Sarah M Jacobs¹, Zahra Shams¹, Evita C Wiegers¹, Jannie P Wijnen¹, Dennis W Klomp¹, Edwin Versteeg¹, Jeroen C.W. Siero^1,2, Angelika Mühlebner^3,4, Wim Van Hecke³, Pieter van Eijsden⁵, Pierre A Robe⁵, Maeike Zijlmans^5,6, and Anja G van der Kolk^1,7
1Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands, ²Spinoza Centre for Neuroimaging Amsterdam, Amsterdam, Netherlands, ³Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands, ⁴Department of Pathology, Amsterdam University Medical Center, location AMC, Amsterdam, Netherlands, ⁵UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands, ⁶Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands, ⁷Department of Radiology, Radboud University Medical Center, Nijmegen, Netherlands

In this clinical study, we combined different (metabolic) MRI sequences at 7T to characterize focal epileptogenic lesions, and uncover potential metabolic markers that could help identifying the culprit lesion in MRI-negative epilepsy patients. Using QSM, we observed increased iron deposition in the affected hippocampus of two HS patients that was not found in the contralateral hippocampus, neither in a suspected HS patient with no abnormal tissue, nor in matched healthy volunteers. No increased iron deposition was found in patients with FCD or matched healthy volunteers. No significantly different metabolite ratios between patients and healthy volunteers were found using SV ¹H-MRS.

Lu Gao¹, Xianjun Li¹, Yuying Feng², Chao Jin², Hua Zhang³, Huanfa Li³, Haipeng Hu⁴, Xiaocheng Wei⁵, and Jian Yang ^2
1Departemnt of diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China, ²The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China, ³Departemnt of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China, ⁴Departemnt of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China, ⁵GE Healthcare, MR Research China, Beijing, Beijing, China

Conventional MRI is difficult to discover the subtle changes caused by epilepsy. Virtual magnetic resonance elastography (vMRE) is based on diffusion MRI, which is sensitive for variety of physiologic and pathologic conditions. This study use vMRE to evaluated left Rolandic epilepsy. We found that left precentral gyrus, left postcentral gryus and left superior temporal gyrus is more stiffer than controls. The longer the seizure duration the stiffer of the brain tissues. vMRE has the potential to noninvasive evaluate epilepsy.

KiChang Kang¹, Anish V. Sathe¹, Isaiah Ailes¹, India Shelley¹, Mashaal Syed¹, Christopher Miller¹, Feroze Mohamed¹, Ashwini Sharan¹, and Mahdi Alizadeh^1
1Thomas Jefferson University, Philadelphia, PA, United States

Temporal lobe epilepsy (TLE) is the most common form of epilepsy which can become medically refractory and referred for surgery. The thalamus has been shown to demonstrate both structural and functional changes in TLE. However, little is known about microstructural alterations within individual thalamic nuclei. In this study, we used diffusion tensor imaging (DTI) to determine if subjects with unilateral TLE demonstrate hemispheric and intra-hemispheric differences in thalamic nuclei across clinical characteristics. We report statistically significant differences in nuclei in subjects with tonic-clonic seizures and mesial temporal sclerosis in both hemispheric and intra-hemispheric comparisons.

Mackenzie Langan^1,2, Gaurav Verma¹, Derek Smith¹, Bradley Delman³, Madeline Fields⁴, Rebecca Feldman*^1,5, and Priti Balchandani*^1
1Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Icahn School of Medicine, Graduate School of Biomedical Sciences, New York, NY, United States, ³Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ⁴Department of Neurology, Mount Sinai Hospital, New York, NY, United States, ⁵Department of Computer Science, Math, Physics, and Statistics, University of British Columbia, Vancouver, BC, Canada

Here we outline a preliminary analysis using a novel method which leverages UHF neuroimaging to measure detectable differences in vasculature within the thalamus that may not be detectable at lower field strengths. We provide a tool for detection and quanitifcation of vessels, perivascular spaces, and subsequent overlaps within the thalamus which may be relevant to uncover possible underlying neuroinflammatory processes in focal epilepsy patients. In our analysis, we found a significant difference in the number of thalamic vessels in patients compared to controls, providing a possible marker to measure abnormal or disordered vessel growth possibly associated with increased seizure activity.

