Estimation of fMRI responses related to epileptic discharges using Bayesian hierarchical modeling

Author:

Cai Zhengchen1,von Ellenrieder Nicolás1,Koupparis Andreas2,Khoo Hui Ming3,Ikemoto Satoru1,Tanaka Masataka4,Abdallah Chifaou1,Rammal Saba1,Dubeau Francois1,Gotman Jean1

Affiliation:

1. The Neuro (Montreal Neurological Institute‐Hospital) McGill University Montreal Quebec Canada

2. The Cyprus Institute of Neurology and Genetics Nicosia Cyprus

3. Department of Neurosurgery Osaka University Graduate School of Medicine Suita Japan

4. Department of Neurosurgery Yao Municipal Hospital Yao‐city Osaka Japan

Abstract

AbstractSimultaneous electroencephalography–functional MRI (EEG‐fMRI) is a unique and noninvasive method for epilepsy presurgical evaluation. When selecting voxels by null‐hypothesis tests, the conventional analysis may overestimate fMRI response amplitudes related to interictal epileptic discharges (IEDs), especially when IEDs are rare. We aimed to estimate fMRI response amplitudes represented by blood oxygen level dependent (BOLD) percentage changes related to IEDs using a hierarchical model. It involves the local and distributed hemodynamic response homogeneity to regularize estimations. Bayesian inference was applied to fit the model. Eighty‐two epilepsy patients who underwent EEG‐fMRI and subsequent surgery were included in this study. A conventional voxel‐wise general linear model was compared to the hierarchical model on estimated fMRI response amplitudes and on the concordance between the highest response cluster and the surgical cavity. The voxel‐wise model overestimated fMRI responses compared to the hierarchical model, evidenced by a practically and statistically significant difference between the estimated BOLD percentage changes. Only the hierarchical model differentiated brief and long‐lasting IEDs with significantly different BOLD percentage changes. Overall, the hierarchical model outperformed the voxel‐wise model on presurgical evaluation, measured by higher prediction performance. When compared with a previous study, the hierarchical model showed higher performance metric values, but the same or lower sensitivity. Our results demonstrated the capability of the hierarchical model of providing more physiologically reasonable and more accurate estimations of fMRI response amplitudes induced by IEDs. To enhance the sensitivity of EEG‐fMRI for presurgical evaluation, it may be necessary to incorporate more appropriate spatial priors and bespoke decision strategies.

Funder

Canadian Institutes of Health Research

Savoy Foundation

Publisher

Wiley

Subject

Neurology (clinical),Neurology,Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology,Anatomy

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