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Neuropediatrics 2023; 54(03): 188-196
DOI: 10.1055/a-1959-9241
Original Article

Abnormal Spontaneous Blood Oxygenation Level Dependent Fluctuations in Children with Focal Cortical Dysplasias: Initial Findings in Surgically Confirmed Cases

Volodia Dangouloff-Ros 
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
5   School of Mental Health and Neurosciences, Maastricht, the Netherlands
,
Jacobus F.A. Jansen
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
5   School of Mental Health and Neurosciences, Maastricht, the Netherlands
,
Joost de Jong
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
5   School of Mental Health and Neurosciences, Maastricht, the Netherlands
,
Alida A. Postma
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
5   School of Mental Health and Neurosciences, Maastricht, the Netherlands
,
Christianne Hoeberigs
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
,
Ludovic Fillon
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
,
Jennifer Boisgontier
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
,
Charles-Joris Roux
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
,
Raphael Levy
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
,
Pascale Varlet
6   Neuropathology Department, GHU Paris, Université de Paris, 1 rue Cabanis, Paris
,
Thomas Blauwblomme
7   Pediatric Neurosurgery Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
8   Université de Paris, INSERM U1129, Pediatric Epilepsies and Brain Plasticity, Paris, France
,
Monika Eisermann
8   Université de Paris, INSERM U1129, Pediatric Epilepsies and Brain Plasticity, Paris, France
9   Department of Clinical Neurophysiology, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Emma Losito
8   Université de Paris, INSERM U1129, Pediatric Epilepsies and Brain Plasticity, Paris, France
10   Pediatric Neurology Department, Reference Center for Rare Epilepsies, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Marie Bourgeois
7   Pediatric Neurosurgery Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Catherine Chiron
8   Université de Paris, INSERM U1129, Pediatric Epilepsies and Brain Plasticity, Paris, France
10   Pediatric Neurology Department, Reference Center for Rare Epilepsies, Hôpital Universitaire Necker-Enfants Malades, Paris, France
11   Department of Nuclear Medicine, SHFJ-CEA, Orsay, France
,
Rima Nabbout
8   Université de Paris, INSERM U1129, Pediatric Epilepsies and Brain Plasticity, Paris, France
10   Pediatric Neurology Department, Reference Center for Rare Epilepsies, Hôpital Universitaire Necker-Enfants Malades, Paris, France
,
Nathalie Boddaert
1   Pediatric Radiology Department, AP-HP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
2   Université de Paris, INSERM U1199, Paris, France
3   Université de Paris, Institut Imagine, Paris, France
,
Walter Backes
4   Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
5   School of Mental Health and Neurosciences, Maastricht, the Netherlands
› Author Affiliations Funding This work was funded by the Alain Rahmouni research grant from the French Society of Radiology.
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Abstract

Background Focal cortical dysplasias (FCD) are a frequent cause of drug-resistant epilepsy in children but are often undetected on structural magnetic resonance imaging (MRI). We aimed to measure and validate the variation of resting state functional MRI (rs-fMRI) blood oxygenation level dependent (BOLD) metrics in surgically proven FCDs in children, to assess the potential yield for detecting and understanding these lesions.

Methods We prospectively included pediatric patients with surgically proven FCD with inconclusive structural MRI and healthy controls, who underwent a ten-minute rs-fMRI acquired at 3T. Rs-fMRI data was pre-processed and maps of values of regional homogeneity (ReHo), degree centrality (DC), amplitude of low frequency fluctuations (ALFF) and fractional ALFF (fALFF) were calculated. The variations of BOLD metrics within the to-be-resected areas were analyzed visually, and quantitatively using lateralization indices. BOLD metrics variations were also analyzed in fluorodeoxyglucose-positron emission tomography (FDG-PET) hypometabolic areas.

Results We included 7 patients (range: 3–15 years) and 6 aged-matched controls (range: 6–17 years). ReHo lateralization indices were positive in the to-be-resected areas in 4/7 patients, and in 6/7 patients in the additional PET hypometabolic areas. These indices were significantly higher compared to controls in 3/7 and 4/7 patients, respectively. Visual analysis revealed a good spatial correlation between high ReHo areas and MRI structural abnormalities (when present) or PET hypometabolic areas. No consistent variation was seen using DC, ALFF, or fALFF.

Conclusion Resting-state fMRI metrics, noticeably increase in ReHo, may have potential to help detect MRI-negative FCDs in combination with other morphological and functional techniques, used in clinical practice and epilepsy-surgery screening.

Keywords

malformation of cortical development - functional MRI - children - epilepsy - seizures

Supplementary Material



Publication History

Received: 17 May 2022

Accepted: 07 October 2022

Accepted Manuscript online:
12 October 2022

Article published online:
27 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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