Zusammenfassung
Die funktionelle Magnetresonanztomographie (fMRT) erlaubt die bildliche Darstellung
umschriebener Hirnaktivität. Die dabei auf Hirnschnitte oder die Hirnoberfläche projizierten
Aktivitätsmuster bei motorischen, sensorischen oder kognitiven Leistungen können in
topografische Beziehungen zu anfallsverursachenden Läsionen gesetzt werden. Inwieweit
diese Informationen insbesondere zur präoperativen Abschätzung eines Operationsrisikos
klinisch genutzt werden können, ist Gegenstand dieser Übersicht.
Abstract
Functional magnetic resonance imaging (fMRI) allows the visualization of localized
brain activation. Localized MR contrast changes associated with sensory-motor or cognitive
brain functions are expressed as activation maps and projected onto structural MRI.
In patients with epilepsy, fMRI promises to delineate epileptogenic lesions from eloquent
cortex. The future clinical use of this method depends highly on its ability to predict
postoperative morbidity. Recent fMRI studies on the localization of the motor strip
and the lateralization of language and memory are discussed.
Key words
Epilepsy - functional MRI - language - memory
Literatur
- 1
Archer J S, Briellmann R S, Syngeniotis A, Abbott D F, Jackson G D.
Spike-triggered fMRI in reading epilepsy: involvement of left frontal cortex working
memory area.
Neurology.
2003;
60
415-421
- 2
Archer J S, Briellman R S, Abbott D F, Syngeniotis A, Wellard R M, Jackson G D.
Benign epilepsy with centro-temporal spikes: spike triggered fMRI shows somato-sensory
cortex activity.
Epilepsia.
2003;
44
200-204
- 3
Bahn M M, Lin W, Silbergeld D L, Miller J W, Kuppusamy K, Cook R J, Hammer G, Wetzel R,
Cross D.
Localization of language cortices by functional MR imaging compared with intracarotid
amobarbital hemispheric sedation.
Am J Radiol.
1997;
169
575-579
- 4
Baxendale S.
The role of functional MRI in the presurgical investigation of temporal lobe epilepsy
patients: a clinical perspective and review.
J Clin Exp Neuropsychol.
2002;
24
664-676
- 5
Bellgowan P S, Binder J R, Swanson S J, Hammeke T A, Springer J A, Frost J A, Mueller W M,
Morris G L.
Side of seizure focus predicts left medial temporal lobe activation during verbal
encoding.
Neurology.
1998;
51
479-484
- 6
Benson R R, FitzGerald D B, LeSueur L L, Kennedy D N, Kwong K K, Buchbinder B R, Davis T L,
Weisskoff R M, Talavage T M, Logan W J, Cosgrove G R, Belliveau J W, Rosen B R.
Language dominance determined by whole brain functional MRI in patients with brain
lesions.
Neurology.
1999;
52
798-809
- 7
Binder J R, Swanson S J, Hammeke T A, Morris G L, Mueller W M, Fischer M, Benbadis S,
Frost J A, Rao S M, Haughton V M.
Determination of language dominance using functional MRI: a comparison with the Wada
test.
Neurology.
1996;
46
978-984
- 8
Binder J R, Achten E, Constable R T, Detre J A, Gaillard W D, Jack C R, Loring D W.
Functional MRI in epilepsy.
Epilepsia.
2002;
43 (Suppl 1)
51-63
- 9
Bookheimer S Y.
Functional MRI applications in clinical epilepsy.
Neuroimage.
1996;
4
139-146
- 10
Bookheimer S Y.
Methodological issues in pediatric neuroimaging.
Mental Retardation and Developmental Disabilities Research Reviews.
2000;
6
161-165
- 11
Boor S, Vucurevic G, Pfleiderer C, Stoeter P, Kutschke G, Boor R.
EEG-related functional MRI in benign childhood epilepsy with centrotemporal spikes.
Epilepsia.
2003;
44
688-692
- 12
Bradley W G, Shey R B.
