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Negative BOLD Response to Interictal Epileptic Discharges in Focal Epilepsy

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Abstract

In EEG–fMRI studies, BOLD responses related to interictal epileptic discharges (IEDs) are most often the expected positive response (activation) but sometimes a surprising negative response (deactivation). The significance of deactivation in the region of IED generation is uncertain. The aim of this study was to determine if BOLD deactivation was caused by specific IED characteristics. Among focal epilepsy patients who underwent 3T EEG–fMRI from 2006 to 2011, those with negative BOLD having a maximum t-value in the IED generating region were selected. As controls, subjects with maximum activation in the IED generating region were selected. We established the relationship between the type of response (activation/deactivation) and (1) presence of slow wave in the IEDs, (2) lobe of epileptic focus, (3) occurrence as isolated events or bursts, (4) spatial extent of the EEG discharge. Fifteen patients with deactivation and 15 with activation were included. The IEDs were accompanied by a slow wave in 87 % of patients whose primary BOLD was a deactivation and only in 33 % of patients with activation. In the deactivation group, the epileptic focus was more frequently in the posterior quadrant and involved larger cortical areas, whereas in the activation group it was more frequently temporal. IEDs were more frequently of long duration in the deactivation group. The main factor responsible for focal deactivations is the presence of a slow wave, which is the likely electrographic correlate of prolonged inhibition. This adds a link to the relationship between electrophysiological and BOLD activities.

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Acknowledgments

The authors thank Natalja Zazubovits for helping to collect and analyze the data. Pittau F. thanks Dr. Gaetano Cantalupo for the thoughtful comments during the manuscript preparation. This work was supported by the Canadian Institutes of Health Research (CIHR) grant MOP-38079. Pittau F. was supported by the Savoy Foundation for epilepsy.

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Authors and Affiliations

  1. Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A3B4, Canada

    Francesca Pittau, Firas Fahoum, Rina Zelmann, François Dubeau & Jean Gotman

  2. IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy

    Francesca Pittau

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  1. Francesca Pittau
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  2. Firas Fahoum
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  3. Rina Zelmann
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  5. Jean Gotman
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Correspondence to Jean Gotman.

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Pittau, F., Fahoum, F., Zelmann, R. et al. Negative BOLD Response to Interictal Epileptic Discharges in Focal Epilepsy. Brain Topogr 26, 627–640 (2013). https://doi.org/10.1007/s10548-013-0302-1

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