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Shirota Y, Akita M, Tajima S, Mochida T, Masaki K, Yumoto M. Origin coordinate influence on performance of temporally extended signal space separation in magnetoencephalography. Clin Neurophysiol 2024; 163:143-151. [PMID: 38744104 DOI: 10.1016/j.clinph.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE Temporally extended signal space separation (tSSS) is a powerful method for artifact suppression in magnetoencephalography (MEG). Because tSSS first separates MEG signals coming from inside and outside a certain sphere, definition of the sphere origin is important. For this study, we explored the influence of origin choice on tSSS performance in spontaneous and evoked activity from epilepsy patients. METHODS Interictal epileptiform discharges (IEDs) and somatosensory evoked fields (SEFs) were processed with two tSSSs: one with the default origin of (0, 0, 40 mm) in the head coordinate, and the other with an individual origin estimated using each patient's anatomical magnetic resonance imaging (MRI). Equivalent current dipoles (ECDs) were calculated for the data. The ECD location and quality of estimation were compared across conditions. RESULTS MEG data from 21 patients revealed marginal differences in ECD location, but the estimation quality inferred from goodness of fit (GOF) and confidence volume (CV) was better for the tSSS with individual origins. This choice affected IEDs more than it affected SEFs. CONCLUSIONS Individual sphere model resulted in better GOF and CV. SIGNIFICANCE Application of tSSS using an individual origin would be more desirable when available. This parameter might influence spontaneous activity more strongly.
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Affiliation(s)
- Yuichiro Shirota
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan.
| | - Megumi Akita
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan
| | - Shotaro Tajima
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan
| | - Tomoyuki Mochida
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan
| | - Katsura Masaki
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan
| | - Masato Yumoto
- Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan
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2
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Bardouille T, Smith V, Vajda E, Leslie CD, Holmes N. Noise Reduction and Localization Accuracy in a Mobile Magnetoencephalography System. SENSORS (BASEL, SWITZERLAND) 2024; 24:3503. [PMID: 38894294 PMCID: PMC11174973 DOI: 10.3390/s24113503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
Magnetoencephalography (MEG) non-invasively provides important information about human brain electrophysiology. The growing use of optically pumped magnetometers (OPM) for MEG, as opposed to fixed arrays of cryogenic sensors, has opened the door for innovation in system design and use cases. For example, cryogenic MEG systems are housed in large, shielded rooms to provide sufficient space for the system dewar. Here, we investigate the performance of OPM recordings inside of a cylindrical shield with a 1 × 2 m2 footprint. The efficacy of shielding was measured in terms of field attenuation and isotropy, and the value of post hoc noise reduction algorithms was also investigated. Localization accuracy was quantified for 104 OPM sensors mounted on a fixed helmet array based on simulations and recordings from a bespoke current dipole phantom. Passive shielding attenuated the vector field magnitude to 50.0 nT at direct current (DC), to 16.7 pT/√Hz at power line, and to 71 fT/√Hz (median) in the 10-200 Hz range. Post hoc noise reduction provided an additional 5-15 dB attenuation. Substantial field isotropy remained in the volume encompassing the sensor array. The consistency of the isotropy over months suggests that a field nulling solution could be readily applied. A current dipole phantom generating source activity at an appropriate magnitude for the human brain generated field fluctuations on the order of 0.5-1 pT. Phantom signals were localized with 3 mm localization accuracy, and no significant bias in localization was observed, which is in line with performance for cryogenic and OPM MEG systems. This validation of the performance of a small footprint MEG system opens the door for lower-cost MEG installations in terms of raw materials and facility space, as well as mobile imaging systems (e.g., truck-based). Such implementations are relevant for global adoption of MEG outside of highly resourced research and clinical institutions.
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Affiliation(s)
- Timothy Bardouille
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada; (V.S.); (E.V.); (C.D.L.)
| | - Vanessa Smith
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada; (V.S.); (E.V.); (C.D.L.)
| | - Elias Vajda
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada; (V.S.); (E.V.); (C.D.L.)
| | - Carson Drake Leslie
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada; (V.S.); (E.V.); (C.D.L.)
| | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK;
- Cerca Magnetics Limited, Units 7–8 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
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3
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Yang Y, Luo S, Wang W, Gao X, Yao X, Wu T. From bench to bedside: Overview of magnetoencephalography in basic principle, signal processing, source localization and clinical applications. Neuroimage Clin 2024; 42:103608. [PMID: 38653131 PMCID: PMC11059345 DOI: 10.1016/j.nicl.2024.103608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
Magnetoencephalography (MEG) is a non-invasive technique that can precisely capture the dynamic spatiotemporal patterns of the brain by measuring the magnetic fields arising from neuronal activity along the order of milliseconds. Observations of brain dynamics have been used in cognitive neuroscience, the diagnosis of neurological diseases, and the brain-computer interface (BCI). In this study, we outline the basic principle, signal processing, and source localization of MEG, and describe its clinical applications for cognitive assessment, the diagnoses of neurological diseases and mental disorders, preoperative evaluation, and the BCI. This review not only provides an overall perspective of MEG, ranging from practical techniques to clinical applications, but also enhances the prevalent understanding of neural mechanisms. The use of MEG is expected to lead to significant breakthroughs in neuroscience.
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Affiliation(s)
- Yanling Yang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; College of Medical Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Shichang Luo
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; College of Medical Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wenjie Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China; College of Medical Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiumin Gao
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Xufeng Yao
- College of Medical Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Tao Wu
- College of Medical Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
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4
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Schulze-Bonhage A, Nitsche MA, Rotter S, Focke NK, Rao VR. Neurostimulation targeting the epileptic focus: Current understanding and perspectives for treatment. Seizure 2024; 117:183-192. [PMID: 38452614 DOI: 10.1016/j.seizure.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024] Open
Abstract
For the one third of people with epilepsy whose seizures are not controlled with medications, targeting the seizure focus with neurostimulation can be an effective therapeutic strategy. In this focused review, we summarize a discussion of targeted neurostimulation modalities during a workshop held in Frankfurt, Germany in September 2023. Topics covered include: available devices for seizure focus stimulation; alternating current (AC) and direct current (DC) stimulation to reduce focal cortical excitability; modeling approaches to simulate DC stimulation; reconciling the efficacy of focal stimulation with the network theory of epilepsy; and the emerging concept of 'neurostimulation zones,' which are defined as cortical regions where focal stimulation is most effective for reducing seizures and which may or may not directly involve the seizure onset zone. By combining experimental data, modeling results, and clinical outcome analysis, rational selection of target regions and stimulation parameters is increasingly feasible, paving the way for a broader use of neurostimulation for epilepsy in the future.
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Affiliation(s)
- Andreas Schulze-Bonhage
- Epilepsy Center, University Medical Center, University of Freiburg, Germany; European Reference Network EpiCare, Belgium; NeuroModul Basic, University of Freiburg, Freiburg, Germany.
| | - Michael A Nitsche
- Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Germany; German Center for Mental Health (DZPG), Germany
| | - Stefan Rotter
- Bernstein Center Freiburg & Faculty of Biology, University of Freiburg, Germany
| | - Niels K Focke
- Epilepsy Center, Clinic for Neurology, University Medical Center Göttingen, Germany
| | - Vikram R Rao
- Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, USA
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5
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Schofield H, Hill RM, Feys O, Holmes N, Osborne J, Doyle C, Bobela D, Corvilian P, Wens V, Rier L, Bowtell R, Ferez M, Mullinger KJ, Coleman S, Rhodes N, Rea M, Tanner Z, Boto E, de Tiège X, Shah V, Brookes MJ. A Novel, Robust, and Portable Platform for Magnetoencephalography using Optically Pumped Magnetometers. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.06.583313. [PMID: 38558964 PMCID: PMC10979878 DOI: 10.1101/2024.03.06.583313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Magnetoencephalography (MEG) measures brain function via assessment of magnetic fields generated by neural currents. Conventional MEG uses superconducting sensors, which place significant limitations on performance, practicality, and deployment; however, the field has been revolutionised in recent years by the introduction of optically-pumped-magnetometers (OPMs). OPMs enable measurement of the MEG signal without cryogenics, and consequently the conception of 'OPM-MEG' systems which ostensibly allow increased sensitivity and resolution, lifespan compliance, free subject movement, and lower cost. However, OPM-MEG remains in its infancy with limitations on both sensor and system design. Here, we report a new OPM-MEG design with miniaturised and integrated electronic control, a high level of portability, and improved sensor dynamic range (arguably the biggest limitation of existing instrumentation). We show that this system produces equivalent measures when compared to an established instrument; specifically, when measuring task-induced beta-band, gamma-band and evoked neuro-electrical responses, source localisations from the two systems were highly comparable and temporal correlation was >0.7 at the individual level and >0.9 for groups. Using an electromagnetic phantom, we demonstrate improved dynamic range by running the system in background fields up to 8 nT. We show that the system is effective in gathering data during free movement (including a sitting-to-standing paradigm) and that it is compatible with simultaneous electroencephalography (EEG - the clinical standard). Finally, we demonstrate portability by moving the system between two laboratories. Overall, our new system is shown to be a significant step forward for OPM-MEG technology and offers an attractive platform for next generation functional medical imaging.
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Affiliation(s)
- Holly Schofield
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - Ryan M. Hill
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - Odile Feys
- Université libre de Bruxelles, ULB Neuroscience Institute, Laboratoire de neuroanatomie et neuroimagerie translationelles, Brussels, Belgium
- Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Department of neurology, Brussels, Belgium
| | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - James Osborne
- QuSpin Inc. 331 South 104 Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Cody Doyle
- QuSpin Inc. 331 South 104 Street, Suite 130, Louisville, Colorado, 80027, USA
| | - David Bobela
- QuSpin Inc. 331 South 104 Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Pierre Corvilian
- Université libre de Bruxelles, ULB Neuroscience Institute, Laboratoire de neuroanatomie et neuroimagerie translationelles, Brussels, Belgium
| | - Vincent Wens
- Université libre de Bruxelles, ULB Neuroscience Institute, Laboratoire de neuroanatomie et neuroimagerie translationelles, Brussels, Belgium
- Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Department of translational neuroimaging, Brussels, Belgium
| | - Lukas Rier
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Maxime Ferez
- Université libre de Bruxelles, ULB Neuroscience Institute, Laboratoire de neuroanatomie et neuroimagerie translationelles, Brussels, Belgium
| | - Karen J. Mullinger
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Sebastian Coleman
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Natalie Rhodes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Molly Rea
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - Zoe Tanner
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - Elena Boto
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
| | - Xavier de Tiège
- Université libre de Bruxelles, ULB Neuroscience Institute, Laboratoire de neuroanatomie et neuroimagerie translationelles, Brussels, Belgium
- Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Department of translational neuroimaging, Brussels, Belgium
| | - Vishal Shah
- QuSpin Inc. 331 South 104 Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Matthew J. Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Cerca Magnetics Limited, 2 Castlebridge Office Village, Kirtley Drive, Nottingham, NG7 1LD, Nottingham, UK
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6
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Fernández-Martín R, Feys O, Juvené E, Aeby A, Urbain C, De Tiège X, Wens V. Towards the automated detection of interictal epileptiform discharges with magnetoencephalography. J Neurosci Methods 2024; 403:110052. [PMID: 38151188 DOI: 10.1016/j.jneumeth.2023.110052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The analysis of clinical magnetoencephalography (MEG) in patients with epilepsy traditionally relies on visual identification of interictal epileptiform discharges (IEDs), which is time consuming and dependent on subjective criteria. NEW METHOD Here, we explore the ability of Independent Components Analysis (ICA) and Hidden Markov Modeling (HMM) to automatically detect and localize IEDs. We tested our pipelines on resting-state MEG recordings from 10 school-aged children with (multi)focal epilepsy. RESULTS In focal epilepsy patients, both pipelines successfully detected visually identified IEDs, but also revealed unidentified low-amplitude IEDs. Success was more mitigated in patients with multifocal epilepsy, as our automated pipeline missed IED activity associated with some foci-an issue that could be alleviated by post-hoc manual selection of epileptiform ICs or HMM states. COMPARISON WITH EXISTING METHODS We compared our results with visual IED detection by an experienced clinical magnetoencephalographer, getting heightened sensitivity and requiring minimal input from clinical practitioners. CONCLUSIONS IED detection based on ICA or HMM represents an efficient way to identify IED localization and timing. The development of these automatic IED detection algorithms provide a step forward in clinical MEG practice by decreasing the duration of MEG analysis and enhancing its sensitivity.
