The overall goal of this project is to determine the ability of 1H MRI/MRS at 4T to localize the epileptogenic focus in partial epilepsy and to predict the outcome of seizure surgery. This application proposes a continuing effort to improve the outcome of seizure surgery by better presurgical localization of intractable partial epilepsy using state of the art neuroimaging techniques. Specifically, we will determine the predictive 'Value added"""""""" of MRI (structural, arterial spin perfusion, and diffusion tensor imaging) and MRS (single voxel and 3D) imaging to the diagnostic evaluation of refractory epilepsy using a 4 Tesla scanner that will be optimized for investigation of neurodegenerative disease. This project will study patients with non-lesional, unifocal, medically refractory, localization related epilepsy. These techniques will be directed at two groups of patients with intractable epilepsy who are being evaluated for seizure surgery (numbers for 5 years): 1) patients with medial temporal lobe epilepsy with and without MRI evidence of mesial temporal sclerosis (n=80), 2) patients with non-lesional neocortical epilepsy (may include cortical malformations) (n=80). Post-operative surgical outcome will be analyzed in relation to the pre-operative neuroimaging findings. Hypotheses: 1) for patients with medically refractory complex partial seizures arising from either the medial temporal lobe or from neocortical regions, structural, perfusion, diffusion and MRS imaging at 4T will be a more sensitive measure of seizure lateralization/localization than conventional MRI performed at 1.5T; 2) for these two patient groups, MRI and MRS measures at 4T that are concordant with the lateralization by video/EEG telemetry will have significantly better post surgical outcomes than patients without concordance. All studies will be performed in a systematic, prospective, blinded, and controlled manner to predict the patients that respond best to seizure surgery. The significance of these studies is that the use of newly developed MRI and MRS techniques at high field strength will lead to improved epilepsy surgery outcomes and will reduce unnecessary surgery in patients with intractable epilepsy.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS031966-12
Application #
7076144
Study Section
Clinical Neuroscience and Disease Study Section (CND)
Program Officer
Fureman, Brandy E
Project Start
1994-05-01
Project End
2010-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
12
Fiscal Year
2006
Total Cost
$875,988
Indirect Cost
Name
California Pacific Medical Center Research Institute
Department
Type
DUNS #
071882724
City
San Francisco
State
CA
Country
United States
Zip Code
94107
Mueller, Susanne G; Bateman, Lisa M; Laxer, Kenneth D (2014) Evidence for brainstem network disruption in temporal lobe epilepsy and sudden unexplained death in epilepsy. Neuroimage Clin 5:208-16
Lindqvist, Daniel; Mueller, Susanne; Mellon, Synthia H et al. (2014) Peripheral antioxidant markers are associated with total hippocampal and CA3/dentate gyrus volume in MDD and healthy controls-preliminary findings. Psychiatry Res 224:168-74
Mueller, Susanne G; Young, Karl; Hartig, Miriam et al. (2013) A two-level multimodality imaging Bayesian network approach for classification of partial epilepsy: preliminary data. Neuroimage 71:224-32
Scanlon, Cathy; Mueller, Susanne G; Cheong, Ian et al. (2013) Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis. J Neurol 260:2320-9
Swaminathan, Shanker; Shen, Li; Risacher, Shannon L et al. (2012) Amyloid pathway-based candidate gene analysis of [(11)C]PiB-PET in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Brain Imaging Behav 6:1-15
Mueller, Susanne G; Laxer, Kenneth D; Scanlon, Cathy et al. (2012) Different structural correlates for verbal memory impairment in temporal lobe epilepsy with and without mesial temporal lobe sclerosis. Hum Brain Mapp 33:489-99
Schuff, Norbert; Tosun, Duygu; Insel, Philip S et al. (2012) Nonlinear time course of brain volume loss in cognitively normal and impaired elders. Neurobiol Aging 33:845-55
Chiang, G C; Zhan, W; Schuff, N et al. (2012) White matter alterations in cognitively normal apoE ?2 carriers: insight into Alzheimer resistance? AJNR Am J Neuroradiol 33:1392-7
Chiang, Gloria C; Insel, Philip S; Tosun, Duygu et al. (2011) Impact of apolipoprotein E4-cerebrospinal fluid ?-amyloid interaction on hippocampal volume loss over 1 year in mild cognitive impairment. Alzheimers Dement 7:514-20
Schneider, Lon S; Insel, Philip S; Weiner, Michael W et al. (2011) Treatment with cholinesterase inhibitors and memantine of patients in the Alzheimer's Disease Neuroimaging Initiative. Arch Neurol 68:58-66

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