# Integration of Advanced Diffusion MRI and 3D Histology for Improved Neurosurgical Targeting

> **NIH NIH R01** · STANFORD UNIVERSITY · 2024 · $561,233

## Abstract

Project Summary:
Overview: Neurosurgical resection, ablation and stimulation can be curative for patients with medically
refractory epilepsy (MRE), however, successful treatment depends on precise localization of the seizure onset
zone (SOZ). Stereo-electroencephalography (EEG) is the gold standard for determining the SOZ and involves
implanting many intra-cranial depth electrodes to detect epileptiform activity. Unfortunately, there are often no
visible lesions on brain MRI and only a crude spatial map from scalp-EEG to guide the stereo-EEG
implantation, resulting in electrode positions that fail to definitively determine the SOZ. To meet the unmet
clinical need for consistent and accurate stereo-EEG guidance we will develop innovative diffusion MRI (dMRI)
encoding paradigms that provide specific sensitivity to epileptic microstructural pathology and validate with 3D
histology and high-density scalp- and stereo-EEG.
Relevance: There are ~400,000 patients with MRE and non-lesional MRI in the U.S. Given the lack of
guidance and sparse sampling of stereo-EEG, identifying the seizure onset zone with confidence is extremely
challenging for in these non-lesional patients. If we are successful in the proposed work, we will enable MRI
identification of a probable lesion location for the majority of patients with MRE. In this way , we will increase
their likelihood of a definitive stereo-EEG identification of the SOZ and enable a potentially curative
neurosurgical treatment option that might not have been possible otherwise.
Approach: Our approach is to: 1) Develop and validate diffusion MRI cortical fiber mapping for detection of the
disrupted cortical architecture within focal cortical dysplasias. 2) Test whether diffusion MRI cortical fiber
mapping can detect focal cortical dysplasias and 3) Test whether diffusion tractography and functional
connectivity MRI can predict seizure propagation. Specifically, we will use these MRI connectivity to predict
probable cortical nodes of the seizure propagation network, as well as, the latency and spatial propagation of
epileptiform activity between stereo-EEG electrodes.
Summary: The proposed neuroimaging methods will improve localization of the SOZ and propagation network
enabling more patients with MRE to be treated more effectively with neurosurgery.

## Key facts

- **NIH application ID:** 10854822
- **Project number:** 5R01NS095985-05
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Jennifer A McNab
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $561,233
- **Award type:** 5
- **Project period:** 2016-07-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10854822

## Citation

> US National Institutes of Health, RePORTER application 10854822, Integration of Advanced Diffusion MRI and 3D Histology for Improved Neurosurgical Targeting (5R01NS095985-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10854822. Licensed CC0.

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