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Affiliation(s)
- Raquel Fernández-Martín
- Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et de Neuroimagerie translationnelles (LNbT), Brussels, Belgium.
| | - Odile Feys
- Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et de Neuroimagerie translationnelles (LNbT), Brussels, Belgium; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), Hôpital Erasme, Department of Neurology, Brussels, Belgium
| | - Elodie Juvené
- Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), Department of Pediatric Neurology, Brussels, Belgium
| | - Alec Aeby
- Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), Department of Pediatric Neurology, Brussels, Belgium
| | - Charline Urbain
- Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et de Neuroimagerie translationnelles (LNbT), Brussels, Belgium; Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Centre for Research in Cognition and Neurosciences (CRCN), Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Brussels, Belgium
| | - Xavier De Tiège
- Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et de Neuroimagerie translationnelles (LNbT), Brussels, Belgium; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), Hôpital Erasme, Service of translational Neuroimaging, Brussels, Belgium
| | - Vincent Wens
- Université libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Laboratoire de Neuroanatomie et de Neuroimagerie translationnelles (LNbT), Brussels, Belgium; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), Hôpital Erasme, Service of translational Neuroimaging, Brussels, Belgium
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7
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Feys O, De Tiège X. From cryogenic to on-scalp magnetoencephalography for the evaluation of paediatric epilepsy. Dev Med Child Neurol 2024; 66:298-306. [PMID: 37421175 DOI: 10.1111/dmcn.15689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 07/09/2023]
Abstract
Magnetoencephalography (MEG) is a neurophysiological technique based on the detection of brain magnetic fields. Whole-head MEG systems typically house a few hundred sensors requiring cryogenic cooling in a rigid one-size-fits-all (commonly adult-sized) helmet to keep a thermal insulation space. This leads to an increased brain-to-sensor distance in children, because of their smaller head circumference, and decreased signal-to-noise ratio. MEG allows detection and localization of interictal and ictal epileptiform discharges, and pathological high frequency oscillations, as a part of the presurgical assessment of children with refractory focal epilepsy, where electroencephalography is not contributive. MEG can also map the eloquent cortex before surgical resection. MEG also provides insights into the physiopathology of both generalized and focal epilepsy. On-scalp recordings based on cryogenic-free sensors have demonstrated their use in the field of childhood focal epilepsy and should become a reference technique for diagnosing epilepsy in the paediatric population. WHAT THIS PAPER ADDS: Magnetoencephalography (MEG) contributes to the diagnosis and understanding of paediatric epilepsy. On-scalp MEG recordings demonstrate some advantages over cryogenic MEG.
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Affiliation(s)
- Odile Feys
- Department of Neurology, Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Bruxelles, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, Université libre de Bruxelles, ULB Neuroscience Institute, Bruxelles, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, Université libre de Bruxelles, ULB Neuroscience Institute, Bruxelles, Belgium
- Department of Translational Neuroimaging, Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Bruxelles, Belgium
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Lahtinen J, Koulouri A, Rampp S, Wellmer J, Wolters C, Pursiainen S. Standardized hierarchical adaptive Lp regression for noise robust focal epilepsy source reconstructions. Clin Neurophysiol 2024; 159:24-40. [PMID: 38244372 DOI: 10.1016/j.clinph.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/02/2023] [Accepted: 12/02/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To investigate the ability of standardization to reduce source localization errors and measurement noise uncertainties for hierarchical Bayesian algorithms with L1- and L2-norms as priors in electroencephalography and magnetoencephalography of focal epilepsy. METHODS Description of the standardization methodology relying on the Hierarchical Bayesian framework, referred to as the Standardized Hierarchical Adaptive Lp-norm Regularization (SHALpR). The performance was tested using real data from two focal epilepsy patients. Simulated data that resembled the available real data was constructed for further localization and noise robustness investigation. RESULTS The proposed algorithms were compared to their non-standardized counterparts, Standardized low-resolution brain electromagnetic tomography, Standardized Shrinking LORETA-FOCUSS, and Dynamic statistical parametric maps. Based on the simulations, the standardized Hierarchical adaptive algorithm using L2-norm was noise robust for 10 dB signal-to-noise ratio (SNR), whereas the L1-norm prior worked robustly also with 5 dB SNR. The accuracy of the standardized L1-normed methodology to localize focal activity was under 1 cm for both patients. CONCLUSIONS Numerical results of the proposed methodology display improved localization and noise robustness. The proposed methodology also outperformed the compared methods when dealing with real data. SIGNIFICANCE The proposed standardized methodology, especially when employing the L1-norm, could serve as a valuable assessment tool in surgical decision-making.
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Affiliation(s)
- Joonas Lahtinen
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere 33720, Finland.
| | - Alexandra Koulouri
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere 33720, Finland.
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Halle (Saale), Halle 06097, Germany; Department of Neurosurgery, University Hospital Erlangen, Erlangen 91054, Germany; Department of Neuroradiology, University Hospital Erlangen, Erlangen 91054, Germany.
| | - Jörg Wellmer
- Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University, Bochum44892, Germany.
| | - Carsten Wolters
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster 48149, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster 48149, Germany.
| | - Sampsa Pursiainen
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere 33720, Finland.
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Hao G, Yan H, Wang X, Gao R, Xue Y, Zhang X, Ni D, Shu W, Qiao L, He L, Yu T. The role of magnetoencephalography in preoperative localization and postoperative outcome prediction in patients with posterior cortical epilepsy. CNS Neurosci Ther 2024; 30:e14602. [PMID: 38332652 PMCID: PMC10853654 DOI: 10.1111/cns.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/16/2023] [Accepted: 01/01/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE We aimed to explore the value of magnetoencephalography in the presurgical evaluation of patients with posterior cortex epilepsy. METHODS A total of 39 patients with posterior cortex epilepsy (PCE) and intact magnetoencephalography (MEG) images were reviewed from August 2019 to July 2022. MEG dipole clusters were classified into single clusters, multiple clusters, and scatter dipoles based on tightness criteria. The association of the surgical outcome with MEG dipole classifications was evaluated using Fisher's exact tests. RESULTS Among the 39 cases, there were 24 cases of single clusters (61.5%), nine cases of multiple clusters (23.1%), and six cases of scattered dipoles (15.4%). Patients with single dipole clusters were more likely to become seizure-free. Among single dipole cluster cases (n = 24), complete MEG dipole resection yielded a more favorable surgical outcome than incomplete resection (83.3% vs. 16.7%, p = 0.007). Patients with concordant MRI and MEG findings achieved a significantly more favorable surgical outcome than discordant patients (66.7% vs. 33.3%, p = 0.044), especially in single dipole cluster patients (87.5% vs. 25.0%, p = 0.005). SIGNIFICANCE MEG can provide additional valuable information regarding surgical candidate selection, epileptogenic zone localization, electrode implantation schedule, and final surgical planning in patients with posterior cortex epilepsy.
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Affiliation(s)
- Guiliang Hao
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Hao Yan
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Xueyuan Wang
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Runshi Gao
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Yansong Xue
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Xiating Zhang
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Duanyu Ni
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Wei Shu
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Liang Qiao
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Liu He
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Tao Yu
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
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10
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Geller AS, Teale P, Kronberg E, Ebersole JS. Magnetoencephalography for Epilepsy Presurgical Evaluation. Curr Neurol Neurosci Rep 2024; 24:35-46. [PMID: 38148387 DOI: 10.1007/s11910-023-01328-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE OF THE REVIEW Magnetoencephalography (MEG) is a functional neuroimaging technique that records neurophysiology data with millisecond temporal resolution and localizes it with subcentimeter accuracy. Its capability to provide high resolution in both of these domains makes it a powerful tool both in basic neuroscience as well as clinical applications. In neurology, it has proven useful in its ability to record and localize epileptiform activity. Epilepsy workup typically begins with scalp electroencephalography (EEG), but in many situations, EEG-based localization of the epileptogenic zone is inadequate. The complementary sensitivity of MEG can be crucial in such cases, and MEG has been adopted at many centers as an important resource in building a surgical hypothesis. In this paper, we review recent work evaluating the extent of MEG influence of presurgical evaluations, novel analyses of MEG data employed in surgical workup, and new MEG instrumentation that will likely affect the field of clinical MEG. RECENT FINDINGS MEG consistently contributes to presurgical evaluation and these contributions often change the plan for epilepsy surgery. Extensive work has been done to develop new analytic methods for localizing the source of epileptiform activity with MEG. Systems using optically pumped magnetometry (OPM) have been successfully deployed to record and localize epileptiform activity. MEG remains an important noninvasive tool for epilepsy presurgical evaluation. Continued improvements in analytic methodology will likely increase the diagnostic yield of the test. Novel instrumentation with OPM may contribute to this as well, and may increase accessibility of MEG by decreasing cost.
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Affiliation(s)
- Aaron S Geller
- Department of Neurology, CU Anschutz Medical School, Aurora, CO, USA.
| | - Peter Teale
- Department of Neurology, CU Anschutz Medical School, Aurora, CO, USA
| | - Eugene Kronberg
- Department of Neurology, CU Anschutz Medical School, Aurora, CO, USA
| | - John S Ebersole
- Department of Neurology, Atlantic Neuroscience Institute, Summit, NJ, USA
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11
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Poghosyan V, Algethami H, Alshahrani A, Asiri S, Aldosari MM. Association Between Magnetoencephalography-Localized Epileptogenic Zone, Surgical Resection Volume, and Postsurgical Seizure Outcome. J Clin Neurophysiol 2024:00004691-990000000-00118. [PMID: 38194636 DOI: 10.1097/wnp.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
PURPOSE Surgical resection of magnetoencephalography (MEG) dipole clusters, reconstructed from interictal epileptiform discharges, is associated with favorable seizure outcomes. However, the relation of MEG cluster resection to the surgical resection volume is not known nor is it clear whether this association is direct and causal, or it may be mediated by the resection volume or other predictive factors. This study aims to clarify these open questions and assess the diagnostic accuracy of MEG in our center. METHODS We performed a retrospective cohort study of 68 patients with drug-resistant epilepsy who underwent MEG followed by resective epilepsy surgery and had at least 12 months of postsurgical follow-up. RESULTS Good seizure outcomes were associated with monofocal localization (χ2 = 6.94, P = 0.001; diagnostic odds ratio = 10.2) and complete resection of MEG clusters (χ2 = 22.1, P < 0.001; diagnostic odds ratio = 42.5). Resection volumes in patients with and without removal of MEG clusters were not significantly different (t = 0.18, P = 0.86; removed: M = 20,118 mm3, SD = 10,257; not removed: M = 19,566 mm3, SD = 10,703). Logistic regression showed that removal of MEG clusters predicts seizure-free outcome independent of the resection volume and other prognostic factors (P < 0.001). CONCLUSIONS Complete resection of MEG clusters leads to favorable seizure outcomes without affecting the volume of surgical resection and independent of other prognostic factors. MEG can localize the epileptogenic zone with high accuracy. MEG interictal epileptiform discharges mapping should be used whenever feasible to improve postsurgical seizure outcomes.
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Affiliation(s)
- Vahe Poghosyan
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, K.S.A.; and
| | - Hanin Algethami
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, K.S.A
| | - Ashwaq Alshahrani
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, K.S.A
| | - Safiyyah Asiri
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, K.S.A
| | - Mubarak M Aldosari
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, K.S.A
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12
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Westin K, Beniczky S, Pfeiffer C, Hämäläinen M, Lundqvist D. On the clinical utility of on-scalp MEG: A modeling study of epileptic activity source estimation. Clin Neurophysiol 2023; 156:143-155. [PMID: 37951041 DOI: 10.1016/j.clinph.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/06/2023] [Accepted: 10/21/2023] [Indexed: 11/13/2023]
Abstract
OBJECTIVE Epilepsy surgery requires localization of the seizure onset zone (SOZ). Today this can only be achieved by intracranial electroencephalography (iEEG). The iEEG electrode placement is guided by findings from non-invasive modalities that cannot themselves detect SOZ-generated initial seizure activity. On scalp magnetoencephalography (osMEG), with sensors placed on the scalp, demonstrates higher sensitivity than conventional MEG (convMEG) and could potentially detect early seizure activity. Here, we modeled EEG, convMEG and osMEG to compare the modalities' ability to localize SOZ activity and to detect epileptic spikes. METHODS We modeled seizure propagation within ten epileptic networks located in the mesial and lateral temporal lobe; basal, dorsal, central and frontopolar frontal lobe; parietal and occipital lobe as well as insula and cingulum. The networks included brain regions often involved in focal epilepsy. 128-channel osMEG, convMEG, EEG and combined osMEG + EEG and convMEG + EEG were modeled, and the SOZ source estimation accuracy was quantified and compared using Student's t-test. RESULTS OsMEG was significantly (p-value <0.01) better than both convMEG and EEG at detecting the earliest SOZ-generated seizure activity and epileptic spikes, and better at localizing seizure activity from all epileptic networks (p < 0.01). CONCLUSIONS Our modeling results clearly show that osMEG has an unsurpassed potential to detect both epileptic spikes and seizure activity from all simulated anatomical sites. SIGNIFICANCE No clinically available non-invasive technique can detect SOZ activity from all brain regions. Our study indicates that osMEG has the potential to become an important clinical tool, improving both non-invasive SOZ localization and iEEG electrode placement accuracy.
