Simultaneous EEG-fMRI acquisition at low, high and ultra-high magnetic fields up to 9.4 T: perspectives and challenges

An open-access dataset of naturalistic viewing using simultaneous EEG-fMRI

In this work, we present a dataset that combines functional magnetic imaging (fMRI) and electroencephalography (EEG) to use as a resource for understanding human brain function in these two imaging modalities. The dataset can also be used for optimizing preprocessing methods for simultaneously collected imaging data. The dataset includes simultaneously collected recordings from 22 individuals (ages: 23-51) across various visual and naturalistic stimuli. In addition, physiological, eye tracking, electrocardiography, and cognitive and behavioral data were collected along with this neuroimaging data. Visual tasks include a flickering checkerboard collected outside and inside the MRI scanner (EEG-only) and simultaneous EEG-fMRI recordings. Simultaneous recordings include rest, the visual paradigm Inscapes, and several short video movies representing naturalistic stimuli. Raw and preprocessed data are openly available to download. We present this dataset as part of an effort to provide open-access data to increase the opportunity for discoveries and understanding of the human brain and evaluate the correlation between electrical brain activity and blood oxygen level-dependent (BOLD) signals.

Effects of Moderate to High Static Magnetic Fields on Reproduction

With the wide application of magnetic resonance imaging in hospitals and permanent magnets in household items, people have increased exposure to various types of static magnetic fields (SMFs) with moderate and high intensities, which has caused a considerable amount of public concern. Studies have shown that some aspects of gametogenesis and early embryonic development can be significantly affected by SMFs, while others have shown no effects. This review summarizes the experimental results of moderate to high-intensity SMFs (1 mT-16.7 T) on the reproductive development of different model animals, and we find that the effects of SMFs are variable depending on experimental conditions. In general, the effects of inhomogeneous SMFs seem to be more significant compared to that of homogeneous SMFs, which is likely due to magnetic forces generated by the magnetic field gradient. Moreover, some electromagnetic fields may have induced bioeffects because of nonnegligible gradient and heat effect, which are much reduced in superconducting magnets. We hope this review can provide a starting point for more in-depth analysis of various SMFs on reproduction, which is indispensable for evaluating the safety and potential applications of SMFs on living organisms in the future. © 2022 Bioelectromagnetics Society.

The Effect of Magnetic Field Gradient and Gadolinium-Based MRI Contrast Agent Dotarem on Mouse Macrophages

Magnetic resonance imaging (MRI) is widely used in diagnostic medicine. MRI uses the static magnetic field to polarize nuclei spins, fast-switching magnetic field gradients to generate temporal and spatial resolution, and radiofrequency (RF) electromagnetic waves to control the spin orientation. All these forms of magnetic static and electromagnetic RF fields interact with human tissue and cells. However, reports on the MRI technique's effects on the cells and human body are often inconsistent or contradictory. In both research and clinical MRI, recent progress in improving sensitivity and resolution is associated with the increased magnetic field strength of MRI magnets. Additionally, to improve the contrast of the images, the MRI technique often employs contrast agents, such as gadolinium-based Dotarem, with effects on cells and organs that are still disputable and not fully understood. Application of higher magnetic fields requires revisiting previously observed or potentially possible bio-effects. This article focuses on the influence of a static magnetic field gradient with and without a gadolinium-based MRI contrast agent (Dotarem) and the cellular and molecular effects of Dotarem on macrophages.

Statistical power or more precise insights into neuro-temporal dynamics? Assessing the benefits of rapid temporal sampling in fMRI

Functional magnetic resonance imaging (fMRI), a non-invasive and widely used human neuroimaging method, is most known for its spatial precision. However, there is a growing interest in its temporal sensitivity. This is despite the temporal blurring of neuronal events by the blood oxygen level dependent (BOLD) signal, the peak of which lags neuronal firing by 4-6 seconds. Given this, the goal of this review is to answer a seemingly simple question - "What are the benefits of increased temporal sampling for fMRI?". To answer this, we have combined fMRI data collected at multiple temporal scales, from 323 to 1000 milliseconds, with a review of both historical and contemporary temporal literature. After a brief discussion of technological developments that have rekindled interest in temporal research, we next consider the potential statistical and methodological benefits. Most importantly, we explore how fast fMRI can uncover previously unobserved neuro-temporal dynamics - effects that are entirely missed when sampling at conventional 1 to 2 second rates. With the intrinsic link between space and time in fMRI, this temporal renaissance also delivers improvements in spatial precision. Far from producing only statistical gains, the array of benefits suggest that the continued temporal work is worth the effort.

When Is Simultaneous Recording Necessary? A Guide for Researchers Considering Combined EEG-fMRI

Electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) provide non-invasive measures of brain activity at varying spatial and temporal scales, offering different views on brain function for both clinical and experimental applications. Simultaneous recording of these measures attempts to maximize the respective strengths of each method, while compensating for their weaknesses. However, combined recording is not necessary to address all research questions of interest, and experiments may have greater statistical power to detect effects by maximizing the signal-to-noise ratio in separate recording sessions. While several existing papers discuss the reasons for or against combined recording, this article aims to synthesize these arguments into a flow chart of questions that researchers can consider when deciding whether to record EEG and fMRI separately or simultaneously. Given the potential advantages of simultaneous EEG-fMRI, the aim is to provide an initial overview of the most important concepts and to direct readers to relevant literature that will aid them in this decision.

Effects of 3.5-23.0 T static magnetic fields on mice: A safety study

People are exposed to various magnetic fields, including the high static/steady magnetic field (SMF) of MRI, which has been increased to 9.4 T in preclinical investigations. However, relevant safety studies about high SMF are deficient. Here we examined whether 3.5-23.0 T SMF exposure for 2 h has severe long-term effects on mice using 112 C57BL/6J mice. The food/water consumption, blood glucose levels, blood routine, blood biochemistry, as well as organ weight and HE stains were all examined. The food consumption and body weight were slightly decreased for 23.0 T-exposed mice (14.6%, P < 0.01, and 1.75-5.57%, P < 0.05, respectively), but not the other groups. While total bilirubin (TBIL), white blood cells, platelet and lymphocyte numbers were affected by some magnetic conditions, most of them were still within normal reference range. Although 13.5 T magnetic fields with the highest gradient (117.2 T/m) caused spleen weight increase, the blood count and biochemistry results were still within the control reference range. Moreover, the highest field 23.0 T with no gradient did not cause organ weight or blood biochemistry abnormality, which indicates that field gradient is a key parameter. Collectively, these data suggest 3.5-23.0 T static magnetic field exposure for 2 h do not have severe long-term effects on mice.

Large-area MRI-compatible epidermal electronic interfaces for prosthetic control and cognitive monitoring

Skin-interfaced medical devices are critically important for diagnosing disease, monitoring physiological health and establishing control interfaces with prosthetics, computer systems and wearable robotic devices. Skin-like epidermal electronic technologies can support these use cases in soft and ultrathin materials that conformally interface with the skin in a manner that is mechanically and thermally imperceptible. Nevertheless, schemes so far have limited the overall sizes of these devices to less than a few square centimetres. Here, we present materials, device structures, handling and mounting methods, and manufacturing approaches that enable epidermal electronic interfaces that are orders of magnitude larger than previously realized. As a proof-of-concept, we demonstrate devices for electrophysiological recordings that enable coverage of the full scalp and the full circumference of the forearm. Filamentary conductive architectures in open-network designs minimize radio frequency-induced eddy currents, forming the basis for structural and functional compatibility with magnetic resonance imaging. We demonstrate the use of the large-area interfaces for the multifunctional control of a transhumeral prosthesis by patients who have undergone targeted muscle-reinnervation surgery, in long-term electroencephalography, and in simultaneous electroencephalography and structural and functional magnetic resonance imaging.

Relationship Between Alpha Rhythm and the Default Mode Network: An EEG-fMRI Study

PURPOSE

Reports of the relationship between the default mode network (DMN) and alpha power are conflicting. Our goal was to assess this relationship by analyzing concurrently obtained EEG/functional MRI data using hypothesis-independent methods.

METHODS

We collected functional MRI and EEG data during eyes-closed rest in 20 participants aged 19 to 37 (10 females) and performed independent component analysis on the functional MRI data and a Hamming-windowed fast Fourier transform on the EEG data. We correlated functional MRI fluctuations in the DMN with alpha power.

RESULTS

Of the six independent components found to have significant relationships with alpha, four contained DMN-associated regions: One independent component was positively correlated with alpha power, whereas all others were negatively correlated. Furthermore, two independent components with opposite relationships with alpha had overlapping voxels in the medial prefrontal cortex and posterior cingulate cortex, suggesting that subpopulations of neurons within these classic nodes within the DMN may have different relationships to alpha power.

CONCLUSIONS

Different parts of the DMN exhibit divergent relationships to alpha power. Our results highlight the relationship between DMN activity and alpha power, indicating that networks, such as the DMN, may have subcomponents that exhibit different behaviors.

