{"id":5050,"date":"2025-12-18T15:12:57","date_gmt":"2025-12-18T13:12:57","guid":{"rendered":"https:\/\/sites.uef.fi\/neuro-innovation\/?p=5050"},"modified":"2025-12-18T15:12:58","modified_gmt":"2025-12-18T13:12:58","slug":"faezeh-heidari-mapping-hidden-brain-patterns-in-focal-structural-drug-resistant-epilepsy-imaging-and-surface-based-morphometry","status":"publish","type":"post","link":"https:\/\/sites.uef.fi\/neuro-innovation\/2025\/12\/18\/faezeh-heidari-mapping-hidden-brain-patterns-in-focal-structural-drug-resistant-epilepsy-imaging-and-surface-based-morphometry\/","title":{"rendered":"Faezeh Heidari: Mapping Hidden Brain Patterns in Focal Structural Drug Resistant Epilepsy: Imaging and Surface-Based Morphometry"},"content":{"rendered":"\n

In my previous blog, we explored the fundamentals of epilepsy and its clinical challenges. <\/a>Now, let\u2019s dive deeper into the imaging and computational approaches that are transforming how we understand and treat focal drug-resistant epilepsy (DRE).<\/strong><\/p>\n\n\n\n

Epilepsy surgery has traditionally focused on removing the visible lesion or the epileptogenic zone (EZ) which is the brain region where seizures originate. But what happens when the lesion is subtle or invisible on MRI? And why do some patients continue to experience seizures even after surgery? The answer lies in hidden structural patterns beyond the lesion<\/strong>, which advanced imaging and computational morphometry can reveal.<\/p>\n\n\n\n

Imaging Beyond the Lesion<\/strong><\/h2>\n\n\n\n

Conventional MRI distinguishes MRI-positive epilepsy<\/strong> (visible abnormalities like focal cortical dysplasia (FCD)) from MRI-negative epilepsy<\/strong>, where scans appear normal despite persistent seizures. This diagnostic gap underscores the need for quantitative imaging<\/strong> to detect subtle cortical changes invisible to standard radiology.<\/p>\n\n\n\n

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Figure 1. <\/strong>First image: MRI\u2013 or MRI negative. Second image: MRI+ or MRI positive (Source: https:\/\/www.nyp.org\/healthlibrary\/multimedia\/seizure-mri?utm_source=chatgpt.com).<\/em><\/figcaption><\/figure>\n\n\n\n

Focal Cortical Dysplasia: Histology and MRI Features<\/strong><\/h2>\n\n\n\n

FCD is the most common cause of focal structural drug-resistant epilepsy. The lesions are subtle and visible in MRI. It is a developmental malformation of the cortex that disrupts normal brain architecture and function, leading to seizures that often resist medication.<\/p>\n\n\n\n

Histological Perspective:<\/em><\/h4>\n\n\n\n

Normal cortex is organized into six layers (L1\u2013L6), with neurons arranged in a structured pattern.<\/p>\n\n\n\n

FCD has three main subtypes depending on how cortical lamination process disrupts during FCD. As seen in Figure 2:<\/p>\n\n\n\n