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Affiliation(s)
- Karin Westin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Clinical Neurophysiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Sándor Beniczky
- Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark and Danish Epilepsy Centre, Dianalund, Denmark
| | - Christoph Pfeiffer
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Matti Hämäläinen
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
| | - Daniel Lundqvist
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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13
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Badier JM, Schwartz D, Bénar CG, Kanzari K, Daligault S, Romain R, Mitryukovskiy S, Fourcault W, Josselin V, Le Prado M, Jung J, Palacios-Laloy A, Romain C, Bartolomei F, Labyt E, Bonini F. Helium Optically Pumped Magnetometers Can Detect Epileptic Abnormalities as Well as SQUIDs as Shown by Intracerebral Recordings. eNeuro 2023; 10:ENEURO.0222-23.2023. [PMID: 37932045 PMCID: PMC10748329 DOI: 10.1523/eneuro.0222-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
Magnetoencephalography based on superconducting quantum interference devices (SQUIDs) has been shown to improve the diagnosis and surgical treatment decision for presurgical evaluation of drug-resistant epilepsy. Still, its use remains limited because of several constraints such as cost, fixed helmet size, and the obligation of immobility. A new generation of sensors, optically pumped magnetometers (OPMs), could overcome these limitations. In this study, we validate the ability of helium-based OPM (4He-OPM) sensors to record epileptic brain activity thanks to simultaneous recordings with intracerebral EEG [stereotactic EEG (SEEG)]. We recorded simultaneous SQUIDs-SEEG and 4He-OPM-SEEG signals in one patient during two sessions. We show that epileptic activities on intracerebral EEG can be recorded by OPMs with a better signal-to noise ratio than classical SQUIDs. The OPM sensors open new venues for the widespread application of magnetoencephalography in the management of epilepsy and other neurologic diseases and fundamental neuroscience.
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Affiliation(s)
- Jean-Michel Badier
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
| | - Denis Schwartz
- MEG Departement, CERMEP-Imagerie du Vivant, Lyon 69003, France
| | - Christian-George Bénar
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
| | - Khoubeib Kanzari
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
| | | | - Rudy Romain
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
- MAG4Health, Grenoble 38000, France
| | - Sergey Mitryukovskiy
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
- MAG4Health, Grenoble 38000, France
| | - William Fourcault
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
| | - Vincent Josselin
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
| | - Matthieu Le Prado
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
- MAG4Health, Grenoble 38000, France
| | - Julien Jung
- Centre de Recherche en Neurosciences de Lyon, Unité Mixte de Recherche S1028, Centre National de la Recherche Scientifique, Hospices Civils de Lyon, Institut National de la Santé et de la Recherche Médicale, Université Lyon 1, Lyon 69002, France
| | - Augustin Palacios-Laloy
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
- MAG4Health, Grenoble 38000, France
| | - Carron Romain
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
- Department of Functional and Stereotactic Neurosurgery, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille 3005, France
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
- Department of Epileptology and Cerebral Rythmology, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille 3005, France
| | - Etienne Labyt
- CEA-LETI, MINATEC, Université Grenoble Alpes, Grenoble 38054, France
- MAG4Health, Grenoble 38000, France
| | - Francesca Bonini
- Institut de Neurosciences des Systèmes, Institut National de la Santé et de la Recherche Médicale, Aix Marseille Université, Marseille 13005, France
- MEG Departement, CERMEP-Imagerie du Vivant, Lyon 69003, France
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14
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Sindhu DM, Mundlamuri RC, Goutham B, Narayanan M, Raghavendra K, Asranna A, Vishwanathan LG, Kulanthaivelu K, Saini J, Mangalore S, Bharath RD, Sadashiva N, Mahadevan A, Jamuna R, Arivazhagan A, Rao MB, Sinha S. Role of magnetoencephalography in predicting the epileptogenic zone and post-operative seizure outcome - A retrospective study. Seizure 2023; 113:41-47. [PMID: 37976800 DOI: 10.1016/j.seizure.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Study assessed the role of MSI in predicting the post-operative seizure outcome. METHODS This retrospective study included patients who underwent MEG and epilepsy surgery and had a minimum 6 months of postoperative follow-up. Concordance of MEG cluster with post-surgical resection cavity was classified as follows Class I) Concordant and region-specific, Class II) Concordant and region non-specific, Class III) Concordant lateralization only and Class IV) Discordant lateralization. The relationship between MSI concordance and post-operative seizure outcome was assessed. RESULTS A total of 183 patients (M: F = 109:74) were included. The mean age at onset of seizures: 8.0 ± 6.4 years. The dipoles were frequent in 123(67.2 %). The primary cluster orientation was regular in 59 (32.2 %) and mixed in 124 (67.8 %) patients. Concordance between MEG and resection cavity: Class I - 124 (67.8 %), class II- 30 (16.4 %), class III- 23 (12.6 %), and class IV- 6 (3.3 %). The post-surgically mean duration of follow-up was 19.52 ± 11.27 months. At 6-month follow-up period, 144 (78.7 %) patients had complete seizure freedom out of which 106 (73.6 %) had class I concordance. Concordance of MEG with resection cavity was associated with a good outcome at 6 months (p = 0.001), 1 year (p = 0.001), 2 years (p = 0.0005) and 5 years (p = 0.04). MEG cluster characteristics had no association with seizure outcome except the strength of the cluster and outcome at 3 years (p = 0.02) follow-up. CONCLUSION The study supports that the complete resection of the MEG cluster had high chance of seizure-freedom and can be used as a complementary noninvasive presurgical evaluation tool.
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Affiliation(s)
| | | | - Bhargava Goutham
- MEG research Lab, NIMHANS, Hosur Road, Bangalore, India; Department of Neurology, NIMHANS, Hosur road, Bangalore, India
| | - Mariyappa Narayanan
- MEG research Lab, NIMHANS, Hosur Road, Bangalore, India; Department of Neurology, NIMHANS, Hosur road, Bangalore, India
| | | | - Ajay Asranna
- Department of Neurology, NIMHANS, Hosur road, Bangalore, India
| | | | - Karthik Kulanthaivelu
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Hosur road, Bangalore, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Hosur road, Bangalore, India
| | - Sandhya Mangalore
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Hosur road, Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Hosur road, Bangalore, India
| | | | - Anita Mahadevan
- Department of Neuropathology, NIMHANS, Hosur road, Bangalore, India
| | - Rajeswaran Jamuna
- Department of Clinical Psychology, NIMHANS, Hosur road, Bangalore, India
| | | | | | - Sanjib Sinha
- MEG research Lab, NIMHANS, Hosur Road, Bangalore, India; Department of Neurology, NIMHANS, Hosur road, Bangalore, India.
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15
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Bagić AI, Bowyer SM, Burgess RC, Funke ME, Lowden A, Mohamed IS, Wilson T, Zhang W, Zillgitt AJ, Tenney JR. Role of optically pumped magnetometers in presurgical epilepsy evaluation: Commentary of the American Clinical Magnetoencephalography Society. Epilepsia 2023; 64:3155-3159. [PMID: 37728519 DOI: 10.1111/epi.17770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/18/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023]
Abstract
One of the major challenges of modern epileptology is the underutilization of epilepsy surgery for treatment of patients with focal, medication resistant epilepsy (MRE). Aggravating this distressing failure to deliver optimum care to these patients is the underuse of proven localizing tools, such as magnetoencephalography (MEG), a clinically validated, non-invasive, neurophysiological method used to directly measure and localize brain activity. A sizable mass of published evidence indicates that MEG can improve identification of surgical candidates and guide pre-surgical planning, increasing the yield of SEEG and improving operative outcomes. However, despite at least 10 common, evidence supported, clinical scenarios in MRE patients where MEG can offer non-redundant information and improve the pre-surgical evaluation, it is regularly used by only a minority of USA epilepsy centers. The current state of the art in MEG sensors employs SQUIDs, which require cooling with liquid helium to achieve superconductivity. This sensor technology has undergone significant generational improvement since whole head MEG scanners were introduced around in 1990s, but still has limitations. Further advances in sensor technology which may make ME G more easily accessible and affordable have been eagerly awaited, and development of new techniques should be encouraged. Of late, optically pumped magnetometers (OPMs) have received considerable attention, even prompting some potential acquisitions of new MEG systems to be put on hold, based on a hope that OPMs will usher in a new generation of MEG equipment and procedures. The development of any new clinical test used to guide intracranial EEG monitoring and/or surgical planning must address several specific issues. The goal of this commentary is to recognize the current state of OPM technology and to suggest a framework for it to advance in the clinical realm where it can eventually be deemed clinically valuable to physicians and patients. The American Clinical MEG Society (ACMEGS) strongly supports more advanced and less expensive technology and looks forward to continuing work with researchers to develop new sensors and clinical devices which will improve the experience and outcome for patients, and perhaps extend the role of MEG. However, currently, there are no OPM devices ready for practical clinical use. Based on the engineering obstacles and the clinical tradeoffs to be resolved, the assessment of experts suggests that there will most likely be another decade relying solely on "frozen SQUIDs" in the clinical MEG field.
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Affiliation(s)
- Anto I Bagić
- University of Pittsburgh Comprehensive Epilepsy Center, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Susan M Bowyer
- MEG Laboratory, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA
| | - Richard C Burgess
- Magnetoencephalography Laboratory, Cleveland Clinic Epilepsy Center, Cleveland, Ohio, USA
| | - Michael E Funke
- Department of Pediatrics, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA
| | - Andrea Lowden
- Division of Pediatric Neurology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ismail S Mohamed
- Department of Pediatrics, University of Alabama, Birmingham, Alabama, USA
| | - Tony Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Wenbo Zhang
- Minnesota Epilepsy Group, Roseville, Minnesota, USA
| | - Andrew J Zillgitt
- Corewell Health William Beaumont University Hospital, Royal Oak, Minnesota, USA
| | - Jeffrey R Tenney
- MEG Center, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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16
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Sun R, Zhang W, Bagić A, He B. Deep learning based source imaging provides strong sublobar localization of epileptogenic zone from MEG interictal spikes. Neuroimage 2023; 281:120366. [PMID: 37716593 PMCID: PMC10771628 DOI: 10.1016/j.neuroimage.2023.120366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023] Open
Abstract
Electromagnetic source imaging (ESI) offers unique capability of imaging brain dynamics for studying brain functions and aiding the clinical management of brain disorders. Challenges exist in ESI due to the ill-posedness of the inverse problem and thus the need of modeling the underlying brain dynamics for regularizations. Advances in generative models provide opportunities for more accurate and realistic source modeling that could offer an alternative approach to ESI for modeling the underlying brain dynamics beyond equivalent physical source models. However, it is not straightforward to explicitly formulate the knowledge arising from these generative models within the conventional ESI framework. Here we investigate a novel source imaging framework based on mesoscale neuronal modeling and deep learning (DL) that can learn the sensor-source mapping relationship directly from MEG data for ESI. Two DL-based ESI models were trained based on data generated by neural mass models and either generic or personalized head models. The robustness of the two DL models was evaluated by systematic computer simulations and clinical validation in a cohort of 29 drug-resistant focal epilepsy patients who underwent intracranial EEG (iEEG) evaluation or surgical resection. Results estimated from pre-operative MEG interictal spikes were quantified using the overlap with resection regions and the distance to the seizure-onset zone (SOZ) defined by iEEG recordings. The DL-based ESI provided robust results when no personalized head geometry is considered, reaching a spatial dispersion of 21.90 ± 19.03 mm, sublobar concordance of 83 %, and sublobar sensitivity and specificity of 66 and 97 % respectively. When using personalized head geometry derived from individual patients' MRI in the training data, personalized DL-based ESI model can further improve the performance and reached a spatial dispersion of 8.19 ± 8.14 mm, sublobar concordance of 93 %, and sublobar sensitivity and specificity of 77 and 99 % respectively. When compared to the SOZ, the localization error of the personalized approach is 15.78 ± 5.54 mm, outperforming the conventional benchmarks. This work demonstrates that combining generative models and deep learning enables an accurate and robust imaging of epileptogenic zone from MEG recordings with strong sublobar precision, suggesting its added value to enhancing MEG source localization and imaging, and to epilepsy source localization and other clinical applications.
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Affiliation(s)
- Rui Sun
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Wenbo Zhang
- Minnesota Epilepsy Group, John Nasseff Neuroscience Center at United Hospital, Saint Paul, USA
| | - Anto Bagić
- Department of Neurology, University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), University of Pittsburgh Medical School, Pittsburgh, USA
| | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA.
