 citations

PubMed: 38556543 DOI: 10.1038/s41598-024-58352-9

Lesion volume and spike frequency on EEG impact perfusion values in focal cortical dysplasia: a pediatric arterial spin labeling study.

Sci Rep 14(1):7601

Authors: Antonio Giulio Gennari, Giulio Bicciato, Santo Pietro Lo Biundo, Raimund Kottke, Ilona Stefanos-Yakoub, Dorottya Cserpan, Ruth O'Gorman Tuura, Georgia Ramantani

Affiliations

  • Department of Neuropediatrics, University Children's Hospital Zurich, 75, 8032, Zurich, Switzerland.
  • MR-Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
  • Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
  • Department of Radiology, University Children's Hospital Zurich, Zurich, Switzerland.
  • University of Zurich, Zurich, Switzerland.
  • Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
  • Department of Neuropediatrics, University Children's Hospital Zurich, 75, 8032, Zurich, Switzerland.
  • University of Zurich, Zurich, Switzerland.
  • Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.

Abstract

Arterial spin labelling (ASL), an MRI sequence non-invasively imaging brain perfusion, has yielded promising results in the presurgical workup of children with focal cortical dysplasia (FCD)-related epilepsy. However, the interpretation of ASL-derived perfusion patterns remains unclear. Hence, we compared ASL qualitative and quantitative findings to their clinical, EEG, and MRI counterparts. We included children with focal structural epilepsy related to an MRI-detectable FCD who underwent single delay pseudo-continuous ASL. ASL perfusion changes were assessed qualitatively by visual inspection and quantitatively by estimating the asymmetry index (AI). We considered 18 scans from 15 children. 16 of 18 (89%) scans showed FCD-related perfusion changes: 10 were hypoperfused, whereas six were hyperperfused. Nine scans had perfusion changes larger than and seven equal to the FCD extent on anatomical images. Hyperperfusion was associated with frequent interictal spikes on EEG (p = 0.047). Perfusion changes in ASL larger than the FCD corresponded to larger lesions (p = 0.017). Higher AI values were determined by frequent interictal spikes on EEG (p = 0.004). ASL showed FCD-related perfusion changes in most cases. Further, higher spike frequency on EEG may increase ASL changes in affected children. These observations may facilitate the interpretation of ASL findings, improving treatment management, counselling, and prognostication in children with FCD-related epilepsy.

MeSH

Epilepsy, Natural Science Disciplines, Artificial Intelligence, Child

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