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From the Brain Research Institute (Drs. Federico, Archer, Abbott, and Jackson), Heidelberg West, Victoria, Australia; University of Melbourne (Drs. Federico and Jackson), Australia; and University of Calgary (Dr. Federico), Alberta, Canada.
Address correspondence and reprint requests to Prof. Graeme Jackson, Brain Research Institute, Neurosciences Building, Austin Health, Banksia Street, Heidelberg West, Victoria, Australia 3081; e-mail: g.jackson{at}brain.org.au
Background: Malformations of cortical development have characteristic interictal discharges, yet the mechanisms of generation of these discharges are not known in humans. Interictal discharges in malformations of cortical development were studied with EEG-fMRI.
Methods: Six subjects with malformations of cortical development and seizures were studied using spike-triggered fMRI at 3 T. The blood oxygen level–dependent (BOLD) signal changes associated with interictal discharges were measured.
Results: All subjects showed spike-related BOLD signal changes. In four subjects, the signal increases were seen in the lesion, and in four subjects, decreases were seen surrounding the lesion. Five subjects had BOLD signal changes at distant cortical sites and three had subcortical changes (basal ganglia, reticular formation, or thalamic).
Conclusion: BOLD signal changes may be directly correlated with overall synaptic activity. Changes were found in and around the lesion of malformations of cortical development and in distant cortical and subcortical structures. The results suggest that EEG-fMRI studies might help elucidate the mechanisms of epileptic discharges in humans.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 12 issue to find the title link for this article.
Editorial, see page 1108
See also page 1263
Supported by the National Health and Medical Research Council of Australia and the Austin Hospital Medical Research Foundation (Heidelberg, Victoria, Australia). P.F. holds a Clinician Scientist Award from the Canadian Institutes of Health Research and a Clinical Fellowship from the Alberta Heritage Foundation for Medical Research.
Received November 22, 2003. Accepted in final form November 22, 2004.
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