Functional organization of the brain with malformations of cortical development

J. Janszky, Alois Ebner, Bernd Kruse, Markus Mertens, Hennric Jokeit, Ruediger J. Seitz, Otto W. Witte, Ingrid Tuxhorn, Friedrich G. Woermann

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Abstract

We examined the localization of cerebral functions in 28 patients with focal epilepsy and malformations of cortical development (MCDs). Polymicrogyria occurred in nine, hemimegalencephaly in four, heterotopia in eight, and focal cortical dysplasia (FCD) in nine cases. We used simple (sensomotor, visual) or complex (language, memory) functional magnetic resonance imaging (fMRI) paradigms. Two thirds of MCDs were activated by simple fMRI paradigms, whereas they less frequently showed activity during complex cognitive fMRI paradigms. During simple paradigms, all disturbances of cortical organization (polymicrogyria, schizencephaly, and mild-type FCD) showed activity, whereas other MCDs (disturbances of earlier steps of cortical development: hemimegalencephaly, Taylor-type FCD, and heterotopia) showed activity in only 44% (p <0.01). The association between the pathophysiology and morphology of MCDs confirms the recently proposed classification system. Both focal neurological signs (p <0.05) and focal electroencephalogram slowing (p <0.05) independently correlated with MCD inactivity, confirming that fMRI showed neuronal functions of MCDs. Conclusively, fMRI visualizes the MCD functions and their relationship to the eloquent cortex, providing useful information before epilepsy surgery. Surgery of cortical organization disturbances should be cautiously performed because these malformations may participate to some degree in brain functions.

Original languageEnglish
Pages (from-to)759-767
Number of pages9
JournalAnnals of Neurology
Volume53
Issue number6
DOIs
Publication statusPublished - Jun 1 2003

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Malformations of Cortical Development
Brain
Magnetic Resonance Imaging
Partial Epilepsy
Electroencephalography
Epilepsy
Language

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Janszky, J., Ebner, A., Kruse, B., Mertens, M., Jokeit, H., Seitz, R. J., ... Woermann, F. G. (2003). Functional organization of the brain with malformations of cortical development. Annals of Neurology, 53(6), 759-767. https://doi.org/10.1002/ana.10545

Functional organization of the brain with malformations of cortical development. / Janszky, J.; Ebner, Alois; Kruse, Bernd; Mertens, Markus; Jokeit, Hennric; Seitz, Ruediger J.; Witte, Otto W.; Tuxhorn, Ingrid; Woermann, Friedrich G.

In: Annals of Neurology, Vol. 53, No. 6, 01.06.2003, p. 759-767.

Research output: Contribution to journalArticle

Janszky, J, Ebner, A, Kruse, B, Mertens, M, Jokeit, H, Seitz, RJ, Witte, OW, Tuxhorn, I & Woermann, FG 2003, 'Functional organization of the brain with malformations of cortical development', Annals of Neurology, vol. 53, no. 6, pp. 759-767. https://doi.org/10.1002/ana.10545
Janszky, J. ; Ebner, Alois ; Kruse, Bernd ; Mertens, Markus ; Jokeit, Hennric ; Seitz, Ruediger J. ; Witte, Otto W. ; Tuxhorn, Ingrid ; Woermann, Friedrich G. / Functional organization of the brain with malformations of cortical development. In: Annals of Neurology. 2003 ; Vol. 53, No. 6. pp. 759-767.
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