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17
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Fawcett J, Davis S, Manford M. Further advances in epilepsy. J Neurol 2023; 270:5655-5670. [PMID: 37458794 DOI: 10.1007/s00415-023-11860-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 10/15/2023]
Abstract
In 2017, one of us reviewed advances in epilepsy (Manford in J Neurol 264:1811-1824, 2017). The current paper brings that review up to date and gives a slight change in emphasis. Once again, the story is of evolution rather than revolution. In recognition that most of our current medications act on neurotransmitters or ion channels, and not on the underlying changes in connectivity and pathways, they have been renamed as antiseizure (ASM) medications rather than antiepileptic drugs. Cenobamate is the one newly licensed medication for broader use in focal epilepsy but there have been a number of developments for specific disorders. We review new players and look forward to new developments in the light of evolving underlying science. We look at teratogenicity; old villains and new concerns in which clinicians play a vital role in explaining and balancing the risks. Medical treatment of status epilepticus, long without evidence, has benefitted from high-quality trials to inform practice; like buses, several arriving at once. Surgical treatment continues to be refined with improvements in the pre-surgical evaluation of patients, especially with new imaging techniques. Alternatives including stereotactic radiotherapy have received further focus and targets for palliative stimulation techniques have grown in number. Individuals' autonomy and quality of life continue to be the subject of research with refinement of what clinicians can do to help persons with epilepsy (PWE) achieve control. This includes seizure management but extends to broader considerations of human empowerment, needs and desires, which may be aided by emerging technologies such as seizure detection devices. The role of specialist nurses in improving that quality has been reinforced by specific endorsement from the International League against Epilepsy (ILAE).
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Affiliation(s)
- Joanna Fawcett
- Department of Neurology, Royal United Hospital, Bath, UK
| | - Sarah Davis
- Department of Neurology, Royal United Hospital, Bath, UK
| | - Mark Manford
- Department of Neurology, Royal United Hospital, Bath, UK.
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18
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Holmes N, Bowtell R, Brookes MJ, Taulu S. An Iterative Implementation of the Signal Space Separation Method for Magnetoencephalography Systems with Low Channel Counts. SENSORS (BASEL, SWITZERLAND) 2023; 23:6537. [PMID: 37514831 PMCID: PMC10385807 DOI: 10.3390/s23146537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
The signal space separation (SSS) method is routinely employed in the analysis of multichannel magnetic field recordings (such as magnetoencephalography (MEG) data). In the SSS method, signal vectors are posed as a multipole expansion of the magnetic field, allowing contributions from sources internal and external to a sensor array to be separated via computation of the pseudo-inverse of a matrix of the basis vectors. Although powerful, the standard implementation of the SSS method on MEG systems based on optically pumped magnetometers (OPMs) is unstable due to the approximate parity of the required number of dimensions of the SSS basis and the number of channels in the data. Here we exploit the hierarchical nature of the multipole expansion to perform a stable, iterative implementation of the SSS method. We describe the method and investigate its performance via a simulation study on a 192-channel OPM-MEG helmet. We assess performance for different levels of truncation of the SSS basis and a varying number of iterations. Results show that the iterative method provides stable performance, with a clear separation of internal and external sources.
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Affiliation(s)
- Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; (R.B.); (M.J.B.)
- Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; (R.B.); (M.J.B.)
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; (R.B.); (M.J.B.)
- Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
| | - Samu Taulu
- Department of Physics, University of Washington, Seattle, WA 98195, USA;
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA 98195, USA
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19
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Holmes N, Rea M, Hill RM, Leggett J, Edwards LJ, Hobson PJ, Boto E, Tierney TM, Rier L, Rivero GR, Shah V, Osborne J, Fromhold TM, Glover P, Brookes MJ, Bowtell R. Enabling ambulatory movement in wearable magnetoencephalography with matrix coil active magnetic shielding. Neuroimage 2023; 274:120157. [PMID: 37149237 PMCID: PMC10465235 DOI: 10.1016/j.neuroimage.2023.120157] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
The ability to collect high-quality neuroimaging data during ambulatory participant movement would enable a wealth of neuroscientific paradigms. Wearable magnetoencephalography (MEG) based on optically pumped magnetometers (OPMs) has the potential to allow participant movement during a scan. However, the strict zero magnetic field requirement of OPMs means that systems must be operated inside a magnetically shielded room (MSR) and also require active shielding using electromagnetic coils to cancel residual fields and field changes (due to external sources and sensor movements) that would otherwise prevent accurate neuronal source reconstructions. Existing active shielding systems only compensate fields over small, fixed regions and do not allow ambulatory movement. Here we describe the matrix coil, a new type of active shielding system for OPM-MEG which is formed from 48 square unit coils arranged on two planes which can compensate magnetic fields in regions that can be flexibly placed between the planes. Through the integration of optical tracking with OPM data acquisition, field changes induced by participant movement are cancelled with low latency (25 ms). High-quality MEG source data were collected despite the presence of large (65 cm translations and 270° rotations) ambulatory participant movements.
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Affiliation(s)
- Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK.
| | - Molly Rea
- Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Ryan M Hill
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
| | - James Leggett
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Lucy J Edwards
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Peter J Hobson
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Elena Boto
- Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Tim M Tierney
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Lukas Rier
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Gonzalo Reina Rivero
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
| | - Vishal Shah
- QuSpin Inc., 331 South 104th Street, Suite 130, Louisville, CO 80027, USA
| | - James Osborne
- QuSpin Inc., 331 South 104th Street, Suite 130, Louisville, CO 80027, USA
| | - T Mark Fromhold
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Paul Glover
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK; Cerca Magnetics Limited, Unit 2 Castlebridge Office Village, Kirtley Drive, Nottingham NG7 1LD, UK
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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20
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Cuesta P, Bruña R, Shah E, Laohathai C, Garcia-Tarodo S, Funke M, Von Allmen G, Maestú F. An individual data-driven virtual resection model based on epileptic network dynamics in children with intractable epilepsy: a magnetoencephalography interictal activity application. Brain Commun 2023; 5:fcad168. [PMID: 37274829 PMCID: PMC10236945 DOI: 10.1093/braincomms/fcad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 01/24/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
Epilepsy surgery continues to be a recommended treatment for intractable (medication-resistant) epilepsy; however, 30-70% of epilepsy surgery patients can continue to have seizures. Surgical failures are often associated with incomplete resection or inaccurate localization of the epileptogenic zone. This retrospective study aims to improve surgical outcome through in silico testing of surgical hypotheses through a personalized computational neurosurgery model created from individualized patient's magnetoencephalography recording and MRI. The framework assesses the extent of the epileptic network and evaluates underlying spike dynamics, resulting in identification of one single brain volume as a candidate for resection. Dynamic-locked networks were utilized for virtual cortical resection. This in silico protocol was tested in a cohort of 24 paediatric patients with focal drug-resistant epilepsy who underwent epilepsy surgery. Of 24 patients who were included in the analysis, 79% (19 of 24) of the models agreed with the patient's clinical surgery outcome and 21% (5 of 24) were considered as model failures (accuracy 0.79, sensitivity 0.77, specificity 0.82). Patients with unsuccessful surgery outcome typically showed a model cluster outside of the resected cavity, while those with successful surgery showed the cluster model within the cavity. Two of the model failures showed the cluster in the vicinity of the resected tissue and either a functional disconnection or lack of precision of the magnetoencephalography-MRI overlapping could explain the results. Two other cases were seizure free for 1 year but developed late recurrence. This is the first study that provides in silico personalized protocol for epilepsy surgery planning using magnetoencephalography spike network analysis. This model could provide complementary information to the traditional pre-surgical assessment methods and increase the proportion of patients achieving seizure-free outcome from surgery.
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Affiliation(s)
- Pablo Cuesta
- Correspondence to: Pablo Cuesta Pza. Ramón y Cajal, s/n. Ciudad Universitaria 28040 Madrid, Spain E-mail:
| | - Ricardo Bruña
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, 28040, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, 28040, Spain
| | - Ekta Shah
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | | | - Stephanie Garcia-Tarodo
- Département de la femme, de l'enfant et de l'adolescent, Hôpital des Enfants - Hôpitaux Universitaires de Genève, Geneva, 1211 Genève 14, Switzerland
| | - Michael Funke
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Gretchen Von Allmen
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Fernando Maestú
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, 28040, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, 28040, Spain
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Universidad Complutense de Madrid, Madrid, 28040, Spain
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21
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Rhodes N, Rea M, Boto E, Rier L, Shah V, Hill RM, Osborne J, Doyle C, Holmes N, Coleman SC, Mullinger K, Bowtell R, Brookes MJ. Measurement of Frontal Midline Theta Oscillations using OPM-MEG. Neuroimage 2023; 271:120024. [PMID: 36918138 PMCID: PMC10465234 DOI: 10.1016/j.neuroimage.2023.120024] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/10/2023] [Accepted: 03/11/2023] [Indexed: 03/14/2023] Open
Abstract
Optically pumped magnetometers (OPMs) are an emerging lightweight and compact sensor that can measure magnetic fields generated by the human brain. OPMs enable construction of wearable magnetoencephalography (MEG) systems, which offer advantages over conventional instrumentation. However, when trying to measure signals at low frequency, higher levels of inherent sensor noise, magnetic interference and movement artefact introduce a significant challenge. Accurate characterisation of low frequency brain signals is important for neuroscientific, clinical, and paediatric MEG applications and consequently, demonstrating the viability of OPMs in this area is critical. Here, we undertake measurement of theta band (4-8 Hz) neural oscillations and contrast a newly developed 174 channel triaxial wearable OPM-MEG system with conventional (cryogenic-MEG) instrumentation. Our results show that visual steady state responses at 4 Hz, 6 Hz and 8 Hz can be recorded using OPM-MEG with a signal-to-noise ratio (SNR) that is not significantly different to conventional MEG. Moreover, we measure frontal midline theta oscillations during a 2-back working memory task, again demonstrating comparable SNR for both systems. We show that individual differences in both the amplitude and spatial signature of induced frontal-midline theta responses are maintained across systems. Finally, we show that our OPM-MEG results could not have been achieved without a triaxial sensor array, or the use of postprocessing techniques. Our results demonstrate the viability of OPMs for characterising theta oscillations and add weight to the argument that OPMs can replace cryogenic sensors as the fundamental building block of MEG systems.
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Affiliation(s)
- Natalie Rhodes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Molly Rea
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Elena Boto
- Cerca Magnetics Ltd. 2, Castlebridge Office Village, Kirtley Dr, Nottingham NG7 1LD; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Lukas Rier
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Vishal Shah
- QuSpin Inc. 331 South 104th Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Ryan M Hill
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK; Cerca Magnetics Ltd. 2, Castlebridge Office Village, Kirtley Dr, Nottingham NG7 1LD
| | - James Osborne
- QuSpin Inc. 331 South 104th Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Cody Doyle
- QuSpin Inc. 331 South 104th Street, Suite 130, Louisville, Colorado, 80027, USA
| | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK; Cerca Magnetics Ltd. 2, Castlebridge Office Village, Kirtley Dr, Nottingham NG7 1LD
| | - Sebastian C Coleman
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Karen Mullinger
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK; Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK; Cerca Magnetics Ltd. 2, Castlebridge Office Village, Kirtley Dr, Nottingham NG7 1LD.
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22
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Roth BJ. Biomagnetism: The First Sixty Years. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094218. [PMID: 37177427 PMCID: PMC10181075 DOI: 10.3390/s23094218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023]
Abstract
Biomagnetism is the measurement of the weak magnetic fields produced by nerves and muscle. The magnetic field of the heart-the magnetocardiogram (MCG)-is the largest biomagnetic signal generated by the body and was the first measured. Magnetic fields have been detected from isolated tissue, such as a peripheral nerve or cardiac muscle, and these studies have provided insights into the fundamental properties of biomagnetism. The magnetic field of the brain-the magnetoencephalogram (MEG)-has generated much interest and has potential clinical applications to epilepsy, migraine, and psychiatric disorders. The biomagnetic inverse problem, calculating the electrical sources inside the brain from magnetic field recordings made outside the head, is difficult, but several techniques have been introduced to solve it. Traditionally, biomagnetic fields are recorded using superconducting quantum interference device (SQUID) magnetometers, but recently, new sensors have been developed that allow magnetic measurements without the cryogenic technology required for SQUIDs.
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Affiliation(s)
- Bradley J Roth
- Department of Physics, Oakland University, Rochester, MI 48309, USA
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23
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Schofield H, Boto E, Shah V, Hill RM, Osborne J, Rea M, Doyle C, Holmes N, Bowtell R, Woolger D, Brookes MJ. Quantum enabled functional neuroimaging: the why and how of magnetoencephalography using optically pumped magnetometers. CONTEMPORARY PHYSICS 2023; 63:161-179. [PMID: 38463461 PMCID: PMC10923587 DOI: 10.1080/00107514.2023.2182950] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 03/12/2024]
Abstract
Non-invasive imaging has transformed neuroscientific discovery and clinical practice, providing a non-invasive window into the human brain. However, whilst techniques like MRI generate ever more precise images of brain structure, in many cases, it's the function within neural networks that underlies disease. Here, we review the potential for quantum-enabled magnetic field sensors to shed light on such activity. Specifically, we describe how optically pumped magnetometers (OPMs) enable magnetoencephalographic (MEG) recordings with higher accuracy and improved practicality compared to the current state-of-the-art. The paper is split into two parts: first, we describe the work to date on OPM-MEG, detailing why this novel biomagnetic imaging technique is proving disruptive. Second, we explain how fundamental physics, including quantum mechanics and electromagnetism, underpins this developing technology. We conclude with a look to the future, outlining the potential for OPM-MEG to initiate a step change in the understanding and management of brain health.