MR imaging evaluation of seizures.
Radiology.
2000;
214
651-656
- 13
Carpentier A, Pugh K R, Westerveld M, Studholme C, Skrinjar O, Thompson J L, Spencer D D,
Constable R T.
Functional MRI of language processing: dependence on input modality and temporal lobe
epilepsy.
Epilepsia.
2001;
42
1241-1254
- 14
Cendes F, Knowlton R C, Novotny E, Li L M, Antel S, Sawrie S, Laxer K D, Arnold D.
Magnetic resonance spectroscopy in epilepsy: clinical issues.
Epilepsia.
2002;
43 (Suppl 1)
32-39
- 15
Dehaene-Lambertz G, Dehaene S, Hertz-Pannier L.
Functional neuroimaging of speech perception in infants.
Science.
2002;
298
2013-2015
- 16
Desmond J E, Sum J M, Wagner A D, Demb J B, Shear P K, Glover G H, Gabrieli J DE,
Morell M J.
Functional MRI measurement of language lateralization in Wada-tested patients.
Brain.
1995;
118
1411-1419
- 17
Detre J A, Sirven J I, Alsop D C, O'Connor M J, French J A.
Localization of subclinical ictal activity by functional magnetic resonance imaging:
correlation with invasive monitoring.
Ann Neurol.
1995;
38
618-624
- 18
Detre J A, Alsop D C, Aguirre G K, Sperling M A.
Coupling of cortical and thalamic ictal activity in human partial epilepsy: demonstration
by functional magnetic resonance imaging.
Epilepsia.
1996;
37
657-661
- 19
Detre J A, Maccotta L, King D, Alsop D C, Glosser G, D'Esposito M, Zarahn E, Aguirre G K,
French J A.
Functional MRI lateralization of memory in temporal lobe epilepsy.
Neurology.
1998;
50
926-932
- 20
Diehl B, Najm I, Ruggieri P. et al .
Postictal diffusion-weighted imaging for the localization of focal epileptic areas
in temporal lobe epilepsy.
Epilepsia.
2001;
42
21-28
- 21
Duncan J S.
Neuroimaging methods to evaluate the etiology and consequences of epilepsy.
Epilepsy Res.
2002;
50
131-140
- 22
Dupont S, Moortele P F Van de, Samson S, Hasboun D, Poline J B, Adam C, Lehericy S,
Bihan D Le, Famson Y, Baulac M.
Episodic memory in left temporal lobe epilepsy: a functional MRI study.
Brain.
2000;
123
1722-1732
- 23
Dupont S, Samson Y, Moortele P F Van de, Poline J B, Adam C, Lehericy S, Bihan D Le,
Baulac M.
Delayed verbal memory retrieval: a functional MRI study in epileptic patients with
structural lesions of the left medial temporal lobe.
Neuroimage.
2001;
14
995-1003
- 24
Fernandez G, Brewer J B, Zhao Z, Glover G H, Gabrieli J D.
Level of sustained entorhinal activity at study correlates with subsequent cued-recall
performance - a functional magnetic resonance imaging study with high acquisition
rate.
Hippocampus.
1999;
9
35-44
- 25
Fernandez G, Greiff A de, Oertzen J von, Reuber M, Lun S, Kluver P, Ruhlmann J, Reul J,
Elger C E.
Language mapping in less than 15 minutes: real time functional MRI during routine
clinical investigation.
Neuroimage.
2001;
14
585-594
- 26
Fox P T, Raichle M E.
Focal physiological uncoupling of cerebral blood flow and oxidative metabolism during
somatosensory stimulation in human subjects.
Proc Natl Acad Sci USA.
1986;
83
1140-1144
- 27
Gaillard W D, Balsamo L, Xu B, Grandin C B, Braniecki S H, Papero P H, Weinstein S,
Conry J, Pearl P L, Sachs B, Sato S, Jabbari B, Vezina L G, Frattali C, Theodore W.
