Spatiotemporal EEG analysis and distributed source estimation in presurgical epilepsy evaluation

Localizing hidden Interictal Epileptiform Discharges with simultaneous intracerebral and scalp high-density EEG recordings

BACKGROUND

Scalp EEG is one of the main tools in the clinical evaluation of epilepsy. In some cases intracranial Interictal Epileptiform Discharges (IEDs) are not visible from the scalp. Recent studies have shown the feasibility of revealing them in the EEG if their timings are extracted from simultaneous intracranial recordings, but their potential for the localization of the epileptogenic zone is not yet well defined.

NEW METHOD

We recorded simultaneous high-density EEG (HD-EEG) and stereo-electroencephalography (SEEG) during interictal periods in 8 patients affected by drug-resistant focal epilepsy. We identified IEDs in the SEEG and systematically analyzed the time-locked signals on the EEG by means of evoked potentials, topographical analysis and Electrical Source Imaging (ESI). The dataset has been standardized and is being publicly shared.

RESULTS

Our results showed that IEDs that were not clearly visible at single-trials could be uncovered by averaging, in line with previous reports. They also showed that their topographical voltage distributions matched the position of the SEEG electrode where IEDs had been identified, and that ESI techniques can reconstruct it with an accuracy of ∼2 cm. Finally, the present dataset provides a reference to test the accuracy of different methods and parameters.

COMPARISON WITH EXISTING METHODS

Our study is the first to systematically compare ESI methods on simultaneously recorded IEDs, and to share a public resource with in-vivo data for their evaluation.

CONCLUSIONS

Simultaneous HD-EEG and SEEG recordings can unveil hidden IEDs whose origins can be reconstructed using topographical and ESI analyses, but results depend on the selected methods and parameters.

The temporal dynamics of the Stroop effect from childhood to young and older adulthood

The processes involved in the Stroop task/effect are thought to involve conflict detection and resolution stages. Little is known about the evolution of these two components over the lifespan. It is well admitted that children and older adults tend to show longer response latencies than young adults. The present study aims at clarifying the rational of such changes from childhood to adulthood and in aging by comparing the impacted cognitive processes across age groups. More precisely, the aim was to clarify if all processes take more time to be executed, hence implying that longer latencies rely mainly on processing speed or if an additional process lengthens the resolution of the conflict in children and/or older adults. To this aim we recorded brain electrical activity using EEG in school-age children, young and older adults while they performed a classic verbal Stroop task. The signal was decomposed in microstate brain networks, and age groups and conditions were compared. Behavioral results evolved following an inverted U-shaped curve. In children, different brain states from the ones observed in adults were highlighted, both in the conflict detection and resolution time-windows. Longer latencies in the incongruent condition were mainly attributed to an overly increased duration of the microstates involved in the conflict resolution time window. In aging, the same microstate maps were reported for both young and older adult groups. The differences in performances between groups could be explained by a disproportionally long conflict detection phase, even compressing the latest stage of response articulation. These results tend to favor a specific immaturity of the brain networks involved coupled with a slowing of the processes in children, while cognitive decline could be mostly explained by a general slowing.

Decision-making in stereotactic epilepsy surgery

Surgery can cure or significantly improve both the frequency and the intensity of seizures in patients with medication-refractory epilepsy. The set of diagnostic and therapeutic interventions involved in the path from initial consultation to definitive surgery is complex and includes a multidisciplinary team of neurologists, neurosurgeons, neuroradiologists, and neuropsychologists, supported by a very large epilepsy-dedicated clinical architecture. In recent years, new practices and technologies have emerged that dramatically expand the scope of interventions performed. Stereoelectroencephalography has become widely adopted for seizure localization; stereotactic laser ablation has enabled more focal, less invasive, and less destructive interventions; and new brain stimulation devices have unlocked treatment of eloquent foci and multifocal onset etiologies. This article articulates and illustrates the full framework for how epilepsy patients are considered for surgical intervention, with particular attention given to stereotactic approaches.

Non-invasive Seizure Localization with Ictal Single-Photon Emission Computed Tomography is Impacted by Preictal/Early Ictal Network Dynamics

OBJECTIVE

More than one third of children with epilepsy have medically intractable seizures. Promising therapies, including targeted neurostimulation and surgery, depend on accurate localization of the epileptogenic zone. Ictal perfusion Single-Photon Emission Computed Tomography (SPECT) can localize the seizure focus noninvasively, with comparable accuracy to that of invasive EEG. However, multiple factors including seizure dynamics may affect its spatial specificity.

METHODS

Using subtracted ictal from interictal SPECT and scalp EEG from 118 pediatric epilepsy patients (40 of whom had surgery after the SPECT studies), information theoretic measures of association and advanced statistical models, this study investigated the impact of preictal and ictal brain network dynamics on SPECT focality.

RESULTS

Network dynamics significantly impacted the SPECT localization ~30 s before to ~45 s following ictal onset. Distributed early ictal connectivity changes, indicative of a rapidly evolving seizure, were negatively associated with SPECT focality. Spatially localized connectivity changes later in the seizure, indicating slower seizure propagation, were positively associated with SPECT focality. In the first ~60 s of the seizure, significantly higher network connectivity was estimated in an area overlapping with the area of hyperperfusion. Finally, ~75% of patients with Engel class 1a/1b outcomes had SPECTs that were concordant with the resected area.

CONCLUSION

Slowly evolving seizures are more likely to be accurately imaged with SPECT, and the identified focus may overlap with brain regions where significant topological changes occur.

SIGNIFICANCE

Measures of preictal/early ictal network dynamics may help optimize the SPECT localization, leading to improved surgical and neurostimulation outcomes in refractory epilepsy.

