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a NSE Epilepsy
Research MRI Unit, Epilepsy Research Group, Department of Clinical
Neurology, Institute of Neurology, UCL, Queen Square, London WC1N3BG,
UK, b NMR Research Unit, Department of
Clinical Neurology
Correspondence to: U Wieshmann, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool, L97LJ, UK wieshmann{at}aol.com
Received 29 June 2000 and in revised form 4 December 2000;
Accepted 14 December
2000
A patient with a mild left hemiparesis and a malformation of
cortical development in the right hemisphere was investigated with fMRI
(functional magnetic resonance imaging) and DTI (diffusion tensor
imaging). The motor cortex was studied using a finger tapping fMRI
experiment. The fibre orientation was studied by displaying the
principal eigenvector of the diffusion tensor in the spatially normalised brain of the patient and of control subjects. In addition, the anisotropy (directionality) of water diffusion of the patient was
statistically compared with control subjects.
The malformation was located in the right central region in the
expected position of the motor cortex. fMRI showed activation anterior
and posterior to the malformation. DTI disclosed that fibres with
rostrocaudal orientation, presumably representing the pyramidal tract,
were deviating from their normal orientation and passing around the
malformation. There were widespread regions of reduced anisotropy
affecting both hemispheres.
In conclusion, fMRI and DTI provided concordant information showing
widespread modified functional and structural organisation including
regions which appeared normal on standard imaging.
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