Language dominance in partial epilepsy patients identified with an fMRI reading task.
Neurology.
2002;
59
256-265
- 28
Golby A J, Poldrack R A, Illes J, Chen D, Desmond J E, Gabrieli J D.
Memory lateralization in medial temporal lobe epilepsy assessed by functional MRI.
Epilepsia.
2002;
43
855-863
- 29
Hagemann G, Krakow K, Woermann F G.
Funktionelle MR-Verfahren in der Epilepsiediagnostik.
Klin Neurophysiol.
2000;
31 (S1)
49-56
- 30
Hammeke T A, Bellgowan P SF, Binder J R.
FMRI: methodology - cognitive function mapping.
Adv Neurol.
2000;
83
221-233
- 31
Helmstaedter C, Kurthen M, Lux S, Reuber M, Elger C E.
Chronic epilepsy and cognition: A longitudinal study in temporal lobe epilepsy.
Ann Neurol.
2003;
54
425-432
- 32
Hertz-Pannier L, Gaillard W D, Mott S H, Cuenod C A, Bookheimer S Y, Weinstein S,
Conry J, Papero P H, Schiff S J, Bihan D Le, Theodore W H.
Noninvasive assessment of language dominance in children and adolescents with functional
MRI: a preliminary study.
Neurology.
1997;
48
1003-1012
- 33
Hertz-Pannier L, Chiron C, Jambaque I, Renaux-Kieffer V, Moortele P F Van de, Delalande O,
Fohlen M, Brunelle F, Bihan D Le.
Late plasticity for language in a child's non-dominant hemisphere: a pre- and post-surgery
fMRI study.
Brain.
2002;
125
361-372
- 34
Hetherington H P, Gadian D G, Ng T C.
Magnetic resonance spectroscopy in epilepsy: technical issues.
Epilepsia.
2002;
43 (suppl 1)
25-31
- 35
Hirsch J, Ruge M I, Kim K HS, Correa D D, Victor J D, Relkin N R, Labar D R, Krol G,
Bilsky M H, Souweidane M M, Angelis L M De, Gutin P H.
An integrated functional magnetic resonance imaging procedure for preoperative mapping
of cortical areas associated with tactile, motor, language, and visual functions.
Neurosurgery.
2000;
47
711-722
- 36
Hufnagel A, Weber J, Marks S, Ludwig T, Greiff A De, Leonhardt G, Widmann G, Stolke D,
Forsting M.
Brain diffusion after single seizures.
Epilepsia.
2003;
44
54-63
- 37
ILAE neuroimaging commission .
Recommendations for neuroimaging of patients with epilepsy.
Epilepsia.
1997;
38 (s10)
1-2
- 38
ILAE Commission on diagnostic strategies .
Recommendations for functional neuroimaging of persons with epilepsy.
Epilepsia.
2000;
41
1350-1356
- 39 Jack C R, Lee C C, Ward H A, Riederer S J.
The role of functional MRI in planning perirolandic surgery. In: Moonen CTW, Bandettini PA Functional MRI. Berlin, Heidelberg; Springer 1999
- 40
Jackson G D, Connelly A, Cross J H, Gordon I, Gadian D G.
Functional magnetic resonance imaging of focal seizures.
Neurology.
1994;
44
850-856
- 41
Janszky J, Ebner A, Kruse B, Mertens M, Jokeit H, Seitz R J, Witte O W, Tuxhorn I,
Woermann F G.
Functional organization of the brain with malformations of cortical development.
Ann Neurol.
2003;
53
759-767
- 42
Jokeit H, Okujava M, Woermann F G.
Memory fMRI lateralizes temporal lobe epilepsy.
Neurology.
2001;
57
1786-1792
- 43
Jokeit H, Okujava M, Woermann F G.
Carbamazepine reduces memory induced activation of mesial temporal lobe structures
- a pharmacological fMRI-study.
BMC Neurology.
