Mapping Epileptic Networks Using Multimodal Imaging

N/ARecruitingNCT06202976

Imagine Institute75 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Epilepsy in Children

Interventions

Secondary data collectionOTHER

clinical data

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Be under 18 years of age on the day of inclusion. * Present with one of the following forms of epilepsy: * refractory focal lesional epilepsy * rare non-lesional 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: * Requiring general anesthesia for MRI * Require sedation specifically for research * Have generalized epilepsy * Be deprived of liberty or under guardianship.

Outcomes

Primary Outcomes

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.

Time frame: 15 years

Secondary Outcomes

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

Time frame: 15 years

Correlate cortical perfusion change on SL-ASMRI and BOLD signal abnormalities on resting-state fMRI

Time frame: 15 years

Compare cortical perfusion abnormalities and resting-state fMRI based on EEG data in MRI.

Time frame: 15 years

Correlate BOLD-MRI perfusion abnormalities with anatomical (DTI (tractography)) and functional (resting-state fMRI) brain connectivity abnormalities.

Time frame: 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.

Time frame: 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.

Time frame: 15 years

Improving understanding of the pathophysiology of rare non-lesional epilepsies

Time frame: 15 years

Mapping Epileptic Networks Using Multimodal Imaging

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts