Optimal Check Size and Reversal Rate to Elicit Pattern-reversal MEG Responses

A review of magnetoencephalography use in pediatric epilepsy: an update on best practice

Introduction: Magnetoencephalography (MEG) is a noninvasive technique that is used for presurgical evaluation of children with drug-resistant epilepsy (DRE).Areas covered: The contributions of MEG for localizing the epileptogenic zone are discussed, in particular in extra-temporal lobe epilepsy and focal cortical dysplasia, which are common in children, as well as in difficult to localize epilepsy such as operculo-insular epilepsy. Further, the authors review current evidence on MEG for mapping eloquent cortex, its performance, application in clinical practice, and potential challenges.Expert opinion: MEG could change the clinical management of children with DRE by directing placement of intracranial electrodes thereby enhancing their yield. With improved identification of a circumscribed epileptogenic zone, MEG could render more patients as suitable candidates for epilepsy surgery and increase utilization of surgery.

Visual field asymmetries in visual evoked responses

Behavioral responses to visual stimuli exhibit visual field asymmetries, but cortical folding and the close proximity of visual cortical areas make electrophysiological comparisons between different stimulus locations problematic. Retinotopy-constrained source estimation (RCSE) uses distributed dipole models simultaneously constrained by multiple stimulus locations to provide separation between individual visual areas that is not possible with conventional source estimation methods. Magnetoencephalography and RCSE were used to estimate time courses of activity in V1, V2, V3, and V3A. Responses to left and right hemifield stimuli were not significantly different. Peak latencies for peripheral stimuli were significantly shorter than those for perifoveal stimuli in V1, V2, and V3A, likely related to the greater proportion of magnocellular input to V1 in the periphery. Consistent with previous results, sensor magnitudes for lower field stimuli were about twice as large as for upper field, which is only partially explained by the proximity to sensors for lower field cortical sources in V1, V2, and V3. V3A exhibited both latency and amplitude differences for upper and lower field responses. There were no differences for V3, consistent with previous suggestions that dorsal and ventral V3 are two halves of a single visual area, rather than distinct areas V3 and VP.

Influence of visual angle on pattern reversal visual evoked potentials

PURPOSE

The aim of this study was to find whether the visual evoked potential (VEP) latencies and amplitude are altered with different visual angles in healthy adult volunteers or not and to determine the visual angle which is the optimum and most appropriate among a wide range of check sizes for the reliable interpretation of pattern reversal VEPs (PRVEPs).

MATERIALS AND METHODS

The present study was conducted on 40 healthy volunteers. The subjects were divided into two groups. One group consisted of 20 individuals (nine males and 11 females) in the age range of 25-57 years and they were exposed to checks subtending a visual angle of 90, 120, and 180 minutes of arc. Another group comprised of 20 individuals (10 males and 10 females) in the age range of 36-60 years and they were subjected to checks subtending a visual angle of 15, 30, and 120 minutes of arc. The stimulus configuration comprised of the transient pattern reversal method in which a black and white checker board is generated (full field) on a VEP Monitor by an Evoked Potential Recorder (RMS EMG. EPMARK II). The statistical analysis was done by One Way Analysis of Variance (ANOVA) using EPI INFO 6.

RESULTS

In Group I, the maximum (max.) P100 latency of 98.8 ± 4.7 and the max. P100 amplitude of 10.05 ± 3.1 μV was obtained with checks of 90 minutes. In Group II, the max. P100 latency of 105.19 ± 4.75 msec as well as the max. P100 amplitude of 8.23 ± 3.30 μV was obtained with 15 minutes. The min. P100 latency in both the groups was obtained with checks of 120 minutes while the min. P100 amplitude was obtained with 180 minutes. A statistically significant difference was derived between means of P100 latency for 15 and 30 minutes with reference to its value for 120 minutes and between the mean value of P100 amplitude for 120 minutes and that of 90 and 180 minutes.

CONCLUSION

Altering the size of stimulus (visual angle) has an effect on the PRVEP parameters. Our study found that the 120 is the appropriate (and optimal) check size that can be used for accurate interpretation of PRVEPs. This will help in better assessment of the optic nerve function and integrity of anterior visual pathways.

Occipital lobe lesions result in a displacement of magnetoencephalography visual evoked field dipoles

PURPOSE

The pattern-reversal visual evoked potential measured electrically from scalp electrodes is known to be decreased, or absent, in patients with occipital lobe lesions. We questioned whether the measurement and source analysis of the neuromagnetic visual evoked field (VEF) might offer additional information regarding visual cortex relative to the occipital lesion.

METHODS

We retrospectively examined 12 children (6-18 years) with occipital lesions on MRI, who underwent magnetoencephalography and ophthalmology as part of their presurgical assessment. Binocular half-field pattern-reversal VEFs were obtained in a 151-channel whole-head magnetoencephalography. Data were averaged and dipole source analyses were performed for each half-field stimulation.

RESULTS

A significant lateral shift (P < 0.02) in the dipole location was observed in the lesional hemisphere compared with those in the nonlesional hemisphere, regardless of the lesion location. No differences were observed in latency, strength (moment), and residual errors of VEF dipoles between the lesional and nonlesional hemispheres.

CONCLUSIONS

Magnetoencephalography demonstrated the mass effect on the dipole location of VEF in children with occipital lesions. Magnetoencephalography may be useful as a screening test of visual function in young patients. We discuss potential explanations for this lateral shift and emphasize the utility of adding the magnetoencephalography pattern-reversal visual evoked field protocol to the neurologic work-up.

Early Visual Processing is Affected by Clinical Subtype in Patients with Unilateral Spatial Neglect: A Magnetoencephalography Study

OBJECTIVE

To determine whether visual evoked magnetic fields (VEFs) elicited by right and left hemifield stimulation differ in patients with unilateral spatial neglect (USN) that results from cerebrovascular accident.

METHODS

Pattern-reversal stimulation of the right and left hemifield was performed in three patients with left USN. Magnetoencephalography (MEG) was recorded using a 160-channel system, and VEFs were quantified in the 400 ms after each stimulus. The presence or absence of VEF components at around 100 ms (P100m component) and 145 ms (N145m component) after stimulus onset was determined. The source of the VEF was determined using a single equivalent current dipole model for spherical volume conduction. All patients were evaluated using the behavioral inattention test (BIT).

RESULTS

In response to right hemifield stimulation, the P100m and N145m components of the VEF were evident in all three patients. In response to left hemifield stimulation, both components were evident in Patient 3, whereas only the P100m component was evident in Patient 1 and only the N145m component was evident in Patient 2. Patient 1 exhibited impairments on the line bisection and cancelation tasks of the BIT, Patient 2 exhibited impairments on the copying, drawing and cancelation tasks of the BIT, and Patient 3 exhibited impairments on the cancelation task of the BIT.

CONCLUSION

These results demonstrate that early VEFs are disrupted in patients with USN and support the concept that deficits in visual processing differ according to the clinical subtype of USN and the lesion location. This study also demonstrates the feasibility of using MEG to explore subtypes of neglect.

Source estimates for MEG/EEG visual evoked responses constrained by multiple, retinotopically-mapped stimulus locations

Studying the human visual system with high temporal resolution is a significant challenge due to the limitations of the available, noninvasive measurement tools. MEG and EEG provide the millisecond temporal resolution necessary for answering questions about intracortical communication involved in visual processing, but source estimation is ill-posed and unreliable when multiple; simultaneously active areas are located close together. To address this problem, we have developed a retinotopy-constrained source estimation method to calculate the time courses of activation in multiple visual areas. Source estimation was disambiguated by: (1) fixing MEG/EEG generator locations and orientations based on fMRI retinotopy and surface tessellations constructed from high-resolution MRI images; and (2) solving for many visual field locations simultaneously in MEG/EEG responses, assuming source current amplitudes to be constant or varying smoothly across the visual field. Because of these constraints on the solutions, estimated source waveforms become less sensitive to sensor noise or random errors in the specification of the retinotopic dipole models. We demonstrate the feasibility of this method and discuss future applications such as studying the timing of attentional modulation in individual visual areas.

Peri-ictal normalization of visual cortex excitability in migraine: an MEG study

To delineate if the change in cortical excitability persists across migraine attacks, visual evoked magnetic fields (VEF) were measured in patients with migraine without aura during the interictal (n = 26) or peri-ictal (n = 21) periods, and were compared with 30 healthy controls. The visual stimuli were checkerboard reversals with four different check sizes (15', 30', 60' and 120'). For each check size, five sequential blocks of 50 VEF responses were recorded to calculate the percentage change of the P100m amplitude in the second to the fifth blocks in comparison with the first block. At check size 120', interictal patients showed a larger amplitude increment than controls [28.1 +/- 38.3% (s.d.) vs. 8.7 +/- 21.3%] in the second block and a larger increment than peri-ictal patients in the second (28.1 +/- 38.3% vs. -3.2 +/- 19.2%), fourth (22.7 +/- 31.2% vs. -5.7 +/- 22.3%) and fifth (20.5 +/- 30.4% vs. -10.8 +/- 30.1%) blocks (P < 0.05). There was no significant difference at other check sizes or between peri-ictal patients and controls. In conclusion, there may be peri-ictal normalization of visual cortical excitability changes in migraine that is dependent on the spatial frequency of the stimuli and reflects a dynamic modulation of cortical activities.