Early Left Parietal Activity Elicited by Direct Gaze: A High-Density EEG Study

Gaze is one of the most important cues for human communication and social interaction. In particular, gaze contact is the most primary form of social contact and it is thought to capture attention. A very early-differentiated brain response to direct versus averted gaze has been hypothesized. Here, we used high-density electroencephalography to test this hypothesis. Topographical analysis allowed us to uncover a very early topographic modulation (40-80 ms) of event-related responses to faces with direct as compared to averted gaze. This modulation was obtained only in the condition where intact broadband faces-as opposed to high-pass or low-pas filtered faces-were presented. Source estimation indicated that this early modulation involved the posterior parietal region, encompassing the left precuneus and inferior parietal lobule. This supports the idea that it reflected an early orienting response to direct versus averted gaze. Accordingly, in a follow-up behavioural experiment, we found faster response times to the direct gaze than to the averted gaze broadband faces. In addition, classical evoked potential analysis showed that the N170 peak amplitude was larger for averted gaze than for direct gaze. Taken together, these results suggest that direct gaze may be detected at a very early processing stage, involving a parallel route to the ventral occipito-temporal route of face perceptual analysis.

Dorsal and ventral stream contributions to form-from-motion perception in a patient with form-from motion deficit: a case report

The main model of visual processing in primates proposes an anatomo-functional distinction between the dorsal stream, specialized in spatio-temporal information, and the ventral stream, processing essentially form information. However, these two pathways also communicate to share much visual information. These dorso-ventral interactions have been studied using form-from-motion (FfM) stimuli, revealing that FfM perception first activates dorsal regions (e.g., MT+/V5), followed by successive activations of ventral regions (e.g., LOC). However, relatively little is known about the implications of focal brain damage of visual areas on these dorso-ventral interactions. In the present case report, we investigated the dynamics of dorsal and ventral activations related to FfM perception (using topographical ERP analysis and electrical source imaging) in a patient suffering from a deficit in FfM perception due to right extrastriate brain damage in the ventral stream. Despite the patient's FfM impairment, both successful (observed for the highest level of FfM signal) and absent/failed FfM perception evoked the same temporal sequence of three processing states observed previously in healthy subjects. During the first period, brain source localization revealed cortical activations along the dorsal stream, currently associated with preserved elementary motion processing. During the latter two periods, the patterns of activity differed from normal subjects: activations were observed in the ventral stream (as reported for normal subjects), but also in the dorsal pathway, with the strongest and most sustained activity localized in the parieto-occipital regions. On the other hand, absent/failed FfM perception was characterized by weaker brain activity, restricted to the more lateral regions. This study shows that in the present case report, successful FfM perception, while following the same temporal sequence of processing steps as in normal subjects, evoked different patterns of brain activity. By revealing a brain circuit involving the most rostral part of the dorsal pathway, this study provides further support for neuro-imaging studies and brain lesion investigations that have suggested the existence of different brain circuits associated with different profiles of interaction between the dorsal and the ventral streams.

Electrical source imaging of interictal spikes using multiple sparse volumetric priors for presurgical epileptogenic focus localization

Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP) approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i) an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii) an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii) an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time epochs were in the same range as the LORETA and ECD techniques. We found distances smaller than 23 mm, with robust results for all the patients. For the finite difference models, we found that the distances to the resection border for the MSVP inversions of the full spike time epochs were generally smaller compared to the MSVP inversions of the time epochs before the spike peak. The results also suggest that the inversions using the finite difference models resulted in slightly smaller distances to the resection border compared to the spherical models. The results we obtained are promising because the MSVP approach allows to study the network of the estimated source-intensities and allows to characterize the spatial extent of the underlying sources.

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A Bayesian ESI technique is evaluated to localize interictal spike activity.

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Averaged spikes in six patients were used that were seizure free after surgery.

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We compared the technique with the LORETA an ECD technique.

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We evaluated both spherical and 5-layered finite difference forward models.

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Our approach is potentially useful to delineate the irritative zone.

Dynamic spatiotemporal brain analyses using high-performance electrical neuroimaging, Part II: A step-by-step tutorial

Our recently published analytic toolbox (Cacioppo et al., 2014), running under MATLAB environment and Brainstorm, offered a theoretical framework and set of validation studies for the automatic detection of event-related changes in the global pattern and global field power of electrical brain activity. Here, we provide a step-by-step tutorial of this toolbox along with a detailed description of analytical plans (aka the Chicago Electrical Neuroimaging Analytics, CENA) for the statistical analysis of brain microstate configuration and global field power in within and between-subject designs. Available CENA functions include: (1) a difference wave function; (2) a high-performance microsegmentation suite (HPMS), which consists of three specific analytic tools: (i) a root mean square error (RMSE) metric for identifying stable states and transition states across discrete event-related brain microstates; (ii) a similarity metric based on cosine distance in n dimensional sensor space to determine whether template maps for successive brain microstates differ in configuration of brain activity, and (iii) global field power (GFP) metrics for identifying changes in the overall level of activation of the brain; (3) a bootstrapping function for assessing the extent to which the solutions identified in the HPMS are robust (reliable, generalizable) and for empirically deriving additional experimental hypotheses; and (4) step-by-step procedures for performing a priori contrasts for data analysis. CENA is freely available for brain data spatiotemporal analyses at https://hpenlaboratory.uchicago.edu/page/cena, with sample data, user tutorial videos, and documentation.

Intrinsic coupling modes in source-reconstructed electroencephalography

Intrinsic coupling of neuronal assemblies constitutes a key feature of ongoing brain activity, yielding the rich spatiotemporal patterns observed in neuroimaging data and putatively supporting cognitive processes. Intrinsic coupling has been investigated in electrophysiological recordings using two types of functional connectivity measures: amplitude and phase coupling. These two coupling modes differ in their likely causes and functions, and have been proposed to provide complementary insights into intrinsic neuronal interactions. Here, we investigate the relationship between amplitude and phase coupling in source-reconstructed electroencephalography (EEG). Volume conduction is a key obstacle for connectivity analysis in EEG-we therefore also test the envelope correlation of orthogonalized signals and the phase lag index. Functional connectivity between six seed source regions (bilateral visual, sensorimotor, and auditory cortices) and all other cortical voxels was computed. For all four measures, coupling between homologous sensory areas in both hemispheres was significantly higher than with other voxels at the same physical distance. The frequency of significant coupling differed between sensory areas: 10 Hz for visual, 30 Hz for auditory, and 40 Hz for sensorimotor cortices. By contrasting envelope correlations and phase locking values, we observed two distinct clusters of voxels showing a different relationship between amplitude and phase coupling. Large clusters contiguous to the seed regions showed an identity (1:1) relationship between amplitude and phase coupling, whereas a cluster located around the contralateral homologous regions showed higher phase than amplitude coupling. These results show a relationship between intrinsic coupling modes that is distinct from the effect of volume conduction.

