Causality within the Epileptic Network: An EEG-fMRI Study Validated by Intracranial EEG

Accurate localization of the Seizure Onset Zone (SOZ) is crucial in patients with drug-resistance focal epilepsy. EEG with fMRI recording (EEG-fMRI) has been proposed as a complementary non-invasive tool, which can give useful additional information in the pre-surgical work-up. However, fMRI maps related to interictal epileptiform activities (IED) often show multiple regions of signal change, or "networks," rather than highly focal ones. Effective connectivity approaches like Dynamic Causal Modeling (DCM) applied to fMRI data potentially offers a framework to address which brain regions drives the generation of seizures and IED within an epileptic network. Here, we present a first attempt to validate DCM on EEG-fMRI data in one patient affected by frontal lobe epilepsy. Pre-surgical EEG-fMRI demonstrated two distinct clusters of blood oxygenation level dependent (BOLD) signal increases linked to IED, one located in the left frontal pole and the other in the ipsilateral dorso-lateral frontal cortex. DCM of the IED-related BOLD signal favored a model corresponding to the left dorso-lateral frontal cortex as driver of changes in the fronto-polar region. The validity of DCM was supported by: (a) the results of two different non-invasive analysis obtained on the same dataset: EEG source imaging (ESI), and "psycho-physiological interaction" analysis; (b) the failure of a first surgical intervention limited to the fronto-polar region; (c) the results of the intracranial EEG monitoring performed after the first surgical intervention confirming a SOZ located over the dorso-lateral frontal cortex. These results add evidence that EEG-fMRI together with advanced methods of BOLD signal analysis is a promising tool that can give relevant information within the epilepsy surgery diagnostic work-up

An electrophysiological validation of stochastic DCM for fMRI

In this note, we assess the predictive validity of stochastic dynamic causal modeling (sDCM) of functional magnetic resonance imaging (fMRI) data, in terms of its ability to explain changes in the frequency spectrum of concurrently acquired electroencephalography (EEG) signal. We first revisit the heuristic model proposed in Kilner et al. (2005), which suggests that fMRI activation is associated with a frequency modulation of the EEG signal (rather than an amplitude modulation within frequency bands). We propose a quantitative derivation of the underlying idea, based upon a neural field formulation of cortical activity. In brief, dense lateral connections induce a separation of time scales, whereby fast (and high spatial frequency) modes are enslaved by slow (low spatial frequency) modes. This slaving effect is such that the frequency spectrum of fast modes (which dominate EEG signals) is controlled by the amplitude of slow modes (which dominate fMRI signals). We then use conjoint empirical EEG-fMRI data—acquired in epilepsy patients—to demonstrate the electrophysiological underpinning of neural fluctuations inferred from sDCM for fMRI