Specificities of arterial spin labeling (ASL) abnormalities in acute seizure

Schertz, Mathieu; Benzakoun, Joseph; Pyatigorskaya, Nadya; Belkacem, Samia; Sahli-Amor, M.; Navarro, Vincent; Cholet, Clément; Leclercq, Delphine; Dormont, Didier; Law-Ye, Bruno

doi:10.1016/j.neurad.2018.11.003

Cited by 15 publications

(8 citation statements)

References 30 publications

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“…ASL has also been correlated with electroencephalography (EEG) findings of seizure foci in 72% of patients. 34 Therefore, ASL seems to be an emerging modality whose findings agree with data establishing increased perfusion and EEG spikes at epileptogenic foci.…”

Section: Seizuresupporting

confidence: 60%

“…Such characterization includes determining seizure focus, ascertaining abnormal peri-ictal perfusion patterns, and ruling out stroke in the setting of acute deficits. 34 Studies of peri-ictal perfusion patterns have shown a postictal perfusion decrease of 71.4% (15/21) in patients studied with ASL. 9 Of these patients, 80% showed areas of postictal hypoperfusion as demonstrated by ASL.…”

Section: Seizurementioning

confidence: 99%

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Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Soldozy¹,

Galindo²,

Snyder³

et al. 2019

Neurosurgical Focus

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Neuroimaging is an indispensable tool in the workup and management of patients with neurological disorders. Arterial spin labeling (ASL) is an imaging modality that permits the examination of blood flow and perfusion without the need for contrast injection. Noninvasive in nature, ASL provides a feasible alternative to existing vascular imaging techniques, including angiography and perfusion imaging. While promising, ASL has yet to be fully incorporated into the diagnosis and management of neurological disorders. This article presents a review of the most recent literature on ASL, with a special focus on its use in moyamoya disease, brain neoplasms, seizures, and migraines and a commentary on recent advances in ASL that make the imaging technique more attractive as a clinically useful tool.

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Section: Seizuresupporting

confidence: 60%

Section: Seizurementioning

confidence: 99%

Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Soldozy¹,

Galindo²,

Snyder³

et al. 2019

Neurosurgical Focus

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show abstract

“…Because it does not require the injection of contrast agents, it has the advantages of easy access, no radiation, short scanning times, and low costs. Recently, ASL has been used widely for the study of neurological disorders, such as epilepsy ( Schertz et al, 2020 ), Alzheimer’s disease ( Iturria-Medina et al, 2016 ; Benedictus et al, 2017 ), Parkinson’s disease ( Lin et al, 2017 ), and preoperative brain tumor grading ( Shen et al, 2016 ; Ningning et al, 2017 ). Furthermore, ASL is capable of explaining the neural basis of IGE and enabling early diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Alterations of Cerebral Perfusion and Functional Connectivity in Children With Idiopathic Generalized Epilepsy

Chen

Ran

et al. 2022

Front. Neurosci.

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BackgroundStudies have demonstrated that adults with idiopathic generalized epilepsy (IGE) have functional abnormalities; however, the neuropathological pathogenesis differs between adults and children. This study aimed to explore alterations in the cerebral blood flow (CBF) and functional connectivity (FC) to comprehensively elucidate the neuropathological mechanisms of IGE in children.MethodsWe obtained arterial spin labeling (ASL) and resting state functional magnetic resonance imaging data of 28 children with IGE and 35 matched controls. We used ASL to determine differential CBF regions in children with IGE. A seed-based whole-brain FC analysis was performed for regions with significant CBF changes. The mean CBF and FC of brain areas with significant group differences was extracted, then its correlation with clinical variables in IGE group was analyzed by using Pearson correlation analysis.ResultsCompared to controls, children with IGE had CBF abnormalities that were mainly observed in the right middle temporal gyrus, right middle occipital gyrus (MOG), right superior frontal gyrus (SFG), left inferior frontal gyrus (IFG), and triangular part of the left IFG (IFGtriang). We observed that the FC between the left IFGtriang and calcarine fissure (CAL) and that between the right MOG and bilateral CAL were decreased in children with IGE. The CBF in the right SFG was correlated with the age at IGE onset. FC in the left IFGtriang and left CAL was correlated with the IGE duration.ConclusionThis study found that CBF and FC were altered simultaneously in the left IFGtriang and right MOG of children with IGE. The combination of CBF and FC may provide additional information and insight regarding the pathophysiology of IGE from neuronal and vascular integration perspectives.

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“…In the assessment, expert-based hypotheses encompassing clinical history, neuropsychological assessment and electrophysiological findings were considered in 12/20 cases. Although most perfusion abnormalities during postictal conditions reflected hypoperfusion, exceptional cases of hyperperfusion have been reported ∗ [23,24]. These findings indicate, similar to peri-ictal imaging in emergency situations, the clinical uncertainty or lack of knowledge about precise termination of seizure and persistence of ongoing epileptic activity in the absence of clinical signs.…”

Section: Peri-ictal Imagingmentioning

confidence: 90%

Recent developments in imaging of epilepsy

Wiest

Beisteiner

2019

Current Opinion in Neurology

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Purpose of review Imaging constitutes one of the key pillars in the diagnostic workup after a first seizure as well as for the presurgical workup in epilepsy. The role of imaging in emergency situations, mainly to support the adequate diagnosis, as well as its role in planning of noninvasive image-guided therapies is less well established. Here, we provide an overview on peri-ictal imaging findings to support differential diagnosis in emergency situations and describe recent attempts toward minimal invasive therapy in the treatment of epilepsy and its comorbidities based on a combination of imaging techniques with ultrasound. Recent findings Peri-ictal perfusion changes can differentiate ictal stroke mimics from acute ischemic stroke if focal areas of increased perfusion are depicted by computed tomography or MRI. Postictal perfusion patterns in patients with persisting neurological symptoms are frequently normal and do not reach enough diagnostic sensitivity to differentiate between stroke and its mimics. Noninvasive magnetic resonance-techniques as arterial spin labeling may provide a higher sensitivity, especially in combination with diffusion-weighted and susceptibility-weighted MRI. Imaging guided focused ultrasound (FUS) bears the potential to ablate epileptogenic tissue and allows suppression of epileptic activity. Imaging guided blood–brain-barrier opening with FUS offers new options for local drug administration. Summary MRI should be considered the method of choice in the differential diagnosis of peri-ictal imaging findings and their differential diagnosis. A combination of various MRI techniques with FUS opens new avenues for treatment of epilepsy.

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Specificities of arterial spin labeling (ASL) abnormalities in acute seizure

Cited by 15 publications

References 30 publications

Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Clinical utility of arterial spin labeling imaging in disorders of the nervous system

Alterations of Cerebral Perfusion and Functional Connectivity in Children With Idiopathic Generalized Epilepsy

Recent developments in imaging of epilepsy

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