Effect of EEG electrode number on epileptic source localization in pediatric patients

OBJECTIVE

To investigate the relationship between EEG source localization and the number of scalp EEG recording channels.

METHODS

128 EEG channel recordings of 5 pediatric patients with medically intractable partial epilepsy were used to perform source localization of interictal spikes. The results were compared with surgical resection and intracranial recordings. Various electrode configurations were tested and a series of computer simulations based on a realistic head boundary element model were also performed in order to further validate the clinical findings.

RESULTS

The improvement seen in source localization substantially decreases as the number of electrodes increases. This finding was evaluated using the surgical resection, intracranial recordings and computer simulation. It was also shown in the simulation that increasing the electrode numbers could remedy the localization error of deep sources. A plateauing effect was seen in deep and superficial sources with further increasing the electrode number.

CONCLUSION

The source localization is improved when electrode numbers increase, but the absolute improvement in accuracy decreases with increasing electrode number.

SIGNIFICANCE

Increasing the electrode number helps decrease localization error and thus can more ably assist the physician to better plan for surgical procedures.

EEG source imaging of brain states using spatiotemporal regression

Relating measures of electroencephalography (EEG) back to the underlying sources is a long-standing inverse problem. Here we propose a new method to estimate the EEG sources of identified electrophysiological states that represent spontaneous activity, or are evoked by a stimulus, or caused by disease or disorder. Our method has the unique advantage of seamlessly integrating a statistical significance of the source estimate while efficiently eliminating artifacts (e.g., due to eye blinks, eye movements, bad electrodes). After determining the electrophysiological states in terms of stable topographies using established methods (e.g.: ICA, PCA, k-means, epoch average), we propose to estimate these states' time courses through spatial regression of a General Linear Model (GLM). These time courses are then used to find EEG sources that have a similar time-course (using temporal regression of a second GLM). We validate our method using both simulated and experimental data. Simulated data allows us to assess the difference between source maps obtained by the proposed method and those obtained by applying conventional source imaging of the state topographies. Moreover, we use data from 7 epileptic patients (9 distinct epileptic foci localized by intracranial EEG) and 2 healthy subjects performing an eyes-open/eyes-closed task to elicit activity in the alpha frequency range. Our results indicate that the proposed EEG source imaging method accurately localizes the sources for each of the electrical brain states. Furthermore, our method is particularly suited for estimating the sources of EEG resting states or otherwise weak spontaneous activity states, a problem not adequately solved before.

BECTS evolving to Landau-Kleffner Syndrome and back by subsequent recovery: a longitudinal language reorganization case study using fMRI, source EEG, and neuropsychological testing

By means of a longitudinal case study, we demonstrated the course of cerebral reorganization of language representation due to epilepsy in a child with benign epilepsy with centro-temporal spikes (BECTS) evolving to Landau-Kleffner Syndrome (LKS) and returning to BECTS. The child underwent the following procedures at the ages of 8.2, 8.6, and 9.3 years: 3D source EEG imaging, language fMRI (sentence generation and reading), and neuropsychological testing. He had a follow-up testing at the age of 10.8 years. Further, 24-h EEGs were regularly performed. At the age of around 8 years, the child was diagnosed initially with left-hemispheric BECTS, which evolved to LKS with continuous bilateral discharges. In addition, 3D source imaging data revealed a left anterior temporal focus with a spreading to the right parietal and left centro-parietal areas. The patient had verbal agnosia with poor verbal yet good performance indices. Functional magnetic resonance imaging (fMRI) showed a left-hemispheric reading network but sentence generation was impossible to perform. After initiation of adequate treatment, continuous discharges disappeared, and only very rare left-hemispheric centro-temporal spikes remained. Verbal IQ and performance IQ increased at the age of 8.6 years. Functional magnetic resonance imaging showed, at this time, a right-hemispheric language activation pattern for sentence generation and reading. At the ages of 9.3 and 10.8 years, language tasks remained right-hemispheric and verbal IQ remained stable, but right-hemispheric non-verbal functions decreased due to possible crowding-out mechanisms.

Computing sources of epileptic discharges using the novel BMA approach: comparison with other distributed inverse solution methods

Electroencephalography (EEG) source localization in epileptology continues to be a challenge for neuroscientists. A number of inverse solution (IS) methodologies have been proposed to solve this problem, and their advantages and limitations have been described. In the present work, a previously developed IS approach called Bayesian model averaging (BMA) is introduced in clinical practice in order to improve the localization accuracy of epileptic discharge sources. For this study, 31 patients with the diagnosis of partial epilepsies were studied: 14 had benign childhood epilepsy with centrotemporal spikes and 17 had temporal lobe epilepsy (TLE). The underlying epileptic sources were localized using the BMA approach, and the results were compared with those expected from the clinical diagnosis. Additional comparisons with results obtained from 3 of the most commonly used distributed IS methods for these purposes (minimum norm [MN], weighted minimum norm [WMN], and low-resolution electromagnetic tomography [LORETA]) were carried out in terms of source localization accuracy and spatial resolutions. The BMA approach estimated discharge sources that were consistent with the clinical diagnosis, and this method outperformed LORETA, MN, and WMN in terms of both localization accuracy and spatial resolution. The BMA was able to localize deeper generators with high accuracy. In conclusion, the BMA methodology has a great potential for the noninvasive accurate localization of epileptic sources, even those located in deeper structures. Therefore, it could be a promising tool for clinical practice in epileptology, although additional studies in other types of epileptic syndromes are necessary.