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Affiliation(s)
- Holly Schofield
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Cerca Magnetics Limited, Nottingham, UK
| | - Elena Boto
- Cerca Magnetics Limited, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | | - Ryan M Hill
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Cerca Magnetics Limited, Nottingham, UK
| | | | - Molly Rea
- Cerca Magnetics Limited, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Cerca Magnetics Limited, Nottingham, UK
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Cerca Magnetics Limited, Nottingham, UK
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24
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Hillebrand A, Holmes N, Sijsma N, O'Neill GC, Tierney TM, Liberton N, Stam AH, van Klink N, Stam CJ, Bowtell R, Brookes MJ, Barnes GR. Non-invasive measurements of ictal and interictal epileptiform activity using optically pumped magnetometers. Sci Rep 2023; 13:4623. [PMID: 36944674 PMCID: PMC10030968 DOI: 10.1038/s41598-023-31111-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
Magneto- and electroencephalography (MEG/EEG) are important techniques for the diagnosis and pre-surgical evaluation of epilepsy. Yet, in current cryogen-based MEG systems the sensors are offset from the scalp, which limits the signal-to-noise ratio (SNR) and thereby the sensitivity to activity from deep structures such as the hippocampus. This effect is amplified in children, for whom adult-sized fixed-helmet systems are typically too big. Moreover, ictal recordings with fixed-helmet systems are problematic because of limited movement tolerance and/or logistical considerations. Optically Pumped Magnetometers (OPMs) can be placed directly on the scalp, thereby improving SNR and enabling recordings during seizures. We aimed to demonstrate the performance of OPMs in a clinical population. Seven patients with challenging cases of epilepsy underwent MEG recordings using a 12-channel OPM-system and a 306-channel cryogen-based whole-head system: three adults with known deep or weak (low SNR) sources of interictal epileptiform discharges (IEDs), along with three children with focal epilepsy and one adult with frequent seizures. The consistency of the recorded IEDs across the two systems was assessed. In one patient the OPMs detected IEDs that were not found with the SQUID-system, and in two patients no IEDs were found with either system. For the other patients the OPM data were remarkably consistent with the data from the cryogenic system, noting that these were recorded in different sessions, with comparable SNRs and IED-yields overall. Importantly, the wearability of OPMs enabled the recording of seizure activity in a patient with hyperkinetic movements during the seizure. The observed ictal onset and semiology were in agreement with previous video- and stereo-EEG recordings. The relatively affordable technology, in combination with reduced running and maintenance costs, means that OPM-based MEG could be used more widely than current MEG systems, and may become an affordable alternative to scalp EEG, with the potential benefits of increased spatial accuracy, reduced sensitivity to volume conduction/field spread, and increased sensitivity to deep sources. Wearable MEG thus provides an unprecedented opportunity for epilepsy, and given its patient-friendliness, we envisage that it will not only be used for presurgical evaluation of epilepsy patients, but also for diagnosis after a first seizure.
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Affiliation(s)
- Arjan Hillebrand
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Brain Imaging, Amsterdam Neuroscience, Amsterdam, The Netherlands.
- Systems and Network Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Ndedi Sijsma
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - George C O'Neill
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Tim M Tierney
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Niels Liberton
- Department of Medical Technology, 3D Innovation Lab, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anine H Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Nicole van Klink
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Brain Imaging, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Neurodegeneration, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Gareth R Barnes
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
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25
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Lahtinen J, Moura F, Samavaki M, Siltanen S, Pursiainen S. In silicostudy of the effects of cerebral circulation on source localization using a dynamical anatomical atlas of the human head. J Neural Eng 2023; 20. [PMID: 36808911 DOI: 10.1088/1741-2552/acbdc1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/21/2023] [Indexed: 02/23/2023]
Abstract
Objective.This study focuses on the effects of dynamical vascular modeling on source localization errors in electroencephalography (EEG). Our aim of thisin silicostudy is to (a) find out the effects of cerebral circulation on the accuracy of EEG source localization estimates, and (b) evaluate its relevance with respect to measurement noise and interpatient variation.Approach.We employ a four-dimensional (3D + T) statistical atlas of the electrical properties of the human head with a cerebral circulation model to generate virtual patients with different cerebral circulatory conditions for EEG source localization analysis. As source reconstruction techniques, we use the linearly constraint minimum variance (LCMV) beamformer, standardized low-resolution brain electromagnetic tomography (sLORETA), and the dipole scan (DS).Main results.Results indicate that arterial blood flow affects source localization at different depths and with varying significance. The average flow rate plays an important role in source localization performance, while the pulsatility effects are very small. In cases where a personalized model of the head is available, blood circulation mismodeling causes localization errors, especially in the deep structures of the brain where the main cerebral arteries are located. When interpatient variations are considered, the results show differences up to 15 mm for sLORETA and LCMV beamformer and 10 mm for DS in the brainstem and entorhinal cortices regions. In regions far from the main arteries vessels, the discrepancies are smaller than 3 mm. When measurement noise is added and interpatient differences are considered in a deep dipolar source, the results indicate that the effects of conductivity mismatch are detectable even for moderate measurement noise. The signal-to-noise ratio limit for sLORETA and LCMV beamformer is 15 dB, while the limit is under 30 dB for DS.Significance.Localization of the brain activity via EEG constitutes an ill-posed inverse problem, where any modeling uncertainty, e.g. a slight amount of noise in the data or material parameter discrepancies, can lead to a significant deviation of the estimated activity, especially in the deep structures of the brain. Proper modeling of the conductivity distribution is necessary in order to obtain an appropriate source localization. In this study, we show that the conductivity of the deep brain structures is particularly impacted by blood flow-induced changes in conductivity because large arteries and veins access the brain through that region.
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Affiliation(s)
- Joonas Lahtinen
- Computing Sciences Unit, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Fernando Moura
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland.,Engineering, Modelling and Applied Social Sciences Center, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
| | - Maryam Samavaki
- Computing Sciences Unit, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Samuli Siltanen
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Sampsa Pursiainen
- Computing Sciences Unit, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
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26
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Maslarova A, Zhao Y, Rösch J, Dörfler A, Coras R, Blümcke I, Lang J, Schmidt M, Hamer HM, Reindl C, Welte TM, Rampp S, Rössler K, Buchfelder M, Brandner S. Surgical planning, histopathology findings and postoperative outcome in MR-negative extra-temporal epilepsy using intracranial EEG, functional imaging, magnetoencephalography, neuronavigation and intraoperative MRI. Clin Neurol Neurosurg 2023; 226:107603. [PMID: 36706680 DOI: 10.1016/j.clineuro.2023.107603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/16/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE MRI-negative drug-resistant epilepsy presents a challenge when it comes to surgical planning, and surgical outcome is worse than in cases with an identified lesion. Although increasing implementation of more powerful MRI scanners and artificial intelligence has led to the detection of previously unrecognizable lesions, in some cases even postoperative pathological evaluation of electrographically epileptogenic zones shows no structural alterations. While in temporal lobe epilepsy a standardized resection approach can usually be performed, the surgical management of extra-temporal lesions is always individual. Here we present a strategy for treating patients with extra-temporal MRI-negative epilepsy focus and report our histological findings and patient outcome. METHODS Patients undergoing epilepsy surgery in the Department of Neurosurgery at the University Hospital Erlangen between 2012 and 2020 were included in the study. Inclusion criteria were: (1) failure to identify a structural lesion on preoperative high-resolution 3 Tesla MRI with a standardized epilepsy protocol and (2) preoperative intracranial EEG (iEEG) diagnostics. RESULTS We identified 8 patients corresponding to the inclusion criteria. Second look MRI analysis by an experienced neuroradiologist including the most recent analysis algorithm utilized in our clinic revealed a possible lesion in two patients. One of the patients with a clear focal cortical dysplasia (FCD) finding on a second look was excluded from further analysis. Of the other 7 patients, in one patient iEEG was performed with subdural electrodes, whereas the other 6 were evaluated with depth electrodes. MEG was performed preoperatively in all but one patient. An MEG focus was implemented in resection planning in 3 patients. FDG PET was performed in all, but only implemented in one patient. Histopathological evaluation revealed one non-lesional case, 4 cases of FCD and 2 cases with mild developmental malformation. All patients were free from permanent neurological deficits and presented with Engel 1A or 1B outcome on the last follow-up. CONCLUSION We demonstrate that extra-temporal MRI-negative epilepsy can be treated successfully provided an extensive preoperative planning is performed. The most important diagnostic was stereo-EEG, whereas additional data from MEG was helpful and FDG PET was rarely useful in our cohort.
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Affiliation(s)
- Anna Maslarova
- Department of Neurosurgery, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yining Zhao
- Department of Neurosurgery, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Julie Rösch
- Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Arnd Dörfler
- Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Roland Coras
- Department of Neuropathology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ingmar Blümcke
- Department of Neuropathology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Johannes Lang
- Department of Neurology, Epilepsy Center Erlangen, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Manuel Schmidt
- Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Hajo M Hamer
- Department of Neurology, Epilepsy Center Erlangen, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Caroline Reindl
- Department of Neurology, Epilepsy Center Erlangen, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tamara M Welte
- Department of Neurology, Epilepsy Center Erlangen, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; Department of Neurosurgery, University Hospital Halle (Saale), Halle, Germany
| | - Karl Rössler
- Neurosurgical Clinic, Vienna Medical University, Vienna, Austria
| | - Michael Buchfelder
- Department of Neurosurgery, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Shi LJ, Li CC, Lin YC, Ding CT, Wang YP, Zhang JC. The association of magnetoencephalography high-frequency oscillations with epilepsy types and a ripple-based method with source-level connectivity for mapping epilepsy sources. CNS Neurosci Ther 2023; 29:1423-1433. [PMID: 36815318 PMCID: PMC10068465 DOI: 10.1111/cns.14115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/09/2023] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To explore the association between high-frequency oscillations (HFOs) and epilepsy types and to improve the accuracy of source localization. METHODS Magnetoencephalography (MEG) ripples of 63 drug-resistant epilepsy patients were detected. Ripple rates, distribution, spatial complexity, and the clustering coefficient of ripple channels were used for the preliminary classification of lateral temporal lobe epilepsy (LTLE), mesial temporal lobe epilepsy (MTLE), and nontemporal lobe epilepsy (NTLE), mainly frontal lobe epilepsy (FLE). Furthermore, the seizure site identification was improved using the Tucker LCMV method and source-level betweenness centrality. RESULTS Ripple rates were significantly higher in MTLE than in LTLE and NTLE (p < 0.05). The LTLE and MTLE were mainly distributed in the temporal lobe, followed by the parietal lobe, occipital lobe, and frontal lobe, whereas MTLE ripples were mainly distributed in the frontal lobe, then parietal lobe and occipital lobe. Nevertheless, the NTLE ripples were primarily in the frontal lobe and partially in the occipital lobe (p < 0.05). Meanwhile, the spatial complexity of NTLE was significantly higher than that of LTLE and MTLE and was lowest in MTLE (p < 0.01). However, an opposite trend was observed for the standardized clustering coefficient compared with spatial complexity (p < 0.01). Finally, the tucker algorithm showed a higher percentage of ripples at the surgical site when the betweenness centrality was added (p < 0.01). CONCLUSION This study demonstrated that HFO rates, distribution, spatial complexity, and clustering coefficient of ripple channels varied considerably among the three epilepsy types. Additionally, tucker MEG estimation combined with ripple rates based on the source-level functional connectivity is a promising approach for presurgical epilepsy evaluation.
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Affiliation(s)
- Li-Juan Shi
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Big Data-Based Precision Medicine, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Can-Cheng Li
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Big Data-Based Precision Medicine, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Yi-Cong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Brain Functional Disease and Neuromodulation of Beijing Key Laboratory, Beijing, China
| | - Cheng-Tao Ding
- Hefei Innovation Research Institute, Beihang University, Hefei, Anhui, China
| | - Yu-Ping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Brain Functional Disease and Neuromodulation of Beijing Key Laboratory, Beijing, China
| | - Ji-Cong Zhang
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Big Data-Based Precision Medicine, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China.,Hefei Innovation Research Institute, Beihang University, Hefei, Anhui, China
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Rampp S, Kaltenhäuser M, Müller-Voggel N, Doerfler A, Kasper BS, Hamer HM, Brandner S, Buchfelder M. MEG Node Degree for Focus Localization: Comparison with Invasive EEG. Biomedicines 2023; 11:biomedicines11020438. [PMID: 36830974 PMCID: PMC9953213 DOI: 10.3390/biomedicines11020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Epilepsy surgery is a viable therapy option for patients with pharmacoresistant focal epilepsies. A prerequisite for postoperative seizure freedom is the localization of the epileptogenic zone, e.g., using electro- and magnetoencephalography (EEG/MEG). Evidence shows that resting state MEG contains subtle alterations, which may add information to the workup of epilepsy surgery. Here, we investigate node degree (ND), a graph-theoretical parameter of functional connectivity, in relation to the seizure onset zone (SOZ) determined by invasive EEG (iEEG) in a consecutive series of 50 adult patients. Resting state data were subjected to whole brain, all-to-all connectivity analysis using the imaginary part of coherence. Graphs were described using parcellated ND. SOZ localization was investigated on a lobar and sublobar level. On a lobar level, all frequency bands except alpha showed significantly higher maximal ND (mND) values inside the SOZ compared to outside (ratios 1.11-1.20, alpha 1.02). Area-under-the-curve (AUC) was 0.67-0.78 for all expected alpha (0.44, ns). On a sublobar level, mND inside the SOZ was higher for all frequency bands (1.13-1.38, AUC 0.58-0.78) except gamma (1.02). MEG ND is significantly related to SOZ in delta, theta and beta bands. ND may provide new localization tools for presurgical evaluation of epilepsy surgery.