Adaptive optimal basis set for BCG artifact removal in simultaneous EEG-fMRI

Electroencephalography (EEG) signals recorded during simultaneous functional magnetic resonance imaging (fMRI) are contaminated by strong artifacts. Among these, the ballistocardiographic (BCG) artifact is the most challenging, due to its complex spatio-temporal dynamics associated with ongoing cardiac activity. The presence of BCG residuals in EEG data may hide true, or generate spurious correlations between EEG and fMRI time-courses. Here, we propose an adaptive Optimal Basis Set (aOBS) method for BCG artifact removal. Our method is adaptive, as it can estimate the delay between cardiac activity and BCG occurrence on a beat-to-beat basis. The effective creation of an optimal basis set by principal component analysis (PCA) is therefore ensured by a more accurate alignment of BCG occurrences. Furthermore, aOBS can automatically estimate which components produced by PCA are likely to be BCG artifact-related and therefore need to be removed. The aOBS performance was evaluated on high-density EEG data acquired with simultaneous fMRI in healthy subjects during visual stimulation. As aOBS enables effective reduction of BCG residuals while preserving brain signals, we suggest it may find wide application in simultaneous EEG-fMRI studies.

Electrophysiological Source Imaging: A Noninvasive Window to Brain Dynamics

Brain activity and connectivity are distributed in the three-dimensional space and evolve in time. It is important to image brain dynamics with high spatial and temporal resolution. Electroencephalography (EEG) and magnetoencephalography (MEG) are noninvasive measurements associated with complex neural activations and interactions that encode brain functions. Electrophysiological source imaging estimates the underlying brain electrical sources from EEG and MEG measurements. It offers increasingly improved spatial resolution and intrinsically high temporal resolution for imaging large-scale brain activity and connectivity on a wide range of timescales. Integration of electrophysiological source imaging and functional magnetic resonance imaging could further enhance spatiotemporal resolution and specificity to an extent that is not attainable with either technique alone. We review methodological developments in electrophysiological source imaging over the past three decades and envision its future advancement into a powerful functional neuroimaging technology for basic and clinical neuroscience applications.

Hypersampling of pseudo-periodic signals by analytic phase projection

A method to upsample insufficiently sampled experimental time series of pseudo-periodic signals is proposed. The result is an estimate of the pseudo-periodic cycle underlying the signal. This "hypersampling" requires a sufficiently sampled reference signal that defines the pseudo-periodic dynamics. The time series and reference signal are combined by projecting the time series values to the analytic phase of the reference signal. The resulting estimate of the pseudo-periodic cycle has a considerably higher effective sampling rate than the time series. The procedure is applied to time series of MRI images of the human brain. As a result, the effective sampling rate could be increased by three orders of magnitude. This allows for capturing the waveforms of the very fast cerebral pulse waves traversing the brain. Hypersampling is numerically compared to the more commonly used retrospective gating. An outlook regarding EEG and optical recordings of brain activity as the reference signal is provided.

Multimodal approaches to functional connectivity in autism spectrum disorders: An integrative perspective

Atypical functional connectivity has been implicated in autism spectrum disorders (ASDs). However, the literature to date has been largely inconsistent, with mixed and conflicting reports of hypo- and hyper-connectivity. These discrepancies are partly due to differences between various neuroimaging modalities. Functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and magnetoencephalography (MEG) measure distinct indices of functional connectivity (e.g., blood-oxygenation level-dependent [BOLD] signal vs. electrical activity). Furthermore, each method has unique benefits and disadvantages with respect to spatial and temporal resolution, vulnerability to specific artifacts, and practical implementation. Thus far, functional connectivity research on ASDs has remained almost exclusively unimodal; therefore, interpreting findings across modalities remains a challenge. Multimodal integration of fMRI, EEG, and MEG data is critical in resolving discrepancies in the literature, and working toward a unifying framework for interpreting past and future findings. This review aims to provide a theoretical foundation for future multimodal research on ASDs. First, we will discuss the merits and shortcomings of several popular theories in ASD functional connectivity research, using examples from the literature to date. Next, the neurophysiological relationships between imaging modalities, including their relationship with invasive neural recordings, will be reviewed. Finally, methodological approaches to multimodal data integration will be presented, and their future application to ASDs will be discussed. Analyses relating transient patterns of neural activity ("states") are particularly promising. This strategy provides a comparable measure across modalities, captures complex spatiotemporal patterns, and is a natural extension of recent dynamic fMRI research in ASDs. © 2017 Wiley Periodicals, Inc. Develop Neurobiol 78: 456-473, 2018.

