Epilepsy Neuroimaging Alliance – Grant Winners

In late 2019, Dr. Flavius Raslau, from the Department of Radiology, initiated a multidisciplinary collaboration that leverages the strengths of the Kentucky Neuroscience Institute's (KNI) Level IV Comprehensive Epilepsy Program and the research expertise housed at the Magnetic Resonance Imaging & Spectroscopy Center (MRISC). This initiative brings together clinical collaborators from UK College of Medicine (radiologists, neurologists, neuropsychologists, neurosurgeons), MRISC scientists (neuroscientists/neuroimagers, physicists). Biostatisticians and researchers from departments in the College of Engineering, (Biomedical and Electrical) in addition to Dr. Raslau, Dr. Peter Hardy and Dr. Riham El Khouli are key members of the team representing the Radiology Department. The team has also successfully formalized partnerships with the highly acclaimed Montreal Neurological Institute (MNI) and the Cleveland Clinic (CCF). Dr. Brian Gold from the Department of Neuroscience, a veteran neuroimaging researcher and interim MRISC director, chairs the Alliance. The Alliance took on the name Functional Imaging and NeuroDiagnostics for Epilepsy and Resective Surgery (FINDERS). In August 2020, the College of Medicine Vice President of Research Dr. Jim Geddes awarded the FINDERS Alliance as grant winners. https://med.uky.edu/alliance/finders Imaging research at UK is poised to become "best-in-class" in epilepsy with the development of advanced neuroimaging and signal analysis that are relatively new and underutilized in epilepsy research. One example is simultaneous EEG-fMRI. EEG can identify epilepsy but has poor spatial resolution and cannot adequately assess deep sources; fMRI has good spatial resolution throughout the brain, including deep regions, but fMRI alone is not specific to epilepsy. However, the implementation of simultaneous EEG-fMRI can be used to map spatio-temporal processes relevant to localizing both the ‘where’ and ‘when’ of epileptic events. Only a few institutions, such as MNI and CCF, have this capability. The Alliance has an opportunity to collaborate with MNI and CCF to bring this technology to UK. Not only is UK poised to match the imaging capability of an elite class, but potentially to exceed it. EEG-fMRI has been performed inter-ictally, but the aim of the Alliance is to create a workflow for the seamless transfer of patients from the Epilepsy Monitoring Unit to the MRI center for "immediate post-ictal" scans. This novel workflow will make possible MR neuroimaging in closer temporal proximity to the seizure event than ever before. Other research lanes will include the exploration of additional neuroimaging techniques (arterial spin labeling and cerebrovascular reactivity) as well as advanced signal analysis (high-frequency-oscillations, source localization, and machine learning). The ultimate clinical goal is to improve presurgical seizure localization without the need to expose an epilepsy patient to additional radiation. This work may lead to better seizure-free outcomes for many epilepsy patients for whom medication no longer is effective. A principal aim of the Alliance is to break down silos and promote transdisciplinary growth. Additionally, an expressed aim of the Alliance is the submission and success of future extramural grant applications by providing structured grantsmanship mentoring of designated clinicians, including Dr. Raslau and Dr. El Khouli. This Alliance grant will doubtless catalyze the FINDERS team’s ability to secure additional, external funding.