Merel JA Eussen^1,2, Jacobus FA Jansen^2,3, Twan Voncken⁴, Mariette HJA Debeij-van Hall⁵, Jos GM Hendriksen^4,5, Jeroen R Vermeulen⁴, Sylvia Klinkenberg⁴, Walter H Backes^2,3, and Gerhard Drenthen^2,3
1Department of Biomedical Technology, Eindhoven University of Technology, Eindhoven, Netherlands, ²Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands, ³School for Mental Health & Neuroscience, Maastricht University, Maastricht, Netherlands, ⁴Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands, ⁵Department of Behavioral Sciences, Kempenhaeghe, Heeze, Netherlands

Cognitive deficits have been reported in children with childhood absence epilepsy (CAE). Regional alterations in morphology in children with CAE are likely related to the changes in the underlying network structure. Structural covariance networks (SCNs) based on interregional correlations of cortical thicknesses can describe these changes. To relate cognitive performance to network efficiency, individual SCNs are derived from anatomical MR images of the control group and one patient. The global efficiency calculated from the resulting SCNs showed a negative relation with cognitive performance for children with CAE.

Fatemeh Salimi ¹, Saeed Masoudnia ², Alireza Fallahi ^2,3, Narges Hoseini Tabatabaei⁴, Mohammadreza Ay^1,2, and Mohammad-Reza Nazem-Zadeh^1,2
1Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ²Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ³Biomedical Engineering, Hamedan University of Technology, Hamedan, Iran (Islamic Republic of), ⁴Medical School, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)

Difficulties in lateralizing the epileptogenic side of the brain challenge the temporal lobe epilepsy (TLE) surgery. We examined structural connectivity in default mode network (DMN) based on graph network analysis for specifying the epileptogenic side of the brain in TLE patients. The results showed significantly different connectivity in DMN nodes among the TLE patients compared to the control cohort. DMN regions with abnormal structural connectivity in TLE subjects corresponded with the epileptogenic brain sides.

Nicolò Rolandi¹, Fulvia Palesi¹, Francesco Padelli², Isabella Giachetti², Domenico Aquino², Paul Summers³, Elena Tartara⁴, Giancarlo Germani³, Valeria Mariani⁵, Egidio D'Angelo^1,6, Laura Tassi⁵, Claudia Angela Michela Gandini Wheeler-Kingshott^1,6,7, and Paolo Vitali^3,8
1Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy, ²Neuroradiology, I.R.C.C.S. Istituto Neurologico Carlo Besta, Milano, Italy, ³Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy, ⁴Epilepsy Centre, IRCCS Mondino Foundation, Pavia, Italy, ⁵“C. Munari” Epilepsy Surgery Centre, ASST Niguarda, Milano, Italy, ⁶Brain Connectivity Center Research Unit, IRCCS Mondino Foundation, Pavia, Italy, ⁷NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, UCL Queen Square Institute of Neurology, London, United Kingdom, ⁸Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy

Temporal lobe epilepsy is characterised by heterogeneous aetiology. In this work we focused on hippocampal sclerosis and cryptogenic groups. In order to characterize microstructure white matter alterations underlying the pathology, we performed a regional analysis of the temporal lobe white matter. Our results showed less disruptive microstructural changes in cryptogenic patients. Alterations in Axial Diffusivity and Neurite Density Index in hippocampal sclerosis potentially indicate significant axonal degeneration. Further investigations are needed to ascertain the value of Orientation Dispersion Index as a possible biomarker to predict surgery outcome.

Alireza Fallahi ^1,2, Mohammad Pooyan³, Jafar Mehvari-Habibabadi ⁴, Narges Hoseini Tabatabaei⁵, Mohammadreza Ay^1,6, and Mohammad-Reza Nazem-Zadeh^1,6
1Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ²Biomedical Engineering, Hamedan University of Technology, Hamedan, Iran (Islamic Republic of), ³Biomedical Engineering, Shahed University, Tehran, Iran (Islamic Republic of), ⁴Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (Islamic Republic of), ⁵Medical School, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ⁶Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)

Five neuroimaging markers including T1 volume, FLAIR signal intensity, and mean diffusivity in hippocampus, and fractional anisotropy in both posteroinferior cingulum and crus of fornix were used for lateralization of temporal lobe epilepsy (TLE). Support vector machine (SVM) was used as a classifier and for measuring the importance of neuroimaging attributes. The classification  results demonstrated that the hippocampal volumetric and mean diffusivity showed the highest correct classification rate and the largest area under the curve (AUC) for the receiver operating characteristic (ROC), thus considered as the most important attributes of TLE laterality among all markers investigated in this study.