Heart-Brain Interactions in the MR Environment: Characterization of the Ballistocardiogram in EEG Signals Collected During Simultaneous fMRI

The ballistocardiographic (BCG) artifact is linked to cardiac activity and occurs in electroencephalographic (EEG) recordings acquired inside the magnetic resonance (MR) environment. Its variability in terms of amplitude, waveform shape and spatial distribution over subject's scalp makes its attenuation a challenging task. In this study, we aimed to provide a detailed characterization of the BCG properties, including its temporal dependency on cardiac events and its spatio-temporal dynamics. To this end, we used high-density EEG data acquired during simultaneous functional MR imaging in six healthy volunteers. First, we investigated the relationship between cardiac activity and BCG occurrences in the EEG recordings. We observed large variability in the delay between ECG and subsequent BCG events (ECG-BCG delay) across subjects and non-negligible epoch-by-epoch variations at the single subject level. The inspection of spatial-temporal variations revealed a prominent non-stationarity of the BCG signal. We identified five main BCG waves, which were common across subjects. Principal component analysis revealed two spatially distinct patterns to explain most of the variance (85% in total). These components are possibly related to head rotation and pulse-driven scalp expansion, respectively. Our results may inspire the development of novel, more effective methods for the removal of the BCG, capable of isolating and attenuating artifact occurrences while preserving true neuronal activity.

EEG-Informed fMRI: A Review of Data Analysis Methods

The simultaneous acquisition of electroencephalography (EEG) with functional magnetic resonance imaging (fMRI) is a very promising non-invasive technique for the study of human brain function. Despite continuous improvements, it remains a challenging technique, and a standard methodology for data analysis is yet to be established. Here we review the methodologies that are currently available to address the challenges at each step of the data analysis pipeline. We start by surveying methods for pre-processing both EEG and fMRI data. On the EEG side, we focus on the correction for several MR-induced artifacts, particularly the gradient and pulse artifacts, as well as other sources of EEG artifacts. On the fMRI side, we consider image artifacts induced by the presence of EEG hardware inside the MR scanner, and the contamination of the fMRI signal by physiological noise of non-neuronal origin, including a review of several approaches to model and remove it. We then provide an overview of the approaches specifically employed for the integration of EEG and fMRI when using EEG to predict the blood oxygenation level dependent (BOLD) fMRI signal, the so-called EEG-informed fMRI integration strategy, the most commonly used strategy in EEG-fMRI research. Finally, we systematically review methods used for the extraction of EEG features reflecting neuronal phenomena of interest.

Simultaneous trimodal PET-MR-EEG imaging: Do EEG caps generate artefacts in PET images?

Trimodal simultaneous acquisition of positron emission tomography (PET), magnetic resonance imaging (MRI), and electroencephalography (EEG) has become feasible due to the development of hybrid PET-MR scanners. To capture the temporal dynamics of neuronal activation on a millisecond-by-millisecond basis, an EEG system is appended to the quantitative high resolution PET-MR imaging modality already established in our institute. One of the major difficulties associated with the development of simultaneous trimodal acquisition is that the components traditionally used in each modality can cause interferences in its counterpart. The mutual interferences of MRI components and PET components on PET and MR images, and the influence of EEG electrodes on functional MRI images have been studied and reported on. Building on this, this study aims to investigate the influence of the EEG cap on the quality and quantification of PET images acquired during simultaneous PET-MR measurements. A preliminary transmission scan study on the ECAT HR+ scanner, using an Iida phantom, showed visible attenuation effect due to the EEG cap. The BrainPET-MR emission images of the Iida phantom with [¹⁸F]Fluordeoxyglucose, as well as of human subjects with the EEG cap, did not show significant effects of the EEG cap, even though the applied attenuation correction did not take into account the attenuation of the EEG cap itself.

How to Build a Hybrid Neurofeedback Platform Combining EEG and fMRI

Multimodal neurofeedback estimates brain activity using information acquired with more than one neurosignal measurement technology. In this paper we describe how to set up and use a hybrid platform based on simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), then we illustrate how to use it for conducting bimodal neurofeedback experiments. The paper is intended for those willing to build a multimodal neurofeedback system, to guide them through the different steps of the design, setup, and experimental applications, and help them choose a suitable hardware and software configuration. Furthermore, it reports practical information from bimodal neurofeedback experiments conducted in our lab. The platform presented here has a modular parallel processing architecture that promotes real-time signal processing performance and simple future addition and/or replacement of processing modules. Various unimodal and bimodal neurofeedback experiments conducted in our lab showed high performance and accuracy. Currently, the platform is able to provide neurofeedback based on electroencephalography and functional magnetic resonance imaging, but the architecture and the working principles described here are valid for any other combination of two or more real-time brain activity measurement technologies.

