Effects of spatial smoothing on fMRI group inferences.

The analysis of functional magnetic resonance imaging (fMRI) data involves multiple stages of data pre-processing before the activation can be statistically detected. Spatial smoothing is a very common pre-processing step in the analysis of functional brain imaging data. This study presents a broad perspective on the influence of spatial smoothing on fMRI group activation results. The data obtained from 20 volunteers during a visual oddball task were used for this study. Spatial smoothing using an isotropic gaussian filter kernel with full width at half maximum (FWHM) sizes 2 to 30 mm with a step of 2 mm was applied in two levels - smoothing of fMRI data and/or smoothing of single-subject contrast files prior to general linear model random-effects group analysis generating statistical parametric maps. Five regions of interest were defined, and several parameters (coordinates of nearest local maxima, t value, corrected threshold, effect size, residual values, etc.) were evaluated to examine the effects of spatial smoothing. The optimal filter size for group analysis is discussed according to various criteria. For our experiment, the optimal FWHM is about 8 mm. We can conclude that for robust experiments and an adequate number of subjects in the study, the optimal FWHM for single-subject inference is similar to that for group inference (about 8 mm, according to spatial resolution). For less robust experiments and fewer subjects in the study, a higher FWHM would be optimal for group inference than for single-subject inferences.

fMRI evaluation of hemispheric language dominance using various methods of laterality index calculation.

Several functional MR imaging studies evaluating the lateralisation of linguistic functions in patients who underwent Wada testing have been reported. There is extensive variance in the Laterality index (LI) calculation across the studies, and the optimal calculation method remains unclear. We attempted to calculate the LI in different ways in the same subjects, in order to find the LI calculation method with the highest correlation to the Wada test. Fifteen patients (10 females, 5 males) suffering from medically intractable temporal lobe epilepsy (TLE) (12 left, 3 right) were admitted for the study. The patients underwent a standardized bilateral intracarotid short-acting barbiturate test. Language testing included spontaneous speech, oral comprehension, reading, object and picture naming, and repetition. All the tasks were scored separately in order to increase the possibility of correlation between Wada and LI. A silent phonemic verbal fluency task (VFT) was used as a language paradigm for functional measurement. Regions of interest (ROIs), with a known association with language function (Broca's area, the lateral prefrontal cortex, etc.), were defined. First, the LIs were calculated from the ROIs using a previously reported method (simple suprathreshold count). Next, we used several new methods of LI calculation (t-weighting of voxels, methods independent of the choice of the statistical threshold, etc.) The most significant correlation with Wada was proven in the LIs that were evaluated from Broca's area (up to R = 0.94, P = 1 x 10(-7)). However, the new LI calculation methods used in the present study did not produce a statistically significant benefit in comparison to previously reported methods.

Combining advanced neuroimaging techniques in presurgical workup of non-lesional intractable epilepsy.

PURPOSE: The rationale for this case report is to assess the degree of congruency between the results of several advanced functional, metabolic, and structural neuroimaging techniques used in patients with MRI-negative focal epilepsy. METHODS: We investigated the presurgical evaluation and post-operative outcome of a patient with intractable, extratemporal epilepsy. Because the habitual seizures in this patient could be easily induced, six, advanced, neurodiagnostic techniques were successively applied (SISCOM, ictal FDG-PET, ictal fMRI, postictal diffusion-weighted imaging, voxel-based morphometry, and MRS imaging). RESULTS: The findings for the neuroimaging methods investigated, within the left central region, were fairly congruent. Subsequent, invasive EEG recordings revealed a seizure-onset zone at the site where most of the neuroimaging had shown abnormal findings. The surgical removal of the epileptogenic zone, as defined by concordant neuroimaging and SEEG data, resulted in seizure-free postoperative outcome. Histopathological findings revealed mild focal cortical dysplasia. CONCLUSION: Great efforts should be made to combine most of the advanced neuroimaging methods in the preoperative assessment of non-lesional epilepsy surgery candidates.

Handedness shift as a consequence of motor cortex reorganization after early functional impairment in left temporal lobe epilepsy--an fMRI case report.

The impact of epileptiform activity on the functional organization of various cortical regions is currently a widely discussed topic. Our patient, suffering from left-sided temporal lobe epilepsy with typical mesiotemporal sclerosis, had a remarkable history of a clear-cut handedness shift in early childhood. In this study, we considered the possibility of the functional reorganization of the motor cortex using functional MRI. The results reflect epileptiform activity as an important formative factor for motor cortex development in our patient.