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Affiliation(s)
- Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle (Saale), 06120 Halle (Saale), Germany
- Correspondence: ; Tel.: +49-9131-85-46921; Fax: +49-9131-85-34476
| | - Martin Kaltenhäuser
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Nadia Müller-Voggel
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Burkhard S. Kasper
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Hajo M. Hamer
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
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29
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Gross J, Junghöfer M, Wolters C. Bioelectromagnetism in Human Brain Research: New Applications, New Questions. Neuroscientist 2023; 29:62-77. [PMID: 34873945 PMCID: PMC9902961 DOI: 10.1177/10738584211054742] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Bioelectromagnetism has contributed some of the most commonly used techniques to human neuroscience such as magnetoencephalography (MEG), electroencephalography (EEG), transcranial magnetic stimulation (TMS), and transcranial electric stimulation (TES). The considerable differences in their technical design and practical use give rise to the impression that these are quite different techniques altogether. Here, we review, discuss and illustrate the fundamental principle of Helmholtz reciprocity that provides a common ground for all four techniques. We show that, more than 150 years after its discovery by Helmholtz in 1853, reciprocity is important to appreciate the strengths and limitations of these four classical tools in neuroscience. We build this case by explaining the concept of Helmholtz reciprocity, presenting a methodological account of this principle for all four methods and, finally, by illustrating its application in practical clinical studies.
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Affiliation(s)
- Joachim Gross
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany,Joachim Gross, Institute for Biomagnetism and Biosignalanalysis, University of Münster, Malmedyweg 15, Münster, 48149, Germany.
| | - Markus Junghöfer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Carsten Wolters
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
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30
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Alkawadri R, Enatsu R, Hämäläinen M, Bagić A. Editorial: Magnetoencephalography: Methodological innovation paves the way for scientific discoveries and new clinical applications. Front Neurol 2022; 13:1056301. [PMID: 36504656 PMCID: PMC9731220 DOI: 10.3389/fneur.2022.1056301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Rafeed Alkawadri
- University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), Department of Neurology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States,*Correspondence: Rafeed Alkawadri ; https://www.humanbrainmapping.net/contactus
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Matti Hämäläinen
- Department of Radiology, Harvard Medical School, Boston, MA, United States,Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
| | - Anto Bagić
- University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), Department of Neurology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States
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31
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Chirkov V, Kryuchkova A, Koptelova A, Stroganova T, Kuznetsova A, Kleeva D, Ossadtchi A, Fedele T. Data-driven approach for the delineation of the irritative zone in epilepsy in MEG. PLoS One 2022; 17:e0275063. [PMID: 36282803 PMCID: PMC9595543 DOI: 10.1371/journal.pone.0275063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022] Open
Abstract
The reliable identification of the irritative zone (IZ) is a prerequisite for the correct clinical evaluation of medically refractory patients affected by epilepsy. Given the complexity of MEG data, visual analysis of epileptiform neurophysiological activity is highly time consuming and might leave clinically relevant information undetected. We recorded and analyzed the interictal activity from seven patients affected by epilepsy (Vectorview Neuromag), who successfully underwent epilepsy surgery (Engel > = II). We visually marked and localized characteristic epileptiform activity (VIS). We implemented a two-stage pipeline for the detection of interictal spikes and the delineation of the IZ. First, we detected candidate events from peaky ICA components, and then clustered events around spatio-temporal patterns identified by convolutional sparse coding. We used the average of clustered events to create IZ maps computed at the amplitude peak (PEAK), and at the 50% of the peak ascending slope (SLOPE). We validated our approach by computing the distance of the estimated IZ (VIS, SLOPE and PEAK) from the border of the surgically resected area (RA). We identified 25 spatiotemporal patterns mimicking the underlying interictal activity (3.6 clusters/patient). Each cluster was populated on average by 22.1 [15.0–31.0] spikes. The predicted IZ maps had an average distance from the resection margin of 8.4 ± 9.3 mm for visual analysis, 12.0 ± 16.5 mm for SLOPE and 22.7 ±. 16.4 mm for PEAK. The consideration of the source spread at the ascending slope provided an IZ closer to RA and resembled the analysis of an expert observer. We validated here the performance of a data-driven approach for the automated detection of interictal spikes and delineation of the IZ. This computational framework provides the basis for reproducible and bias-free analysis of MEG recordings in epilepsy.
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Affiliation(s)
- Valerii Chirkov
- Berlin School of Mind and Brain, Humboldt University, Berlin, Germany
| | - Anna Kryuchkova
- Center for Neurocognitive Research, MEG Center, MSUPE, Moscow, Russian Federation
| | - Alexandra Koptelova
- Center for Neurocognitive Research, MEG Center, MSUPE, Moscow, Russian Federation
| | - Tatiana Stroganova
- Center for Neurocognitive Research, MEG Center, MSUPE, Moscow, Russian Federation
| | - Alexandra Kuznetsova
- Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Daria Kleeva
- Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Alexei Ossadtchi
- Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Tommaso Fedele
- Institute of Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
- * E-mail:
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32
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Seedat ZA, Rier L, Gascoyne LE, Cook H, Woolrich MW, Quinn AJ, Roberts TPL, Furlong PL, Armstrong C, St. Pier K, Mullinger KJ, Marsh ED, Brookes MJ, Gaetz W. Mapping Interictal activity in epilepsy using a hidden Markov model: A magnetoencephalography study. Hum Brain Mapp 2022; 44:66-81. [PMID: 36259549 PMCID: PMC9783449 DOI: 10.1002/hbm.26118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 02/05/2023] Open
Abstract
Epilepsy is a highly heterogeneous neurological disorder with variable etiology, manifestation, and response to treatment. It is imperative that new models of epileptiform brain activity account for this variability, to identify individual needs and allow clinicians to curate personalized care. Here, we use a hidden Markov model (HMM) to create a unique statistical model of interictal brain activity for 10 pediatric patients. We use magnetoencephalography (MEG) data acquired as part of standard clinical care for patients at the Children's Hospital of Philadelphia. These data are routinely analyzed using excess kurtosis mapping (EKM); however, as cases become more complex (extreme multifocal and/or polymorphic activity), they become harder to interpret with EKM. We assessed the performance of the HMM against EKM for three patient groups, with increasingly complicated presentation. The difference in localization of epileptogenic foci for the two methods was 7 ± 2 mm (mean ± SD over all 10 patients); and 94% ± 13% of EKM temporal markers were matched by an HMM state visit. The HMM localizes epileptogenic areas (in agreement with EKM) and provides additional information about the relationship between those areas. A key advantage over current methods is that the HMM is a data-driven model, so the output is tuned to each individual. Finally, the model output is intuitive, allowing a user (clinician) to review the result and manually select the HMM epileptiform state, offering multiple advantages over previous methods and allowing for broader implementation of MEG epileptiform analysis in surgical decision-making for patients with intractable epilepsy.
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Affiliation(s)
- Zelekha A. Seedat
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK,Young EpilepsySt Pier's LaneLingfieldRH7 6PWUK
| | - Lukas Rier
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - Lauren E. Gascoyne
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - Harry Cook
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - Mark W. Woolrich
- Oxford Centre for Human Brain ActivityUniversity Department of Psychiatry, Warneford HospitalOxfordUK
| | - Andrew J. Quinn
- Oxford Centre for Human Brain ActivityUniversity Department of Psychiatry, Warneford HospitalOxfordUK
| | - Timothy P. L. Roberts
- Department of RadiologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | | | - Caren Armstrong
- Department of RadiologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA,Pediatric Epilepsy Program, Division of Child NeurologyCHOPPhiladelphiaPennsylvaniaUSA
| | | | - Karen J. Mullinger
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK,Centre for Human Brain Health, School of PsychologyUniversity of BirminghamBirminghamUK
| | - Eric D. Marsh
- Department of RadiologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA,Pediatric Epilepsy Program, Division of Child NeurologyCHOPPhiladelphiaPennsylvaniaUSA,Departments of Neurology and PaediatricsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Matthew J. Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - William Gaetz
- Department of RadiologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
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33
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Shoeibi A, Moridian P, Khodatars M, Ghassemi N, Jafari M, Alizadehsani R, Kong Y, Gorriz JM, Ramírez J, Khosravi A, Nahavandi S, Acharya UR. An overview of deep learning techniques for epileptic seizures detection and prediction based on neuroimaging modalities: Methods, challenges, and future works. Comput Biol Med 2022; 149:106053. [DOI: 10.1016/j.compbiomed.2022.106053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 02/01/2023]
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34
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Ntolkeras G, Tamilia E, AlHilani M, Bolton J, Ellen Grant P, Prabhu SP, Madsen JR, Stufflebeam SM, Pearl PL, Papadelis C. Presurgical accuracy of dipole clustering in MRI-negative pediatric patients with epilepsy: Validation against intracranial EEG and resection. Clin Neurophysiol 2022; 141:126-138. [PMID: 33875376 PMCID: PMC8803140 DOI: 10.1016/j.clinph.2021.01.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To assess the utility of interictal magnetic and electric source imaging (MSI and ESI) using dipole clustering in magnetic resonance imaging (MRI)-negative patients with drug resistant epilepsy (DRE). METHODS We localized spikes in low-density (LD-EEG) and high-density (HD-EEG) electroencephalography as well as magnetoencephalography (MEG) recordings using dipoles from 11 pediatric patients. We computed each dipole's level of clustering and used it to discriminate between clustered and scattered dipoles. For each dipole, we computed the distance from seizure onset zone (SOZ) and irritative zone (IZ) defined by intracranial EEG. Finally, we assessed whether dipoles proximity to resection was predictive of outcome. RESULTS LD-EEG had lower clusterness compared to HD-EEG and MEG (p < 0.05). For all modalities, clustered dipoles showed higher proximity to SOZ and IZ than scattered (p < 0.001). Resection percentage was higher in optimal vs. suboptimal outcome patients (p < 0.001); their proximity to resection was correlated to outcome (p < 0.001). No difference in resection percentage was seen for scattered dipoles between groups. CONCLUSION MSI and ESI dipole clustering helps to localize the SOZ and IZ and facilitate the prognostic assessment of MRI-negative patients with DRE. SIGNIFICANCE Assessing the MSI and ESI clustering allows recognizing epileptogenic areas whose removal is associated with optimal outcome.
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Affiliation(s)
- Georgios Ntolkeras
- Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eleonora Tamilia
- Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michel AlHilani
- Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; The Hillingdon Hospital NHS Foundation Trust, London, United Kingdom
| | - Jeffrey Bolton
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Neuroradiology, Department of Radiology, Boston Children's Hospital, Harvard Medical School, MA, USA
| | - Sanjay P Prabhu
- Division of Neuroradiology, Department of Radiology, Boston Children's Hospital, Harvard Medical School, MA, USA
| | - Joseph R Madsen
- Division of Epilepsy Surgery, Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven M Stufflebeam
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Phillip L Pearl
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Christos Papadelis
- Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX, USA; School of Medicine, Texas Christian University and University of North Texas Health Science Center, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA.
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35
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Feys O, Corvilain P, Aeby A, Sculier C, Holmes N, Brookes M, Goldman S, Wens V, De Tiège X. On-Scalp Optically Pumped Magnetometers versus Cryogenic Magnetoencephalography for Diagnostic Evaluation of Epilepsy in School-aged Children. Radiology 2022; 304:429-434. [PMID: 35503013 DOI: 10.1148/radiol.212453] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Magnetoencephalography (MEG) is an established method used to detect and localize focal interictal epileptiform discharges (IEDs). Current MEG systems house hundreds of cryogenic sensors in a rigid, one-size-fits-all helmet, which results in several limitations, particularly in children. Purpose To determine if on-scalp MEG based on optically pumped magnetometers (OPMs) alleviates the main limitations of cryogenic MEG. Materials and Methods In this prospective single-center study conducted in a tertiary university teaching hospital, participants underwent cryogenic (102 magnetometers, 204 planar gradiometers) and on-scalp (32 OPMs) MEG. The two modalities for the detection and localization of IEDs were compared. The t test was used to compare IED amplitude and signal-to-noise ratio (SNR). Distributed source modeling was performed on OPM-based and cryogenic MEG data. Results Five children (median age, 9.4 years [range, 5-11 years]; four girls) with self-limited idiopathic (n = 3) or refractory (n = 2) focal epilepsy were included. IEDs were identified in all five children with comparable sensor topographies for both MEG devices. IED amplitudes were 2.3 (7.2 of 3.1) to 4.6 (3.2 of 0.7) times higher (P < .001) with on-scalp MEG, and the SNR was 27% (16.7 of 13.2) to 60% (12.8 of 8.0) higher (P value range: .001-.009) with on-scalp MEG in all but one participant (P = .93), whose head movements created pronounced motion artifacts. The neural source of averaged IEDs was located at approximately 5 mm (n = 3) or higher (8.3 mm, n = 1; 15.6 mm, n = 1) between on-scalp and cryogenic MEG. Conclusion Despite the limited number of sensors and scalp coverage, on-scalp magnetoencephalography (MEG) based on optically pumped magnetometers helped detect interictal epileptiform discharges in school-aged children with epilepsy with a higher amplitude, higher signal-to-noise ratio, and similar localization value compared with conventional cryogenic MEG. Online supplemental material is available for this article. © RSNA, 2022 See also the editorial by Widjaja in this issue.
