Ictal Functional Neuroimaging of Childhood Absence Epilepsy

Absence seizures in Childhood Absence Epilepsy (CAE) are 5 10 second episodes of impaired consciousness that are characterized on electroencephalography (EEG) by frontally-predominant, 3 4 Hz spike and wave discharges (SWD). The aims of this study were to use simultaneous EEG, functional magnetic resonance imaging (fMRI), and behavioral testing to identify the neural networks involved in absence seizures as well as to examine the timecourse of those ictal fMRI changes. It was hypothesized that absence seizures involve wide-reaching neural networks including the areas traditionally associated with normal attention processing and that absence seizures produce fMRI signal changes not only during the seizure, but before and after it as well. In this study, we recorded 88 absence seizures from a cohort of 42 children with pure CAE. These seizures were recorded as subjects participated in simultaneous EEG-fMRI scanning while engaged in a continuous performance task (CPT) of attentional vigilance or a repetitive tapping task (RTT) requiring repetitive motor activity. Using a novel, voxel-based percent fMRI change analysis combined with a volume of interest analysis, the second-by-second fMRI signal timecourse of the absence seizures were examined across numerous brain regions of interest, from 20 seconds before seizure onset through 40 seconds after seizure onset. EEG frequency analysis revealed seizures with a mean duration of 6.6 seconds and an abrupt onset and ending that were comprised of frontally-predominant, 3 4 Hz SWD. Ictal behavioral testing demonstrated abrupt onset of impairments during periods of SWD. These behavioral impairments were typical of CAE absence seizures in that impairments were greater in the CPT of attentional vigilance (omission error rate, OER = 81%) than in RTT testing (OER = 39 %) (p \u3c 0.003). The ictal fMRI changes we observed varied depending upon the method of fMRI signal analysis used. Using the traditional general liner model, and assuming the standard hemodynamic response (HRF) function, this study replicated results consistent with previous ictal absence fMRI studies showing ictal activations primarily in the thalamus and ictal deactivations in traditional default mode areas. Using a more data-driven, novel voxel-based fMRI percentage change analysis to examine the ictal fMRI timecourse on a second-by-second basis, both ictally as well as pre- and post- ictally, this study, however, demonstrated ictal involvement of diverse brain regions before, during, and after the seizure. Activation was demonstrated up to 16 seconds before seizure onset, starting first in the parietal and orbital-medial frontal cortices and progressing to lateral frontal and lateral temporal cortices followed by the occipital and Rolandic cortices and finally the thalamus. Deactivation followed a similar anatomic progression and lasted up to 17 seconds after the end of SWD. These findings reveal a complex and long-lasting sequence of fMRI changes in CAE absence seizures that are not detectable by conventional HRF modeling and are important in the understanding and eventual treatment of absence seizures associated with CAE

A feasibility study of several 3D printing methods for applications in epilepsy surgery.

OBJECTIVE: To describe the process of three-dimensional printing in epilepsy surgery using three different methods: low-force stereolithography (SLA), filament deposition modeling (FDM), and Polyjet Stratasys, while comparing them in terms of printing efficiency, cost, and clinical utility. MRI and CT images of patient anatomy have been limited to review in the two-dimensional plane, which provides only partial representation of intricate intracranial structures. There has been growing interest in 3D printing of physical models of this complex anatomy to be used as an educational tool and for surgical visualization. One specific application is in epilepsy surgery where there are challenges in visualizing complex intracranial anatomy in relation to implanted surgical tools. METHODS: MRI and CT data from patients with refractory epilepsy from a single center that underwent surgery are converted into 3D volumes, or stereolithography files. These were then printed using three popular 3D printing methods: SLA, FDM, and Polyjet. Faculty were surveyed on the impact of 3D modeling on the surgical planning process. RESULTS: All three methods generated physical models with an increasing degree of resolution, transparency, and clinical utility directly related to cost of production and accurate representation of anatomy. Polyjet models were the most transparent and clearly represented intricate implanted electrodes but had the highest associated cost. FDM produced relatively inexpensive models that, however, were nearly completely opaque, limiting clinical utility. SLA produced economical and highly transparent models but was limited by single material capacity. SIGNIFICANCE: Three-dimensional printing of patient-specific anatomy is feasible with a variety of printing methods. The clinical utility of lower-cost methods is limited by model transparency and lack of multi-material overlay respectively. Polyjet successfully generated transparent models with high resolution of internal structures but is cost-prohibitive. Further research needs to be done to explore cost-saving methods of modeling

Magnetic properties of bulk Zn₁₋ₓMnₓO and Zn₁₋ₓCoₓO single crystals

© 2004 American Institute of Physics. The electronic version of this article is the complete one and can be found at: http://dx.doi.org/10.1063/1.1830084DOI: 10.1063/1.1830084Manganese and cobalt-doped ZnO have been produced using a modified melt-growth technique. X-ray diffraction measurements indicate that the samples are high-quality single crystals with ω−2θ full width at half maximum values of 78 arc sec for the undoped ZnO and 252 arc sec for Zn₁₋ₓMnₓO (x = 0.05). The lattice parameter of the Zn₁₋ₓMnₓO was observed to increase with Mn concentration. Transmission measurements showed systematic variations dominated by absorption from interatomic Mn²⁺ and Co²⁺ transitions. No evidence of diluted magnetic semiconductor mean-field ferromagnetic behavior was observed in any of these nominally noncarrier-doped samples. The magnetic properties instead showed paramagnetic behavior for Zn₁₋ₓMnₓO dominated by an antiferromagnetic Mn–Mn exchange interaction at low temperatures. Zn ₁₋ₓ CoₓO showed hysteresis that was attributed to superparamagnetic Co clusters embedded in a diamagnetic ZnO matrix. It has been shown that in the bulk single-crystal form, intrinsic and noncarrier-doped Zn₁₋ₓTMₓO is not ferromagnetic; thus creative processing and doping techniques are necessary to achieve practical ferromagnetism in these materials