2001b;
1
6,
, at http//www.biomedcentral.com/1471-2377/1/6
- 44
Krainik A, Lehericy S, Duffau H, Capelle L, Chainay H, Cornu P, Cohen L, Boch A L,
Mangin J F, Bihan D Le, Marsault C.
Postoperative speech disorder after medial frontal surgery: Role of the supplementary
motor area.
Neurology.
2003;
60
587-594
- 45
Krakow K, Woermann F G, Symms M R, Allen P J, Lemieux L, Barker G J, Duncan J S, Fish D R.
EEG-triggered functional MRI of interictal epileptiform activity in patients with
partial seizures.
Brain.
1999;
122
1679-1688
- 46
Krings T, Schreckenberger M, Rohde V, Foltys H, Spetzger U, Sabri O, Reinges M H,
Kemeny S, Meyer P T, Moller-Hartmann W, Korinth M, Gilsbach J M, Buell U, Thron A.
Metabolic and electrophysiological validation of functional MRI.
J Neurol Neurosurg Psychiatry.
2001;
71
762-771
- 47
Krings T, Topper R, Willmes K, Reinges M H, Gilsbach J M, Thron A.
Activation in primary and secondary motor areas in patients with CNS neoplasms and
weakness.
Neurology.
2002;
58
381-390
- 48
Laufs H, Krakow K, Sterzer P, Eger E, Beyerle A, Salek-Haddadi A, Kleinschmidt A.
Electroencephalographic signatures of attentional and cognitive default modes in spontaneous
brain activity fluctuations at rest.
Proc Natl Acad Sci USA.
2003;
100
11053-11058
- 49
Lehericy S, Cohen L, Bazin B, Samson S, Giacomini E, Rougetet R, Hertz-Pannier L,
Bihan D Le, Marsault C, Baulac M.
Functional MR evaluation of temporal and frontal language dominance compared with
the Wada test.
Neurology.
2000;
54
1625-1633
- 50
Logothetis N K, Pauls J, Augath M, Trinath T, Oeltermann A.
Neurophysiological investigation of the basis of the fMRI signal.
Nature.
2001;
412
150-157
- 51
Lux H D, Heinemann U, Dietzel I.
Ionic changes and alterations in the size of the extracellular space during epileptic
activity.
Adv Neurol.
1986;
44
619-639
- 52
Niendorf T.
Methodische Grundlagen moderner Magnet-Resonanz-Bildgebungsverfahren und ihre Anwendung
in der Neurologie.
Klin Neurophysiol.
2000;
31 (S 1)
2-17
- 53
Ogawa S, Lee T M, Kay A R, Tank D W.
Brain magnetic resonance imaging with contrast dependent on blood oxygenation.
Proc Natl Acad Sci USA.
1990;
87
9868-9872
- 54
Penfield W.
The evidence for a cerebral vascular mechanism in epilepsy.
Ann Intern Med.
1933;
7
303-310
- 55
Price C J, Friston K J.
Cognitive conjunction: a new approach to brain activation experiments.
Neuroimage.
1997;
5
261-270
- 56
Rosenow F, Lüders H.
Presurgical evaluation of epilepsy.
Brain.
2001;
124
1683-1700
- 57
Rutten G J, Ramsey N F, Rijen P van C, Noordmans H J, Veelen C W van.
Development of a functional magnetic resonance imaging protocol for intraoperative
localization of critical temporoparietal language areas.
Ann Neurol.
2002;
51
350-360
- 58
Salek-Haddadi A, Lemieux L, Merschhemke M, Friston K J, Duncan J S, Fish D R.
Functional magnetic resonance imaging of human absence seizures.
Ann Neurol.
2003;
53
663-667
- 59
Seeck M, Lazeyras F, Michel C M, Blanke O, Gericke C A, Ives J, Delavelle J, Golay X,
Haenggeli C A, Tribolet N de, Landis T.
Non-invasive epileptic focus localization using EEG-triggered functional MRI and electromagnetic
tomography.
