4-T fMRI of the motor and sensory cortices in patients with polymicrogyria and epilepsy

ObjectiveMalformations of cortical development (MCD) are an increasingly recognized cause of medically intractable epilepsy. We assessed the role of fMRI in evaluating the motor and somatosensory cortices, as well as if there is possible reorganization of these vital areas in patients with polymicrogyria.MethodsWe included 2 patients with polymicrogyria and epilepsy. Somatosensory and motor cortices were assessed with a 4 T fMRI. These findings were compared with direct cortical stimulation.ResultsLocalization of the sensorimotor cortices was adequately identified by fMRI. These vital areas did not reorganize outside the malformation of cortical development.ConclusionfMRI is a tool that can allow identification of these vital areas of the brain in a non-invasive manner.Practice implicationsAdequate localization of the sensorimotor cortices is important for optimal patient selection, surgical strategy, and to determine the maximal extent of the resection. The clinical implications for such understanding are not limited to it; these findings should help researchers understand more of the neurobiology of MCDs and even possibly clues to the mechanisms of epileptogenesis associated with such malformations.