Involvement of the Thalamus, Hippocampus, and Brainstem in Hypsarrhythmia of West Syndrome: Simultaneous Recordings of Electroencephalography and fMRI Study

EEG-fMRI findings of all patients with WS. A, Combined t-maps of 4 HRFs on EEG-fMRI of all patients at the onset of WS. The first (leftmost) axial image of each patient shows the axial slice with the maximum t value. All children showed significant BOLD response in the brainstem, hippocampus, thalamus, and basal ganglia, as well as multiple cerebral neocortices. B, EEG-fMRI findings of 6 children who had focal epileptiform discharges in the remote period after ACTH therapy. Significant BOLD responses in the brainstem, thalamus, and hippocampus are shown by arrows on sagittal, axial, and coronal sections of each patient. Positive BOLD responses are indicated by yellow arrows, and negative BOLD responses are indicated by blue arrows. The MNI coordinates of maximum t values are described in the Online Supplemental Data. In both A and B, all significant BOLD responses from 4 HRFs are shown. Pt. indicates patient; t-max, time-to-maximum.