Electroencephalogr Clin Neurophysiol.
1998;
106
508-512
- 60
Semah F, Picot M C, Adam C, Broglin D, Arzimanoglou A, Bazin B, Cavalcanti D, Baulac M.
Is the underlying cause of epilepsy a major prognostic factor for recurrence?.
Neurology.
1998;
51
1256-1262
- 61
Souweidane M M, Kim K HS, McDowall R, Ruge M I, Lis E, Krol G, Hirsch J.
Brain mapping in sedated infants and young children with passive-functional magnetic
resonance imaging.
Pediatric Neurosurgery.
1999;
30
86-92
- 62
Spreer J, Arnold S, Quiske A, Wohlfath R, Ziyeh S, Altenmuller D, Herpers M, Kassubek J,
Klisch J, Steinhoff B J, Honegger J, Schulze-Bonhage A, Schumacher M.
Determination of hemisphere dominance for language: comparison of frontal and temporal
fMRI activation with intracarotid amytal testing.
Neuroradiology.
2002;
44
467-474
- 63
Springer J A, Binder J R, Hammeke T A, Swanson S J, Frost J A, Bellgowan P SF, Brewer C C,
Perry H M, Mueller W M.
Language dominance in neurologically normal and epilepsy subjects - a functional MRI
study.
Brain.
1999;
122
2033-2045
- 64
Staudt M, Grodd W, Gerloff C, Erb M, Stitz J, Krageloh-Mann I.
Two types of ipsilateral reorganization in congenital hemiparesis: a TMS and fMRI
study.
Brain.
2002;
125
2222-2237
- 65
Turner R, Bihan D Le, Moonen C T, Despres D, Frank J.
Echo-planar time course MRI of cat brain oxygenation changes.
Magn Reson Med.
1991;
22
159-166
- 66
Warach S, Levin J M, Schomer D L, Holman B L, Edelman R R.
Hyperperfusion of ictal seizure focus demonstrated by MR perfusion imaging.
Am J Neuroradiol.
1994;
15
965-968
- 67
Warach S, Ives J R, Schlaug G, Patel M R, Darby D G, Thangerej V, Edelman R R, Schomer D L.
EEG-triggered echo-planar functional MRI in epilepsy.
Neurology.
1996;
47
89-93
- 68
Wieshmann U C, Symms M R, Shorvon S D.
Diffusion changes in status epilepticus.
Lancet.
1997;
350
493-494
- 69
Worthington C, Vincent D J, Bryant A E, Roberts D R, Vera C L, Ross D A, George M S.
Comparison of functional magnetic resonance imaging for language localization and
intracarotid speech amytal testing in presurgical evaluation for intractable epilepsy
- preliminary results.
Stereotact Funct Neurosurg.
1997;
69
197-201
- 70
Woermann F G, Jokeit H, Luerding R, Freitag H, Schulz R, Guertler S, Okujava M, Wolf P,
Tuxhorn I, Ebner A.
Language lateralization by Wada test and fMRI in 100 patients with epilepsy.
Neurology.
2003;
61
699-701
- 71
Wolf R L, Alsop D C, Levy-Reis I, Meyer P T, Maldjian J A, Gonzalez-Atavales J, French J A,
Alavi A, Detre J A.
Detection of mesial temporal lobe hypoperfusion in patients with temporal lobe epilepsy
by use of arterial spin labeled perfusion MR imaging.
AJNR Am J Neuroradiol.
2001;
22
1334-1341
- 72
Yetkin F Z, Swanson S, Fischer M, Akansel G, Morris G, Mueller W, Haughton V.
Functional MR of frontal lobe activation: comparison with Wada language results.
AJNR Am J Neuroradiol.
1998;
19
1095-1098
Dr. med. Friedrich G. Woermann
MRT · Krankenhaus Mara · Epilepsiezentrum Bethel
Maraweg 21
33617 Bielefeld
Email: fgw@mara.de