EEG source imaging in epilepsy--practicalities and pitfalls

EEG source imaging (ESI) is a model-based imaging technique that integrates temporal and spatial components of EEG to identify the generating source of electrical potentials recorded on the scalp. Recent advances in computer technologies have made the analysis of ESI data less time-consuming, and have rekindled interest in this technique as a clinical diagnostic tool. On the basis of the available body of evidence, ESI seems to be a promising tool for epilepsy evaluation; however, the precise clinical value of ESI in presurgical evaluation of epilepsy and in localization of eloquent cortex remains to be investigated. In this Review, we describe two fundamental issues in ESI; namely, the forward and inverse problems, and their solutions. The clinical application of ESI in surgical planning for patients with medically refractory focal epilepsy, and its use in source reconstruction together with invasive recordings, is also discussed. As ESI can be used to map evoked responses, we discuss the clinical utility of this technique in cortical mapping-an essential process when planning resective surgery for brain regions that are in close proximity to eloquent cortex.

Rhythm evokes action: early processing of metric deviances in expressive music by experts and laymen revealed by ERP source imaging

To examine how musical expertise tunes the brain to subtle metric anomalies in an ecological musical context, we presented piano compositions ending on standard and deviant cadences (endings) to expert pianists and musical laymen, while high-density EEG was recorded. Temporal expectancies were manipulated by substituting standard "masculine" cadences at metrically strong positions with deviant, metrically unaccented, "feminine" cadences. Experts detected metrically deviant cadences better than laymen. Analyses of event-related potentials demonstrated that an early P3a-like component (~150-300 ms), elicited by musical closure, was significantly enhanced at frontal and parietal electrodes in response to deviant endings in experts, whereas a reduced response to deviance occurred in laymen. Putative neuronal sources contributing to the modulation of this component were localized in a network of brain regions including bilateral supplementary motor areas, middle and posterior cingulate cortex, precuneus, associative visual areas, as well as in the right amygdala and insula. In all these regions, experts showed enhanced responses to metric deviance. Later effects demonstrated enhanced activations within the same brain network, as well as higher processing speed for experts. These results suggest that early brain responses to metric deviance in experts may rely on motor representations mediated by the supplementary motor area and motor cingulate regions, in addition to areas involved in self-referential imagery and relevance detection. Such motor representations could play a role in temporal sensory prediction evolved from musical training and suggests that rhythm evokes action more strongly in highly trained instrumentalists.

Perceptual reversals during binocular rivalry: ERP components and their concomitant source differences

We used an intermittent stimulus presentation to investigate event-related potential (ERP) components associated with perceptual reversals during binocular rivalry. The combination of spatiotemporal ERP analysis with source imaging and statistical parametric mapping of the concomitant source differences yielded differences in three time windows: reversals showed increased activity in early visual (∼120 ms) and in inferior frontal and anterior temporal areas (∼400-600 ms) and decreased activity in the ventral stream (∼250-350 ms). The combination of source imaging and statistical parametric mapping suggests that these differences were due to differences in generator strength and not generator configuration, unlike the initiation of reversals in right inferior parietal areas. These results are discussed within the context of the extensive network of brain areas that has been implicated in the initiation, implementation, and appraisal of bistable perceptual reversals.

Interictal spike analysis of high-density EEG in patients with partial epilepsy

OBJECTIVE

The aim of this study is to investigate the use of interictal spikes to localize epileptogenic brain from noninvasive scalp EEG recordings in patients with medically intractable epilepsy.

METHODS

Source reconstructions were performed using a high density electrode montage and a low density electrode montage by means of a distributed source modeling method. The source of interictal spike activity was localized using both a realistic geometry boundary element method (BEM) head model and 3-shell spherical head model.

RESULTS

In the analysis of 7 patients, the high density electrode montage was found to provide results more consistent with the suspected region of epileptogenic brain identified for surgical resection using intracranial EEG recordings and structural MRI lesions, as compared to the spatial low density electrode montage used in routine clinical practice. Furthermore, the realistic geometry BEM head model provided better source localization.

CONCLUSIONS

Our results indicate the merits of using high density scalp EEG recordings and realistic geometry head modeling for source localization of interictal spikes in patients with partial epilepsy.

SIGNIFICANCE

The present results suggest further improvement of source localization accuracy of epileptogenic brain from interictal EEG recorded using high density scalp electrode montage and realistic geometry head models.

Understanding actions of others: the electrodynamics of the left and right hemispheres. A high-density EEG neuroimaging study

Background

When we observe an individual performing a motor act (e.g. grasping a cup) we get two types of information on the basis of how the motor act is done and the context: what the agent is doing (i.e. grasping) and the intention underlying it (i.e. grasping for drinking). Here we examined the temporal dynamics of the brain activations that follow the observation of a motor act and underlie the observer's capacity to understand what the agent is doing and why.

Methodology/Principal Findings

Volunteers were presented with two-frame video-clips. The first frame (T0) showed an object with or without context; the second frame (T1) showed a hand interacting with the object. The volunteers were instructed to understand the intention of the observed actions while their brain activity was recorded with a high-density 128-channel EEG system. Visual event-related potentials (VEPs) were recorded time-locked with the frame showing the hand-object interaction (T1). The data were analyzed by using electrical neuroimaging, which combines a cluster analysis performed on the group-averaged VEPs with the localization of the cortical sources that give rise to different spatio-temporal states of the global electrical field. Electrical neuroimaging results revealed four major steps: 1) bilateral posterior cortical activations; 2) a strong activation of the left posterior temporal and inferior parietal cortices with almost a complete disappearance of activations in the right hemisphere; 3) a significant increase of the activations of the right temporo-parietal region with simultaneously co-active left hemispheric sources, and 4) a significant global decrease of cortical activity accompanied by the appearance of activation of the orbito-frontal cortex.

Conclusions/Significance

We conclude that the early striking left hemisphere involvement is due to the activation of a lateralized action-observation/action execution network. The activation of this lateralized network mediates the understanding of the goal of object-directed motor acts (mirror mechanism). The successive right hemisphere activation indicates that this hemisphere plays an important role in understanding the intention of others.

