Localizing confined epileptic foci in patients with an unclear focus or presumed multifocality using a component

Elias Ebrahimzadeh1, Mohammad Shams2, Ali Rahimpour Jongani3, Farhanaz Fayaz4, Mohia Mirbagheri1, Nasser Hakimi5, Leila Rajabion6 and Hamid Soltanianzadeh1,7 **Iran, Tehran, Northern Kargar Street, University of Tehran, University of Tehran, Faculty of Electrical and Computer Engineering, Faculty of Electrical and Computer Engineering 1 CIPCE** **2Neural Engineering Laboratory, Department of Electrical and Computer Engineering, George Mason University, Fairfax, Virginia, USA** **3 Department of Psychological Sciences, University of California, Mercedes, California, USA ** **4 Department of Biomedical Engineering, Faculty of Electrical Engineering, North Tehran Payam Noor University, Tehran, Iran** **Department 5 Neonatology, Department of Pediatrics at UMCU-Wilhelmina Children's Hospital, Utrecht, The Netherlands** **6 Graduate School, SUNY Empire State College, Manhattan, New York, USA** **7 Image Analysis Laboratory, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA** Accurate localization of epileptic foci is an inevitable prerequisite in epilepsy surgery.... Simultaneous recording of EEG-fMRI has recently opened new horizons for the localization of foci in patients with epilepsy and has brought more promising results compared to single-modality methods, although it is still subject to limitations such as the potential added value in the study of the lack of access to its events.. Pre-surgery evaluation of patients with complex source localization.... Adult candidates ineligible for surgery due to indeterminate focality and/or presumed multifocality based on EEG underwent EEG-fMRI.... Adopting a component-based approach, this study attempts to identify the neural behavior of epileptiform generators and use the components of interest as the classical model that will later be used in the classical model.. Retrospective.... Twenty-eight sets of epileptic discharges Interictal (IED) was evaluated from nine patients... In eight patients, at least one significant, positive BOLD response was topographically associated with IED.... These patients were excluded due to unclear focus in four patients, multifocal hypothesis in three cases, and a combination of the two conditions in two cases.... Component-based EEG-fMRI improved localization in five of six patients with indeterminate EEG-Multi-FRI foci.. favoring one foci in five patients and confirmed multiple foci in one patient.... In seven patients, component-based EEG-fMRI opened a new perspective for surgery, and in two of these patients, intracranial EEG supported the EEG-fMRI results.... In these cases Complex, component-based EEG-fMRI improved either source localization or confirmed with a candidacy decision that statistically confirmed a negative decision.. The EEG-fMRI method leads to a more realistic estimation of localization compared to the conventional EEG-fMRI approach, making it a valuable tool in the preoperative evaluation of patients with resistant epilepsy.... To ensure correct implementation, instructions for use We have incorporated component-based EEG-fMRI into clinical practice..