High resolution structural, functional and spectroscopic magnetic resonance (MR) imaging of the brain are powerful technologies for the study of epilepsy. Image-guided surgical resection has proven to be an effective treatment for many cases of medically intractable epilepsy. In neocortical, bilateral or otherwise diffuse epilepsy, however, localization of the epileptogenic region is more difficult and it is often impossible to surgically remove all of the potentially epileptogenic tissue due to its involvement in brain function. Responsive neurostimulation has emerged as a promising complementary technique for the treatment of epilepsy which can also serve as a powerful tool for interrogating brain function. We are pursuing a program of MR imaging research on the study of localization-related epilepsy and its response to two interventions: surgical resection and responsive neurostimulation. Key challenges include developing high field MR image acquisition technology, developing an improved understanding of the biochemical and functional signatures of the epileptogenic region and surrounding tissue, improved modeling of neurostimulation and the integration of this multimodal information into the planning and treatment environments. These goals will be achieved in this bioengineering research partnership (BRP) by bringing together six academic and two industrial partners to carry out four integrated programs of bioengineering development and scientific investigation: 1) advanced development of MR imaging technology (structural, functional, and spectroscopic) for the study and treatment of localization-related epilepsy, 2) development of image analysis strategies for image-guided planning, modeling, intervention, and evaluation, 3) multimodal investigation of alterations in the presence of epilepsy and their relationship to electrical connectivity as seen from intracranial EEG signals, and 4) investigation of functional and biochemical changes in the brain, as quantified by MR, in response to resection and neurostimulation therapy. These programs of research are designed to lead to improvement of our understanding and treatment of patients with localization-related epilepsy through the use of advanced integrated magnetic resonance imaging.
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