Noninvasive cortical imaging of epileptiform activities from interictal spikes in pediatric patients

Improved non-invasive localization of the epileptogenic foci prior to epilepsy surgery would improve surgical outcome in patients with partial seizure disorders. A critical component for the identification of the epileptogenic brain is the analysis of electrophysiological data obtained during ictal activity from prolonged intracranial recordings. The development of a noninvasive means to identify the seizure onset zone (SOZ) would thus play an important role in treating patients with intractable epilepsy. In the present study, we have investigated non-invasive imaging of epileptiform activity in patients with medically intractable epilepsy by means of a cortical potential imaging (CPI) technique. Eight pediatric patients (1M/7F, ages 4-14 years) with intractable partial epilepsy were studied. Each patient had multiple (6 to 14) interictal spikes (IIS) subjected to the CPI analysis. Realistic geometry boundary element head models were built using each individual's MRI in order to maximize the imaging precision. CPI analysis was performed on the IISs, and extrema in the estimated CPI images were compared with SOZs as determined from the ictal electrocorticogram (ECoG) recordings, as well as the resected areas in the patients and surgical outcomes. The distances between the maximum cortical activities of the IISs reflected by the estimated cortical potential distributions and the SOZs were determined to quantitatively evaluate the performance of the CPI in localizing the epileptogenic zone. Ictal ECoG recordings revealed that six patients exhibited a single epileptogenic focus while two patients had multiple foci. In each patient, the CPI results revealed an area of activity overlapping with the SOZs as identified by ictal ECoG. The distance from the extreme of the CPI images at the peak of IIS to the nearest intracranial electrode associated with the onset of the ictal activity was evaluated for each patient and the averaged distance was 4.6mm. In the group of patients studied, the CPI imaged epileptogenic foci were within the resected areas. According to the follow-up of the eight patients included, two were seizure free and six had substantial reduction in seizure frequency. These promising results demonstrate the potential for noninvasive localization of the epileptogenic focus from interictal scalp EEG recordings. Confirmation of our results may have a significant impact on the process of presurgical planning in pediatric patients with intractable epilepsy by dramatically reducing or potentially eliminating the use of intracranial recording.

Decrease in propagation of interictal epileptiform activity after introduction of levetiracetam visualized with electric source imaging

Different neuroimaging techniques (fMRI, spectroscopy, PET) are being used to evaluate candidate drugs in pharmacological development. In patients with epilepsy fast propagation of the epileptiform activity between different brain areas occurs. Electric Source Imaging (ESI), in contrast to the aforementioned techniques, has a millisecond time resolution, allowing visualization of this fast propagation. The purpose of the current project was to use ESI to investigate whether introduction of an antiepileptic drug (levetiracetam, LEV) would change the propagation patterns of the interictal epileptiform activity. Thirty patients with epilepsy were subject to an EEG recording before (pre-LEV) and after (in-LEV) introduction of LEV. Interictal spikes with similar topographic distribution were averaged within each subject, and a distributed source model was used to localize the EEG sources of the epileptiform activity. The temporal development of the activity within 20 regions of interest (ROIs) was determined, and source propagation between different regions was compared between the pre-LEV and in-LEV recordings. Patients with epileptic seizures showed propagation in 22/24 identified spike types in the pre-LEV recordings. In the in-LEV recordings only 7/15 spike types showed propagation, and six of these seven propagating spikes were recorded in patients with poor effect of treatment. Also in patients without seizures LEV tended to suppress propagation. We conclude that the observed suppression of source propagation can be considered as an indicator of effective antiepileptic treatment. ESI might thus become a useful tool in the early clinical evaluation of new candidate drugs in pharmacological development.

Errors can be related to pre-stimulus differences in ERP topography and their concomitant sources

Much of the variation in both neuronal and behavioral responses to stimuli can be explained by pre-stimulus fluctuations in brain activity. We hypothesized that also errors are the result of stochastic fluctuations in pre-stimulus activity and investigated the temporal dynamics of the scalp topography and their concomitant intracranial generators of stimulus- and response-locked high-density event-related potentials (ERPs) to errors and correct trials in a Stroop task. We found significant differences in ERP map topography and intracranial sources before the onset of the stimulus and after the initiation of the response but not as a function of stimulus-induced conflict. Before the stimulus, topographic differences were accompanied by differential activity in lateral frontal, parietal and temporal areas known to be involved in voluntary reorientation of attention and cognitive control. Differential post-response activity propagated both medially and laterally on a rostral-caudal axis of a network typically involved in performance monitoring. Analysis of the statistical properties of error occurrences revealed their stochasticity.

Comparator and non-comparator mechanisms of change detection in the context of speech--an ERP study

Automatic change detection reflects a cognitive memory-based comparison mechanism as well as a sensorial non-comparator mechanism based on differential states of refractoriness. The purpose of this study was to examine whether the comparator mechanism of the mismatch negativity component (MMN) is differentially affected by the lexical status of the deviant. Event-related potential (ERP) data was collected during an "oddball" paradigm designed to elicit the MMN from 15 healthy subjects that were involved in a counting task. Topography pattern analysis and source estimation were utilized to examine the deviance (deviants vs. standards), cognitive (deviants vs. control counterparts) and refractoriness (standards vs. control counterparts) effects elicited by standard-deviant pairs ("deh-day"; "day-deh"; "teh-tay") embedded within "oddball" blocks. Our results showed that when the change was salient regardless of lexical status (i.e., the /e:/ to /eI/ transition) the response tapped the comparator based-mechanism of the MMN which was located in the cuneus/posterior cingulate, reflected sensitivity to the novelty of the auditory object, appeared in the P2 latency range and mainly involved topography modulations. In contrast, when the novelty was low (i.e., the /eI/ to /e:/ transition) an acoustic change complex was elicited which involved strength modulations over the P1/N1 range and implicated the middle temporal gyrus. This result pattern also resembled the one displayed by the non-comparator mechanism. These findings suggest spatially and temporally distinct brain activities of comparator mechanisms of change detection in the context of speech.