Anish Vinay Sathe¹, Michael Kogan², KiChang Kang¹, Jingya Miao¹, Mashaal Syed¹, Isaiah Ailes¹, Caio Matias¹, Feroze Mohamed¹, Ashwini Sharan¹, and Mahdi Alizadeh^1
1Thomas Jefferson University, Philadelphia, PA, United States, ²The University of New Mexico, Albuquerque, NM, United States

Epilepsy is a disease involving seizure initiation and often spread. sEEG has shown that areas of seizure spread are correlated with onset regions. We find that seed-to-voxel analysis via amplitude synchronization of fMRIs of epilepsy patients can also detect significant correlations between seizure onset and spread zones. These results validate fMRI analysis as a promising noninvasive method to detect other correlated brain regions that may be involved in seizure propagation.

Siu Lung Tang¹, Kristina Sabaroedin², Will Wilson², Daniel Pittman², Paolo Federico², and Pierre LeVan^2
1Department of Pediatrics, University of Calgary, Calgary, AB, Canada, ²Department of Radiology, University of Calgary, Calgary, AB, Canada

The potential of using features derived from resting-state fMRI time series to localize epileptic brain areas was studied. Static and dynamic correlations between local spike rates measured with intracranial EEG and regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and functional connectivity (FC), respectively, were analyzed based on data collected from 13 subjects with refractory epilepsy. While static measures of ReHo and ALFF were not statistically correlated with spike rates measured during long-term monitoring, static correlation with FC was apparent. However, in dynamic analysis, temporal variations in instantaneous spike rates were associated with synchronous fluctuations of both ALFF and FC.

Alireza Fallahi ¹, Mohammad Pooyan², Jafar Mehvari-Habibabadi ³, Narges Hoseini Tabatabaei⁴, Mohammadreza Ay^1,5, and Mohammad-Reza Nazem-Zadeh^1,5
1Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ²Biomedical Engineering, Shahed University, Tehran, Iran (Islamic Republic of), ³Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (Islamic Republic of), ⁴Medical School, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), ⁵Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)

In this study, six graph theoretical measures were identified as nodal level epileptogenicity in TLE patients using functional connectivity analysis. The aim of this study is to define brain nodes that have significant difference between left and right TLE patients using resting state functional connectivity analysis. Clustering coefficient, degree centrality, betweenness centrality, node neighbor’s degree, closeness centrality, and page rank were calculated as graph theoretical characteristics and multi-dimensional scaling (MDS) was used as a statistical method. Results of the applied method suggested significant nodes for prediction of laterality in TLE patients.

Vishwa Shukla¹, Molly Faith Charney¹, Sheryl Foster^2,3, Wufan Zhao¹, Han Sam Jiang¹, Kasia Kozlowska^4,5,6, and Alexander P Lin^1
1Radiology, Brigham and Women's Hospital, Boston, MA, United States, ²Sydney School of Health Sciences, The University of Sydney, Sydney, Australia, ³Radiology, Westmead Hospital, Westmead, Australia, ⁴The Children’s Hospital at Westmead Clinical School, Sydney, Australia, ⁵Psychiatry, Child & Adolescent Health, University of Sydney Medical School, Sydney, Australia, ⁶Westmead Institute for Medical Research, Westmead, Australia

Functional Neurological Disorder (FND) is characterized by a broad array of neurological symptoms that are thought to reflect aberrant activity in neural networks. This study aims to compare the neurochemical levels in the posterior default mode network (pDMN) in children and adolescents with FND and healthy controls using magnetic resonance spectroscopy (MRS). FND patients exhibited lower levels of tNAA/tCr in the pDMN compared to controls, indicating potential neuronal alterations or modified neuronal-glial signaling.

Stephanie S. G. Brown¹, Katherine Manning¹, and Anthony Holland^1
1Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom

Prader-Willi Syndrome (PWS) is a neurodevelopmental disorder characterised by intellectual disability, emotional dysregulation and importantly, marked overeating behaviour. The hypothalamus controls food intake and satiety by endocrine control, and evidence from animal studies has shown that lesions of the hypothalamic nuclei result in hyperphagia. However, studies examining the hypothalamus in humans in vivo are scarce. We show here significantly lower volumes of the hypothalamus and hypothalamic nuclei in PWS compared to healthy controls and general population obese individuals. Our findings are strongly suggestive that impaired appetite control and problematic eating behaviours are a consequence of abnormal hypothalamic structure in PWS.