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Affiliation(s)
- Odile Feys
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Pierre Corvilain
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Alec Aeby
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Claudine Sculier
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Niall Holmes
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Matthew Brookes
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Serge Goldman
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Vincent Wens
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
| | - Xavier De Tiège
- From the Departments of Neurology (O.F.), Pediatric Neurology (C.S., F.C.), Nuclear Medicine (S.G.), and Translational Neuroimaging (V.W., X.D.T.), CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Translational Neuroimaging and Neuroanatomy (Laboratoire de Neuroimagerie et Neuroanatomie translationnelles) (LNT), ULB Neuroscience Institute, Université Libre de Bruxelles, 808 Lennik St, Brussels, Belgium (O.F., P.C., S.G., V.W., X.D.T.); Department of Pediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium (A.A.); and Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom (N.H., M.B.)
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HEGAZY M, GAVVALA J. Magnetoencephalography in clinical practice. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:523-529. [DOI: 10.1590/0004-282x-anp-2021-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/14/2021] [Indexed: 11/22/2022]
Abstract
ABSTRACT Magnetoencephalography (MEG) is a neurophysiological technique that measures the magnetic fields associated with neuronal activity in the brain. It is closely related but distinct from its counterpart electroencephalography (EEG). The first MEG was recorded more than 50 years ago and has technologically evolved over this time. It is now well established in clinical practice particularly in the field of epilepsy surgery and functional brain mapping. However, underutilization and misunderstanding of the clinical applications of MEG is a challenge to more widespread use of this technology. A fundamental understanding of the neurophysiology and physics of MEG is discussed in this article as well as practical issues related to implementation, analysis, and clinical applications. The future of MEG and some potential clinical applications are briefly reviewed.
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Billardello R, Ntolkeras G, Chericoni A, Madsen JR, Papadelis C, Pearl PL, Grant PE, Taffoni F, Tamilia E. Novel User-Friendly Application for MRI Segmentation of Brain Resection following Epilepsy Surgery. Diagnostics (Basel) 2022; 12:diagnostics12041017. [PMID: 35454065 PMCID: PMC9032020 DOI: 10.3390/diagnostics12041017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022] Open
Abstract
Delineation of resected brain cavities on magnetic resonance images (MRIs) of epilepsy surgery patients is essential for neuroimaging/neurophysiology studies investigating biomarkers of the epileptogenic zone. The gold standard to delineate the resection on MRI remains manual slice-by-slice tracing by experts. Here, we proposed and validated a semiautomated MRI segmentation pipeline, generating an accurate model of the resection and its anatomical labeling, and developed a graphical user interface (GUI) for user-friendly usage. We retrieved pre- and postoperative MRIs from 35 patients who had focal epilepsy surgery, implemented a region-growing algorithm to delineate the resection on postoperative MRIs and tested its performance while varying different tuning parameters. Similarity between our output and hand-drawn gold standards was evaluated via dice similarity coefficient (DSC; range: 0-1). Additionally, the best segmentation pipeline was trained to provide an automated anatomical report of the resection (based on presurgical brain atlas). We found that the best-performing set of parameters presented DSC of 0.83 (0.72-0.85), high robustness to seed-selection variability and anatomical accuracy of 90% to the clinical postoperative MRI report. We presented a novel user-friendly open-source GUI that implements a semiautomated segmentation pipeline specifically optimized to generate resection models and their anatomical reports from epilepsy surgery patients, while minimizing user interaction.
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Affiliation(s)
- Roberto Billardello
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA; (G.N.); (A.C.); (P.E.G.)
- Advanced Robotics and Human-Centered Technologies-CREO Lab, Università Campus Bio-Medico di Roma, 00128 Rome, Italy;
- Correspondence: (R.B.); (E.T.)
| | - Georgios Ntolkeras
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA; (G.N.); (A.C.); (P.E.G.)
- Baystate Children’s Hospital, Springfield, MA 01199, USA
| | - Assia Chericoni
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA; (G.N.); (A.C.); (P.E.G.)
- Advanced Robotics and Human-Centered Technologies-CREO Lab, Università Campus Bio-Medico di Roma, 00128 Rome, Italy;
| | - Joseph R. Madsen
- Epilepsy Surgery Program, Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Christos Papadelis
- Jane and John Justin Neurosciences Center, Cook Children’s Health Care System, Fort Worth, TX 76104, USA;
| | - Phillip L. Pearl
- Division of Epilepsy and Clinical Neurophysiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Patricia Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA; (G.N.); (A.C.); (P.E.G.)
| | - Fabrizio Taffoni
- Advanced Robotics and Human-Centered Technologies-CREO Lab, Università Campus Bio-Medico di Roma, 00128 Rome, Italy;
| | - Eleonora Tamilia
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Newborn Medicine Division, Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA; (G.N.); (A.C.); (P.E.G.)
- Correspondence: (R.B.); (E.T.)
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Poghosyan V, Rampp S, Wang ZI. Editorial: Magnetoencephalography (MEG) in Epilepsy and Neurosurgery. Front Hum Neurosci 2022; 16:873153. [PMID: 35360284 PMCID: PMC8963912 DOI: 10.3389/fnhum.2022.873153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Vahe Poghosyan
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
- *Correspondence: Vahe Poghosyan
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Zhong Irene Wang
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
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Zhang C, Liu W, Zhang J, Zhang X, Huang P, Sun B, Zhan S, Cao C. Utility of magnetoencephalography combined with stereo-electroencephalography in resective epilepsy surgery: a 2-year follow-up. Seizure 2022; 97:94-101. [DOI: 10.1016/j.seizure.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022] Open
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Papadelis C, Conrad SE, Song Y, Shandley S, Hansen D, Bosemani M, Malik S, Keator C, Perry MS. Case Report: Laser Ablation Guided by State of the Art Source Imaging Ends an Adolescent's 16-Year Quest for Seizure Freedom. Front Hum Neurosci 2022; 16:826139. [PMID: 35145387 PMCID: PMC8821813 DOI: 10.3389/fnhum.2022.826139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/03/2022] [Indexed: 01/14/2023] Open
Abstract
Epilepsy surgery is the most effective therapeutic approach for children with drug resistant epilepsy (DRE). Recent advances in neurosurgery, such as the Laser Interstitial Thermal Therapy (LITT), improved the safety and non-invasiveness of this method. Electric and magnetic source imaging (ESI/MSI) plays critical role in the delineation of the epileptogenic focus during the presurgical evaluation of children with DRE. Yet, they are currently underutilized even in tertiary epilepsy centers. Here, we present a case of an adolescent who suffered from DRE for 16 years and underwent surgery at Cook Children's Medical Center (CCMC). The patient was previously evaluated in a level 4 epilepsy center and treated with multiple antiseizure medications for several years. Presurgical evaluation at CCMC included long-term video electroencephalography (EEG), magnetoencephalography (MEG) with simultaneous conventional EEG (19 channels) and high-density EEG (256 channels) in two consecutive sessions, MRI, and fluorodeoxyglucose - positron emission tomography (FDG-PET). Video long-term EEG captured nine focal-onset clinical seizures with a maximal evolution over the right frontal/frontal midline areas. MRI was initially interpreted as non-lesional. FDG-PET revealed a small region of hypometabolism at the anterior right superior temporal gyrus. ESI and MSI performed with dipole clustering showed a tight cluster of dipoles in the right anterior insula. The patient underwent intracranial EEG which indicated the right anterior insular as seizure onset zone. Eventually LITT rendered the patient seizure free (Engel 1; 12 months after surgery). Retrospective analysis of ESI and MSI clustered dipoles found a mean distance of dipoles from the ablated volume ranging from 10 to 25 mm. Our findings highlight the importance of recent technological advances in the presurgical evaluation and surgical treatment of children with DRE, and the underutilization of epilepsy surgery in children with DRE.
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Affiliation(s)
- Christos Papadelis
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States
- School of Medicine, Texas Christian University, University of North Texas Health Science Center, Fort Worth, TX, United States
- *Correspondence: Christos Papadelis orcid.org/0000-0001-6125-9217
| | - Shannon E. Conrad
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
| | - Yanlong Song
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States
| | - Sabrina Shandley
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
| | - Daniel Hansen
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
| | - Madhan Bosemani
- Department of Radiology, Cook Children's Medical Center, Fort Worth, TX, United States
| | - Saleem Malik
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
| | - Cynthia Keator
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
| | - M. Scott Perry
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States
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Validating EEG, MEG and Combined MEG and EEG Beamforming for an Estimation of the Epileptogenic Zone in Focal Cortical Dysplasia. Brain Sci 2022; 12:brainsci12010114. [PMID: 35053857 PMCID: PMC8796031 DOI: 10.3390/brainsci12010114] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/04/2023] Open
Abstract
MEG and EEG source analysis is frequently used for the presurgical evaluation of pharmacoresistant epilepsy patients. The source localization of the epileptogenic zone depends, among other aspects, on the selected inverse and forward approaches and their respective parameter choices. In this validation study, we compare the standard dipole scanning method with two beamformer approaches for the inverse problem, and we investigate the influence of the covariance estimation method and the strength of regularization on the localization performance for EEG, MEG, and combined EEG and MEG. For forward modelling, we investigate the difference between calibrated six-compartment and standard three-compartment head modelling. In a retrospective study, two patients with focal epilepsy due to focal cortical dysplasia type IIb and seizure freedom following lesionectomy or radiofrequency-guided thermocoagulation (RFTC) used the distance of the localization of interictal epileptic spikes to the resection cavity resp. RFTC lesion as reference for good localization. We found that beamformer localization can be sensitive to the choice of the regularization parameter, which has to be individually optimized. Estimation of the covariance matrix with averaged spike data yielded more robust results across the modalities. MEG was the dominant modality and provided a good localization in one case, while it was EEG for the other. When combining the modalities, the good results of the dominant modality were mostly not spoiled by the weaker modality. For appropriate regularization parameter choices, the beamformer localized better than the standard dipole scan. Compared to the importance of an appropriate regularization, the sensitivity of the localization to the head modelling was smaller, due to similar skull conductivity modelling and the fixed source space without orientation constraint.
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Nenonen J, Helle L, Jaiswal A, Bock E, Ille N, Bornfleth H. Sensitivity of a 29-Channel MEG Source Montage. Brain Sci 2022; 12:brainsci12010105. [PMID: 35053848 PMCID: PMC8773883 DOI: 10.3390/brainsci12010105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022] Open
Abstract
In this paper, we study the performance of a source montage corresponding to 29 brain regions reconstructed from whole-head magnetoencephalographic (MEG) recordings, with the aim of facilitating the review of MEG data containing epileptiform discharges. Test data were obtained by superposing simulated signals from 100-nAm dipolar sources to a resting state MEG recording from a healthy subject. Simulated sources were placed systematically to different cortical locations for defining the optimal regularization for the source montage reconstruction and for assessing the detectability of the source activity from the 29-channel MEG source montage. The signal-to-noise ratio (SNR), computed for each source from the sensor-level and source-montage signals, was used as the evaluation parameter. Without regularization, the SNR from the simulated sources was larger in the sensor-level signals than in the source montage reconstructions. Setting the regularization to 2% increased the source montage SNR to the same level as the sensor-level SNR, improving the detectability of the simulated events from the source montage reconstruction. Sources producing a SNR of at least 15 dB were visually detectable from the source-montage signals. Such sources are located closer than about 75 mm from the MEG sensors, in practice covering all areas in the grey matter. The 29-channel source montage creates more focal signals compared to the sensor space and can significantly shorten the detection time of epileptiform MEG discharges for focus localization.
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Affiliation(s)
- Jukka Nenonen
- Megin Oy, Keilasatama 5, FI-02150 Espoo, Finland; (L.H.); (A.J.); (E.B.)
- Correspondence: ; Tel.: +358-9-756-2400
| | - Liisa Helle
- Megin Oy, Keilasatama 5, FI-02150 Espoo, Finland; (L.H.); (A.J.); (E.B.)
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, FI-00076 Aalto, Finland
| | - Amit Jaiswal
- Megin Oy, Keilasatama 5, FI-02150 Espoo, Finland; (L.H.); (A.J.); (E.B.)
