Interictal Electroencephalography and Functional Magnetic Resonance Imaging Reveals Involvement of Mesial Anterior Frontal Structures in Patients With Hyperkinetic Semiology Type I

Abstract

Purpose: This work investigates the presence of common anatomic regions associated with interictal activity in patients with hyperkinetic seizures type I by means of concurrent electroencephalography and functional magnetic resonance imaging. Methods: Six patients with hyperkinetic seizures type I were evaluated with video-EEG and electroencephalography and functional magnetic resonance imaging in the context of their presurgical evaluation. Statistical Parametric Mapping was used to perform a correlation study between the occurrence of interictal spikes on EEG and suprathreshold blood oxygen level–dependent changes in the whole-brain volume. Results: In all patients, Statistical Parametric Mapping revealed suprathreshold blood oxygen level–dependent clusters in the mesial anterior frontal areas, including the rostral mesial superior frontal gyrus and the anterior cingulate, associated with the patients' typical interictal activity. Conclusions: The electroencephalography and functional magnetic resonance imaging findings contribute to our understanding of hyperkinetic seizures type I semiology generation and can inform stereo-EEG targeting for surgical planning in refractory cases.