Methods for Determining Frequency- and Region-Dependent Relationships Between Estimated LFPs and BOLD Responses in Humans

The relationship between electrophysiological and functional magnetic resonance imaging (fMRI) signals remains poorly understood. To date, studies have required invasive methods and have been limited to single functional regions and thus cannot account for possible variations across brain regions. Here we present a method that uses fMRI data and singe-trial electroencephalography (EEG) analyses to assess the spatial and spectral dependencies between the blood-oxygenation-level-dependent (BOLD) responses and the noninvasively estimated local field potentials (eLFPs) over a wide range of frequencies (0–256 Hz) throughout the entire brain volume. This method was applied in a study where human subjects completed separate fMRI and EEG sessions while performing a passive visual task. Intracranial LFPs were estimated from the scalp-recorded data using the ELECTRA source model. We compared statistical images from BOLD signals with statistical images of each frequency of the eLFPs. In agreement with previous studies in animals, we found a significant correspondence between LFP and BOLD statistical images in the gamma band (44–78 Hz) within primary visual cortices. In addition, significant correspondence was observed at low frequencies (<14 Hz) and also at very high frequencies (>100 Hz). Effects within extrastriate visual areas showed a different correspondence that not only included those frequency ranges observed in primary cortices but also additional frequencies. Results therefore suggest that the relationship between electrophysiological and hemodynamic signals thus might vary both as a function of frequency and anatomical region.

Distribution-based minimum-norm estimation with multiple trials

The goal of this study is to develop a source imaging method for electroencephalography and magnetoencephalography by analyzing a distance measure based on a Euclidean norm of difference between pre- and post-stimulus brain activities. Conventional source imaging techniques generally detect evoked responses by averaging multiple trials at each source point. These methods are limited in their ability to fully analyze complex brain signals with a mixture of evoked and induced activities because they compare means or variances. In this article, we propose a novel approach for eliciting significant evoked and induced activity. To this aim, response and baseline ranges from each trial are separately mapped in an anatomically constrained source space by minimum-norm estimation. The extent within a distribution and the distance between distributions of brain activities at each source point are estimated from the set of trials. Then, this distance analysis determines the degree of difference between the response and baseline activities. The statistical significance of the distance comparison was computed using a nonparametric permutation test. In the evaluation of simulated data sets, the proposed method provided robust images of the simulated location (p<0.05), whereas the average method did not detect the perturbed source. A total of 200 randomly selected locations were tested with a signal-to-noise ratio (SNR) of 2dB, and the error between simulated points and the maximum-value-points analyzed using this method was 9+/-15 mm.

Second-language learning and changes in the brain

Presumably, second-language (L2) learning is mediated by changes in the brain. Little is known about what changes in the brain, how the brain changes, or when these changes occur during learning. Here, we illustrate by way of example how modern brain-based methods can be used to discern some of the changes that occur during L2 learning. Preliminary results from three studies indicate that classroom-based L2 instruction can result in changes in the brain's electrical activity, in the location of this activity within the brain, and in the structure of the learners' brains. These changes can occur during the earliest stages of L2 acquisition.

Auditory scene analysis: the interaction of stimulation rate and frequency separation on pre-attentive grouping

Segregation of auditory inputs into meaningful acoustic groups is a key element of auditory scene analysis. Previously, we showed that two interwoven sets of tones differing widely along multiple feature dimensions (duration, pitch and location) were pre-attentively separated into different groups, and that tones separated in this manner did not elicit the mismatch negativity component with respect to each other. Grouping was studied with human subjects using a stimulus rate too slow to induce streaming. Here, we varied the separation of tone sequences along a single feature dimension, i.e. frequency. Frequency differences were either 24 Hz (small) or 1054 Hz (large). Two relatively slow stimulus rates were used (2.7 or 1 tone/s) to explicitly investigate grouping outside the so-called 'streaming effect', which requires rates of about 4 tones/s or faster. Two tones were presented in a quasi-random manner with embedded trains of one to four identical tones in a row. Deviants were defined as frequency switches after trains of four identical tones. Mismatch negativity was only elicited for small frequency switches at the slower stimulation rate. The data indicate that pre-attentive grouping of tones occurred when the frequency difference that separated them was large, regardless of stimulation rate. For small frequency differences, inputs were only grouped separately when the stimulation rate was relatively fast.

Ictal source analysis: localization and imaging of causal interactions in humans

We propose a new integrative approach to characterize the structure of seizures in the space, time, and frequency domains. Such characterization leads to a new technical development of ictal source analysis for the presurgical evaluation of epilepsy patients. The present new ictal source analysis method consists of three parts. First, a three-dimensional source scanning procedure is performed by a spatio-temporal FINE source localization method to locate the multiple sources responsible for the time evolving ictal rhythms at their onsets. Next, the dynamic behavior of the sources is modeled by a multivariate autoregressive process (MVAR). Lastly, the causal interaction patterns among the sources as a function of frequency are estimated from the MVAR modeling of the source temporal dynamics. The causal interaction patterns indicate the dynamic communications between sources, which are useful in distinguishing the primary sources responsible for the ictal onset from the secondary sources caused by the ictal propagation. The present ictal analysis strategy has been applied to a number of seizures from five epilepsy patients, and their results are consistent with observations from either MRI lesions or SPECT scans, which indicate its effectiveness. Each step of the ictal source analysis is statistically evaluated in order to guarantee the confidence in the results.

Automated localization of magnetoencephalographic interictal spikes by adaptive spatial filtering

OBJECTIVE

Automated adaptive spatial filtering techniques can be applied to magnetoencephalographic (MEG) data collected from people with epilepsy. Source waveforms estimated by these methods have higher signal-to-noise ratio (SNR) than spontaneous MEG data, allowing identification and location of interictal spikes. The software tool SAM(g(2)) provides an adaptive spatial filtering algorithm for MEG data that yields source images of excess kurtosis and provides source time-courses in voxels exhibiting high excess kurtosis. The sensitivity and specificity of SAM(g(2)) in epilepsy is unknown.

METHODS

Interictal MEG data from 36 patients with intractable epilepsy were analyzed using SAM(g(2)), and results compared with equivalent current dipole (ECD) fit procedures.