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, FI-00076 Aalto, Finland
| | - Elizabeth Bock
- Megin Oy, Keilasatama 5, FI-02150 Espoo, Finland; (L.H.); (A.J.); (E.B.)
| | - Nicole Ille
- BESA GmbH, 82166 Gräfelfing, Germany; (N.I.); (H.B.)
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Zillgitt A, Haykal MA, Elisevich K, Patra S, Sherburn F, Bowyer SM, Burdette DE. Magnetoencephalography-identified preictal spiking correlates to preictal spiking on stereotactic EEG. Epilepsy Behav Rep 2022; 19:100538. [PMID: 35573060 PMCID: PMC9095747 DOI: 10.1016/j.ebr.2022.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/01/2022] Open
Abstract
Ictal MEG can assist in sEEG implantation strategy and may improve surgical outcome. Preictal spiking is a seizure onset pattern that has been described with intracranial EEG, but preictal spiking can also be an ictal pattern on MEG. MEG-predominant or MEG-unique preictal spiking may represent neuronal hypersynchronization arising from a tangential source.
Magnetoencephalography (MEG) is a noninvasive diagnostic modality that directly measures neuronal signaling by recording the magnetic field created from dendritic, intracellular, electrical currents of the neuron at the surface of the head. In clinical practice, MEG is used in the epilepsy presurgical evaluation and most commonly is an “interictal” study that can provide source localization of spike-wave discharges. However, seizures may be recorded during MEG (“ictal MEG”) and mapping of these discharges may provide more accurate localization of the seizure onset zone. In addition, spike-negative EEG with unique MEG spike-waves may be present in up to 1/3 of MEG studies and unique MEG seizures (EEG-negative seizures) have been reported. This case report describes a patient with unique MEG seizures that exhibited MEG pre-ictal spiking in a tight cluster consistent with the independent interictal epileptiform activity. Stereotactic EEG demonstrated pre-ictal spiking concordant with the MEG pre-ictal spiking.
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Moreau JT, Simard-Tremblay E, Albrecht S, Rosenblatt B, Baillet S, Dudley RWR. Overnight Ictal Magnetoencephalography. Neurol Clin Pract 2021; 11:e732-e735. [PMID: 34840892 DOI: 10.1212/cpj.0000000000000937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/07/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Jeremy T Moreau
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
| | - Elisabeth Simard-Tremblay
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
| | - Steffen Albrecht
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
| | - Bernard Rosenblatt
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
| | - Sylvain Baillet
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
| | - Roy W R Dudley
- McConnell Brain Imaging Centre (JTM, SB), Montreal Neurological Institute and Hospital; Division of Neurology and Department of Clinical Neurophysiology (EST, BR), Montreal Children's Hospital; Department of Pathology (SA), Montreal Children's Hospital; and Division of Neurosurgery, Department of Pediatric Surgery (RWRD), Montreal Children's Hospital
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45
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Vogel S, Kaltenhäuser M, Kim C, Müller-Voggel N, Rössler K, Dörfler A, Schwab S, Hamer H, Buchfelder M, Rampp S. MEG Node Degree Differences in Patients with Focal Epilepsy vs. Controls-Influence of Experimental Conditions. Brain Sci 2021; 11:1590. [PMID: 34942895 PMCID: PMC8699109 DOI: 10.3390/brainsci11121590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
Drug-resistant epilepsy can be most limiting for patients, and surgery represents a viable therapy option. With the growing research on the human connectome and the evidence of epilepsy being a network disorder, connectivity analysis may be able to contribute to our understanding of epilepsy and may be potentially developed into clinical applications. In this magnetoencephalographic study, we determined the whole-brain node degree of connectivity levels in patients and controls. Resting-state activity was measured at five frequency bands in 15 healthy controls and 15 patients with focal epilepsy of different etiologies. The whole-brain all-to-all imaginary part of coherence in source space was then calculated. Node degree was determined and parcellated and was used for further statistical evaluation. In comparison to controls, we found a significantly higher overall node degree in patients with lesional and non-lesional epilepsy. Furthermore, we examined the conditions of high/reduced vigilance and open/closed eyes in controls, to analyze whether patient node degree levels can be achieved. We evaluated intraclass-correlation statistics (ICC) to evaluate the reproducibility. Connectivity and specifically node degree analysis could present new tools for one of the most common neurological diseases, with potential applications in epilepsy diagnostics.
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Affiliation(s)
- Stephan Vogel
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
- Friedrich Alexander University Erlangen Nürnberg (FAU), 91054 Erlangen, Germany
| | - Martin Kaltenhäuser
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
| | - Cora Kim
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
| | - Nadia Müller-Voggel
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
| | - Karl Rössler
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria;
| | - Arnd Dörfler
- Department of Neuroradiology, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Stefan Schwab
- Department of Neurology, University Hospital Erlangen, 91054 Erlangen, Germany; (S.S.); (H.H.)
| | - Hajo Hamer
- Department of Neurology, University Hospital Erlangen, 91054 Erlangen, Germany; (S.S.); (H.H.)
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany; (M.K.); (C.K.); (N.M.-V.); (M.B.); (S.R.)
- Department of Neurosurgery, University Hospital Halle (Saale), 06120 Halle (Saale), Germany
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Resting-State MEG Source Space Network Metrics Associated with the Duration of Temporal Lobe Epilepsy. Brain Topogr 2021; 34:731-744. [PMID: 34652579 DOI: 10.1007/s10548-021-00875-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
To evaluate the relationship between the network metrics of 68 brain regions and duration of temporal lobe epilepsy (TLE). Magnetoencephalography (MEG) data from 53 patients with TLE (28 left TLE, 25 right TLE) were recorded between seizures at resting state and analyzed in six frequency bands: delta (0.1-4 Hz), theta (4-8 Hz), lower alpha (8-10 Hz), upper alpha (10-13 Hz), beta (13-30 Hz), and lower gamma (30-48 Hz). Three local network metrics, betweenness centrality, nodal degree, and nodal efficiency, were chosen to analyze the functional brain network. In Left, Right, and All (Left + Right) TLE groups, different metrics provide significant positive or negative correlations with the duration of TLE, in different frequency bands, and in different brain regions. In the Left TLE group, significant correlation between TLE duration and metric exists in the delta, beta, or lower gamma band, with network betweenness centrality, nodal degree, or nodal efficiency, in left caudal middle frontal, left middle temporal, or left supramarginal. In the Right TLE group, significant correlation exists in lower gamma or delta band, with nodal degree, or nodal efficiency, in left precuneus or right temporal pole. In the All TLE group, the significant correlation exists in delta, theta, beta, or lower gamma band, with nodal degree, or betweenness centrality, in either left or right hemisphere. Network metrics for some specific brain regions changed in patients with TLE as the duration of their TLE increased. Further researching these changes may be important for studying the pathogenesis, presurgical evaluation, and clinical treatment of long-term TLE.
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Laohathai C, Ebersole JS, Mosher JC, Bagić AI, Sumida A, Von Allmen G, Funke ME. Practical Fundamentals of Clinical MEG Interpretation in Epilepsy. Front Neurol 2021; 12:722986. [PMID: 34721261 PMCID: PMC8551575 DOI: 10.3389/fneur.2021.722986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG.
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Affiliation(s)
- Christopher Laohathai
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
- Department of Neurology, Saint Louis University, Saint Louis, MO, United States
| | - John S. Ebersole
- Northeast Regional Epilepsy Group, Atlantic Health Neuroscience Institute, Summit, NJ, United States
| | - John C. Mosher
- Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Anto I. Bagić
- University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), Department of Neurology, University of Pittsburgh Medical Center, Pittsburg, PA, United States
| | - Ai Sumida
- Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Gretchen Von Allmen
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Michael E. Funke
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
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Papadelis C, Perry MS. Localizing the Epileptogenic Zone with Novel Biomarkers. Semin Pediatr Neurol 2021; 39:100919. [PMID: 34620466 PMCID: PMC8501232 DOI: 10.1016/j.spen.2021.100919] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 01/01/2023]
Abstract
Several noninvasive methods, such as high-density EEG or magnetoencephalography, are currently used to delineate the epileptogenic zone (EZ) during the presurgical evaluation of patients with drug resistant epilepsy (DRE). Yet, none of these methods can reliably identify the EZ by their own. In most cases a multimodal approach is needed. Challenging cases often require the implantation of intracranial electrodes, either through stereo-taxic EEG or electro-corticography. Recently, a growing body of literature introduces novel biomarkers of epilepsy that can be used for analyzing both invasive as well as noninvasive electrophysiological data. Some of these biomarkers are able to delineate the EZ with high precision, augment the presurgical evaluation, and predict the surgical outcome of patients with DRE undergoing surgery. However, the use of these epilepsy biomarkers in clinical practice is limited. Here, we summarize and discuss the latest technological advances in the presurgical neurophysiological evaluation of children with DRE with emphasis on electric and magnetic source imaging, high frequency oscillations, and functional connectivity.
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Affiliation(s)
- Christos Papadelis
- Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX; School of Medicine, Texas Christian University and University of North Texas Health Science Center, Fort Worth, TX; Department of Bioengineering, University of Texas at Arlington, Arlington, TX; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
| | - M Scott Perry
- Jane and John Justin Neurosciences Center, Cook Children’s Health Care System, Fort Worth, TX, USA
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[Imaging in the presurgical evaluation of epilepsy]. DER NERVENARZT 2021; 93:592-598. [PMID: 34491376 PMCID: PMC9200687 DOI: 10.1007/s00115-021-01180-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
Während zwei Drittel der PatientInnen mit Epilepsie durch Medikamente anfallsfrei werden, ist die Erkrankung bei 30 % pharmakoresistent. Bei pharmakoresistenter fokaler Epilepsie bietet die Epilepsiechirurgie eine etwa 65 %ige Chance auf Anfallsfreiheit. Vorab muss der Anfallsfokus exakt eingegrenzt werden, wofür bildgebende Methoden unverzichtbar sind. In den letzten Jahren hat sich in der Prächirurgie der Anteil von PatientInnen mit unauffälliger konventioneller Magnetresonanztomographie (MRT) erhöht. Allerdings konnte die Sensitivität der MRT durch spezielle Aufnahmesequenzen und Techniken der Postprozessierung gesteigert werden. Die Quellenlokalisation des Signals von Elektro- und Magnetenzephalographie (EEG und MEG) verortet den Ursprung iktaler und interiktaler epileptischer Aktivität im Gehirn. Nuklearmedizinische Untersuchungen wie die interiktale Positronen-Emissions-Tomographie (PET) und die iktale Einzelphotonen-Emissionscomputertomographie (SPECT) detektieren chronische oder akute anfallsbezogene Veränderungen des Hirnmetabolismus und können auch bei nichtlokalisierendem MRT auf den epileptogenen Fokus hinweisen. Alle Befunde zusammengenommen werden zur Planung eventueller invasiver EEG-Ableitungen und letztlich der chirurgischen Operation eingesetzt. Konkordante Befunde sind mit besseren chirurgischen Ergebnissen assoziiert und zeigen auch im Langzeitverlauf signifikant höhere Anfallsfreiheitsraten.
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Beltrachini L, von Ellenrieder N, Eichardt R, Haueisen J. Optimal design of on-scalp electromagnetic sensor arrays for brain source localisation. Hum Brain Mapp 2021; 42:4869-4879. [PMID: 34245061 PMCID: PMC8449117 DOI: 10.1002/hbm.25586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/09/2021] [Accepted: 06/25/2021] [Indexed: 11/11/2022] Open
Abstract
Optically pumped magnetometers (OPMs) are quickly widening the scopes of noninvasive neurophysiological imaging. The possibility of placing these magnetic field sensors on the scalp allows not only to acquire signals from people in movement, but also to reduce the distance between the sensors and the brain, with a consequent gain in the signal‐to‐noise ratio. These advantages make the technique particularly attractive to characterise sources of brain activity in demanding populations, such as children and patients with epilepsy. However, the technology is currently in an early stage, presenting new design challenges around the optimal sensor arrangement and their complementarity with other techniques as electroencephalography (EEG). In this article, we present an optimal array design strategy focussed on minimising the brain source localisation error. The methodology is based on the Cramér‐Rao bound, which provides lower error bounds on the estimation of source parameters regardless of the algorithm used. We utilise this framework to compare whole head OPM arrays with commercially available electro/magnetoencephalography (E/MEG) systems for localising brain signal generators. In addition, we study the complementarity between EEG and OPM‐based MEG, and design optimal whole head systems based on OPMs only and a combination of OPMs and EEG electrodes for characterising deep and superficial sources alike. Finally, we show the usefulness of the approach to find the nearly optimal sensor positions minimising the estimation error bound in a given cortical region when a limited number of OPMs are available. This is of special interest for maximising the performance of small scale systems to ad hoc neurophysiological experiments, a common situation arising in most OPM labs.
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Affiliation(s)
- Leandro Beltrachini
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff
| | | | - Roland Eichardt
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany
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