Optimized Intracranial EEG Targeting in Focal Epilepsy Based Upon Neuroimaging Connectomics

What this Trial Is About

Researchers are studying noninvasive imaging methods to better understand and predict brain activity patterns related to seizures in people with focal drug-resistant epilepsy, particularly those undergoing evaluation for epilepsy surgery. The study aims to develop imaging biomarkers that can map epileptic networks and improve surgical outcomes by guiding electrode placement and targeting seizure spread more precisely. This research is important as over 20 million individuals worldwide have focal epilepsy that does not respond to medication and might benefit from surgery. Participants with medication-resistant epilepsy who are expected to have temporal lobe epilepsy and are planned for intracranial EEG (IEEG) monitoring will undergo advanced MRI scans at 3 Tesla and 7 Tesla magnetic field strengths. These neuroimaging tests will be combined with IEEG recordings that measure brain activity directly from implanted electrodes. The study involves mapping structural brain connections using diffusion tensor imaging and correlating functional MRI networks with seizure activity captured on IEEG to create models that predict seizure dynamics and surgical outcomes. During the study, participants will undergo MRI scans before electrode implantation and IEEG monitoring as part of their clinical care. Researchers will analyze how brain structure and function relate to seizure activity using imaging and electrical recordings. They will assess outcomes such as the coupling of brain structure and function, the relationship between seizure onset and MRI network patterns, and imaging biomarkers associated with seizure origin. The study's findings may support more personalized, less invasive approaches to epilepsy surgery in the future.

Localizing Epileptic Networks Using MRI and iEEG