Microstructural and functional correlates of glutamate concentration in the posterior cingulate cortex

Glutamate is the major excitatory neurotransmitter in the human brain and has a central role in both intrinsic and stimulus-induced activity. We conducted a study in a cohort of healthy, male volunteers in which glutamate levels were measured in the posterior cingulate cortex (PCC) using 1H magnetic resonance spectroscopy at 3T. The advantages of simultaneous electroencephalography and magnetic resonance imaging (EEG-MRI) were exploited and the subjects were measured in the same session and under the same physiological conditions. Diffusion tensor imaging (DTI), functional MRI (fMRI) and EEG were measured in order to investigate the functional and microstructural correlates of glutamate. The concentration of glutamate (institute units) was calculated and those values were tested for correlation with the metrics of resting state fMRI, DTI, and EEG electrical sources. Our results showed that the concentration of glutamate in the PCC had a significant negative correlation with the tissue mean diffusivity in the same area. The analysis of resting state networks did not show any relationship between the concentration of glutamate and the intrinsic activity of the resting state networks. The concentration of glutamate showed a positive correlation with the electrical generators of α-1 frequency and a negative correlation with the generators of α-2 and β-1 electrical generators. © 2017 Wiley Periodicals, Inc.

Towards high-quality simultaneous EEG-fMRI at 7 T: Detection and reduction of EEG artifacts due to head motion

The enhanced functional sensitivity offered by ultra-high field imaging may significantly benefit simultaneous EEG-fMRI studies, but the concurrent increases in artifact contamination can strongly compromise EEG data quality. In the present study, we focus on EEG artifacts created by head motion in the static B0 field. A novel approach for motion artifact detection is proposed, based on a simple modification of a commercial EEG cap, in which four electrodes are non-permanently adapted to record only magnetic induction effects. Simultaneous EEG-fMRI data were acquired with this setup, at 7 T, from healthy volunteers undergoing a reversing-checkerboard visual stimulation paradigm. Data analysis assisted by the motion sensors revealed that, after gradient artifact correction, EEG signal variance was largely dominated by pulse artifacts (81-93%), but contributions from spontaneous motion (4-13%) were still comparable to or even larger than those of actual neuronal activity (3-9%). Multiple approaches were tested to determine the most effective procedure for denoising EEG data incorporating motion sensor information. Optimal results were obtained by applying an initial pulse artifact correction step (AAS-based), followed by motion artifact correction (based on the motion sensors) and ICA denoising. On average, motion artifact correction (after AAS) yielded a 61% reduction in signal power and a 62% increase in VEP trial-by-trial consistency. Combined with ICA, these improvements rose to a 74% power reduction and an 86% increase in trial consistency. Overall, the improvements achieved were well appreciable at single-subject and single-trial levels, and set an encouraging quality mark for simultaneous EEG-fMRI at ultra-high field.

Removal of pulse artefact from EEG data recorded in MR environment at 3T. Setting of ICA parameters for marking artefactual components: application to resting-state data

Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) allow for a non-invasive investigation of cerebral functions with high temporal and spatial resolution. The main challenge of such integration is the removal of the pulse artefact (PA) that affects EEG signals recorded in the magnetic resonance (MR) scanner. Often applied techniques for this purpose are Optimal Basis Set (OBS) and Independent Component Analysis (ICA). The combination of OBS and ICA is increasingly used, since it can potentially improve the correction performed by each technique separately. The present study is focused on the OBS-ICA combination and is aimed at providing the optimal ICA parameters for PA correction in resting-state EEG data, where the information of interest is not specified in latency and amplitude as in, for example, evoked potential. A comparison between two intervals for ICA calculation and four methods for marking artefactual components was performed. The performance of the methods was discussed in terms of their capability to 1) remove the artefact and 2) preserve the information of interest. The analysis included 12 subjects and two resting-state datasets for each of them. The results showed that none of the signal lengths for the ICA calculation was highly preferable to the other. Among the methods for the identification of PA-related components, the one based on the wavelets transform of each component emerged as the best compromise between the effectiveness in removing PA and the conservation of the physiological neuronal content.