RESULTS

When SNR of interictal spikes was high (compared to background) with a clear single focus, in most cases there was good agreement between ECD and SAM(g(2)). With multiple foci, there was typically overlap but imperfect concordance between results of ECD and SAM(g(2)).

CONCLUSIONS

SAM(g(2)) may in some cases be equivalent to manual ECD fit for localizing interictal spikes with single locus and good SNR. Further studies are required to validate SAM(g(2)) with multiple foci or poor SNR.

SIGNIFICANCE

In some cases, SAM(g(2)) might eventually assist or replace manual ECD analysis of MEG data.

3D source localization of interictal spikes in epilepsy patients with MRI lesions

The present study aims to accurately localize epileptogenic regions which are responsible for epileptic activities in epilepsy patients by means of a new subspace source localization approach, i.e. first principle vectors (FINE), using scalp EEG recordings. Computer simulations were first performed to assess source localization accuracy of FINE in the clinical electrode set-up. The source localization results from FINE were compared with the results from a classic subspace source localization approach, i.e. MUSIC, and their differences were tested statistically using the paired t-test. Other factors influencing the source localization accuracy were assessed statistically by ANOVA. The interictal epileptiform spike data from three adult epilepsy patients with medically intractable partial epilepsy and well-defined symptomatic MRI lesions were then studied using both FINE and MUSIC. The comparison between the electrical sources estimated by the subspace source localization approaches and MRI lesions was made through the coregistration between the EEG recordings and MRI scans. The accuracy of estimations made by FINE and MUSIC was also evaluated and compared by R(2) statistic, which was used to indicate the goodness-of-fit of the estimated sources to the scalp EEG recordings. The three-concentric-spheres head volume conductor model was built for each patient with three spheres of different radii which takes the individual head size and skull thickness into consideration. The results from computer simulations indicate that the improvement of source spatial resolvability and localization accuracy of FINE as compared with MUSIC is significant when simulated sources are closely spaced, deep, or signal-to-noise ratio is low in a clinical electrode set-up. The interictal electrical generators estimated by FINE and MUSIC are in concordance with the patients' structural abnormality, i.e. MRI lesions, in all three patients. The higher R(2) values achieved by FINE than MUSIC indicate that FINE provides a more satisfactory fitting of the scalp potential measurements than MUSIC in all patients. The present results suggest that FINE provides a useful brain source imaging technique, from clinical EEG recordings, for identifying and localizing epileptogenic regions in epilepsy patients with focal partial seizures. The present study may lead to the establishment of a high-resolution source localization technique from scalp-recorded EEGs for aiding presurgical planning in epilepsy patients.

EEG Source Imaging in Pediatric Epilepsy Surgery: A New Perspective in Presurgical Workup

PURPOSE

Epilepsy is a relatively frequent disease in children, with considerable impact on cognitive and social life. Successful epilepsy surgery depends on unambiguous focus identification and requires a comprehensive presurgical workup, including several neuroimaging techniques [magnetic resonance imaging, positron emission tomography (PET), and single-photon emission computed tomography (SPECT)]. These may be difficult to apply in younger or developmentally delayed children or both, requiring sedation, and hence, a significant workforce. Modern electric source imaging (ESI) provides accurate epileptic source-localization information in most patients, with minimal patient discomfort or need for cooperation. The purpose of the present study was to determine the usefulness of ESI in pediatric EEG recordings performed with routine electrode arrays.

METHODS

Preoperative EEGs recorded from 19 to 29 scalp electrodes were reviewed, and interictal epileptiform activity was analyzed by using a linear source-imaging procedure (depth-weighted minimum norm) in combination with statistical parametric mapping.

RESULTS

In 27 (90%) of 30 patients, the ESI correctly localized the epileptogenic region. These numbers compare favorably with the results from other imaging techniques in the same patients (PET, 82%; ictal SPECT, 70%). In extratemporal epilepsy, ESI was correct in all cases, and in temporal lobe epilepsy, in 10 of 13 cases. In two temporal lobe patients showing less-accurate ESI results, 128-electrode data could be analyzed, and in both cases, the 128-electrode ESI was correct.

CONCLUSIONS

ESI with standard clinical EEG recordings provides excellent localizing information in pediatric patients, in particular in extratemporal lobe epilepsy. The lower yield in temporal lobe epilepsy seems to be due to undersampling of basal temporal areas with routine scalp recordings.

A cortical potential imaging study from simultaneous extra- and intracranial electrical recordings by means of the finite element method

In the present study, we have validated the cortical potential imaging (CPI) technique for estimating cortical potentials from scalp EEG using simultaneously recorded electrocorticogram (ECoG) in the presence of strong local inhomogeneity, i.e., Silastic ECoG grid(s). The finite element method (FEM) was used to model the realistic postoperative head volume conductor, which includes the scalp, skull, cerebrospinal fluid (CSF) and brain, as well as the Silastic ECoG grid(s) implanted during the surgical evaluation in epilepsy patients, from the co-registered magnetic resonance (MR) and computer tomography (CT) images. A series of computer simulations were conducted to evaluate the present FEM-based CPI technique and to assess the effect of the Silastic ECoG grid on the scalp EEG forward solutions. The present simulation results show that the Silastic ECoG grid has substantial influence on the scalp potential forward solution due to the distortion of current pathways in the presence of the extremely low conductive materials. On the other hand, its influence on the estimated cortical potential distribution is much less than that on the scalp potential distribution. With appropriate numerical modeling and inverse estimation techniques, we have demonstrated the feasibility of estimating the cortical potentials from the scalp EEG with the implanted Silastic ECoG gird(s), in both computer simulations and in human experimentation. In an epilepsy patient undergoing surgical evaluation, the cortical potentials were reconstructed from the simultaneously recorded scalp EEG, in which main features of spatial patterns during interictal spike were preserved and over 0.75 correlation coefficient value was obtained between the recorded and estimated cortical potentials. The FEM-based CPI technique provides a means of connecting the simultaneous recorded ECoG and the scalp EEG and promises to become an effective tool to evaluate and validate CPI techniques using clinic data.

Hypothesis testing in distributed source models for EEG and MEG data

Hypothesis testing in distributed source models for the electro- or magnetoencephalogram is generally performed for each voxel separately. Derived from the analysis of functional magnetic resonance imaging data, such a statistical parametric map (SPM) ignores the spatial smoothing in hypothesis testing with distributed source models. For example, when intending to test a single voxel, actually an entire region of voxels is tested simultaneously. Because there are more parameters than observations, typically constraints are employed to arrive at a solution which spatially smooths the solution. If ignored, it can be concluded from the hypothesis test that there is activity at some location where there is none. In addition, an SPM on distributed source models gives the illusion of very high resolution. As an alternative, a multivariate approach is suggested in which a region of interest is tested that is spatially smooth. In simulations with MEG and EEG it is shown that clear hypothesis testing in distributed source models is possible, provided that there is high correspondence between what is intended to be tested and what is actually tested. The approach is also illustrated by an application to data from an experiment measuring visual evoked fields when presenting checkerboard patterns.

Prediction of response speed by anticipatory high-frequency (gamma band) oscillations in the human brain

Response to a stimulus is faster when a subject is attending and knows beforehand how to respond. It has been suggested recently that this occurs because ongoing neuronal activity is spatially and temporally structured during states of expectancy preceding a stimulus. This mechanism is believed to mediate top-down processing, facilitating the early grouping and selection of distributed neuronal ensembles implicated in ensuing sensory-motor processing. To validate this model, it must be shown that some features of this early ongoing neural activity are correlated with subsequent perceptual decisions or behavioral events. We investigated this hypothesis in an electrophysiologic study in 12 subjects carrying out a simple visuomotor reaction-time task. Local field potentials (LFP) at each brain voxel were estimated using a linear distributed inverse solution termed "ELECTRA" for each single trial of each subject. The energy of oscillations for different frequency bands was computed for the period between the warning cue and visual stimuli by applying a time-frequency decomposition to the estimated LFP. A nonparametric correlation coefficient was then calculated between energy of oscillations and reaction times for each single sweep. Gamma band oscillatory activity in a frontoparietal network before stimulus onset significantly correlated with reaction time for a significant amount of subjects. These results provide direct evidence for the role of neural oscillations as a top-down attentional control mechanism that mediates the speed of motor actions.

Combined MEG/EEG analysis of the interictal spike complex in mesial temporal lobe epilepsy

We studied the functional organization of the interictal spike complex in 30 patients with mesial temporal lobe epilepsy (MTLE) using combined magnetoencephalography (MEG)/electroencephalography (EEG) recordings. Spikes could be recorded in 14 patients (47%) during the 2- to 3-h MEG/EEG recording session. The MEG and EEG spikes were subjected to separate dipole analyses; the MEG spike dipole localizations were superimposed on MRI scans. All spike dipoles could be localized to the temporal lobe with a clear preponderance in the medial region. Based on dipole orientations in MEG, patients could be classified into two groups: patients with anterior medial vertical (AMV) dipoles, suggesting epileptic activity in the mediobasal temporal lobe and patients with anterior medial horizontal (AMH) dipoles, indicating involvement of the temporal pole and the anterior parts of the lateral temporal lobe. Whereas patients with AMV dipoles had strictly unitemporal interictal and ictal EEG changes during prolonged video-EEG monitoring, 50% of patients with AMH dipoles showed evidence of bitemporal affection on interictal and ictal EEG. Nine patients underwent epilepsy surgery so far. Whereas all five patients with AMV dipoles became completely seizure-free postoperatively (Class Ia), two out of four patients with AMH dipoles experienced persistent auras (Class Ib). This difference, however, was not statistically significant. We therefore conclude that combined MEG/EEG dipole modeling can identify subcompartments of the temporal lobe involved in epileptic activity and may be helpful to differentiate between subtypes of mesial temporal lobe epilepsy noninvasively.

EEG source imaging

OBJECTIVE

Electroencephalography (EEG) is an important tool for studying the temporal dynamics of the human brain's large-scale neuronal circuits. However, most EEG applications fail to capitalize on all of the data's available information, particularly that concerning the location of active sources in the brain. Localizing the sources of a given scalp measurement is only achieved by solving the so-called inverse problem. By introducing reasonable a priori constraints, the inverse problem can be solved and the most probable sources in the brain at every moment in time can be accurately localized.

METHODS AND RESULTS

Here, we review the different EEG source localization procedures applied during the last two decades. Additionally, we detail the importance of those procedures preceding and following source estimation that are intimately linked to a successful, reliable result. We discuss (1) the number and positioning of electrodes, (2) the varieties of inverse solution models and algorithms, (3) the integration of EEG source estimations with MRI data, (4) the integration of time and frequency in source imaging, and (5) the statistical analysis of inverse solution results.

CONCLUSIONS AND SIGNIFICANCE

We show that modern EEG source imaging simultaneously details the temporal and spatial dimensions of brain activity, making it an important and affordable tool to study the properties of cerebral, neural networks in cognitive and clinical neurosciences.

Actual and mental motor preparation and execution: a spatiotemporal ERP study

Studies evaluating the role of the executive motor system in motor imagery came to a general agreement in favour of the activation of the primary motor area (M1) during imagery, although in reduced proportion as compared to motor execution. It is still unclear whether this difference occurs within the preparation period or the execution period of the movement, or both. In the present study, EEG was used to investigate separately the preparation and the execution periods of overt and covert movements in adults. We designed a paradigm that randomly mixed actual and kinaesthetic imagined trials of an externally paced sequence of finger key presses. Sixty channel event-related potentials were recorded to capture the cerebral activations underlying the preparation for motor execution and motor imagery, as well as cerebral activations implied in motor execution and motor imagery. Classical waveform analysis was combined with data-driven spatiotemporal segmentation analysis. In addition, a LAURA source localization algorithm was applied to functionally define brain related motor areas. Our results showed first that the difference between actual and mental motor acts takes place at the late stage of the preparation period and consists of a quantitative modulation of the activity of common structures in M1. Second, they showed that primary motor structures are involved to the same extent in the actual or imagined execution of a motor act. These findings reinforce and refine the functional equivalence hypothesis between actual and imagined motor acts.