Simultaneous EEG-fMRI at ultra-high field: artifact prevention and safety assessment

The simultaneous recording of scalp electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) can provide unique insights into the dynamics of human brain function, and the increased functional sensitivity offered by ultra-high field fMRI opens exciting perspectives for the future of this multimodal approach. However, simultaneous recordings are susceptible to various types of artifacts, many of which scale with magnetic field strength and can seriously compromise both EEG and fMRI data quality in recordings above 3T. The aim of the present study was to implement and characterize an optimized setup for simultaneous EEG-fMRI in humans at 7 T. The effects of EEG cable length and geometry for signal transmission between the cap and amplifiers were assessed in a phantom model, with specific attention to noise contributions from the MR scanner coldheads. Cable shortening (down to 12 cm from cap to amplifiers) and bundling effectively reduced environment noise by up to 84% in average power and 91% in inter-channel power variability. Subject safety was assessed and confirmed via numerical simulations of RF power distribution and temperature measurements on a phantom model, building on the limited existing literature at ultra-high field. MRI data degradation effects due to the EEG system were characterized via B0 and B1(+) field mapping on a human volunteer, demonstrating important, although not prohibitive, B1 disruption effects. With the optimized setup, simultaneous EEG-fMRI acquisitions were performed on 5 healthy volunteers undergoing two visual paradigms: an eyes-open/eyes-closed task, and a visual evoked potential (VEP) paradigm using reversing-checkerboard stimulation. EEG data exhibited clear occipital alpha modulation and average VEPs, respectively, with concomitant BOLD signal changes. On a single-trial level, alpha power variations could be observed with relative confidence on all trials; VEP detection was more limited, although statistically significant responses could be detected in more than 50% of trials for every subject. Overall, we conclude that the proposed setup is well suited for simultaneous EEG-fMRI at 7 T.

[Simultaneous EEG-fMRI measurements: insights in applications and challenges]

BACKGROUND

The following article presents an introduction to simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI) measurements which have undergone a huge development during the last few years.

OBJECTIVES

The idea behind combining both non-invasive methods is to join the excellent temporal resolution of EEG (ms) together with the superior spatial resolution of fMRI (mm). In this article the status quo of the method and perspectives regarding multimodal imaging are discussed.

MATERIAL AND METHODS

Simultaneous EEG-fMRI measurements are affected by scanner and cardioballistic artifacts. We present common artifact subtraction methods in order to achieve a feasible data quality and outline what to consider when planning and recording EEG and fMRI simultaneously. Moreover, we discuss different analysis strategies.

RESULTS

Combined EEG-fMRI measurements have already increased our knowledge about the underlying relationships between the blood oxygenation level-dependent (BOLD) response and the EEG signal and are applied to answer widespread research questions. Simultaneous measurements are an essential part of multimodal imaging in investigating the underlying processing mechanisms of the brain as well as in advancing our understanding of neuropsychiatric diseases.

CONCLUSIONS

Current developments in multimodal imaging focus on the combination of electrophysiological and MRI parameters within ultra-high field MRI as well as on positron emission tomography (PET) in a trimodal approach.

EEG/fMRI contributions to our understanding of genetic generalized epilepsies

The first reports of combined EEG and fMRI used for evaluation of epileptic spikes date back to the mid-90s. At that time, the technique was called EEG-triggered fMRI--the "triggered" corresponded to an epilepsy specialist reviewing live EEG while the patient was located in the scanner; after the spike was identified, a scan was initiated to collect the data. Since then major progress has been made in combined EEG/fMRI data collection and analyses. These advances allow studying the electrophysiology of genetic generalized epilepsies (GGEs) in vivo in greater detail than ever. In addition to continuous data collection, we now have better methods for removing physiologic and fMRI-related artifacts, more advanced understanding of the hemodynamic response functions, and better computational methods to address the questions regarding the origins of the epileptiform discharge generators in patients with GGEs. These advances have allowed us to examine numerous cohorts of children and adults with GGEs while not only looking for spike and wave generators but also examining specific types of GGEs (e.g., juvenile myoclonic epilepsy or childhood absence epilepsy), drug-naïve patients, effects of medication resistance, or effects of epileptiform abnormalities and/or seizures on brain connectivity. While the discussion is ongoing, the prevailing thought is that the GGEs as a group are a network disorder with participation from multiple nodes including the thalami and cortex with the clinical presentation depending on which node of the participating network is affected by the disease process. This review discusses the contributions of EEG/fMRI to our understanding of GGEs.