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Biomedical subjects

Fernando Maestú

Publications and source records attributed to Fernando Maestú.

5 recordsLinked to original sources

Magnetoencephalographic localization of peritumoral temporal epileptic focus previous surgical resection.

UNLABELLED: Magnetoencephalography (MEG) is suggested as a localizing technique of epileptogenic areas in drug-resistant seizure patients due to intracraneal lesions. A male 42-year-old patient who begins at 26 with partial complex drug-resistant seizures is put forward. MRI shows a 9 mm diameter lesion located in left superior temporal gyrus which seems compatible with cavernoma. Both conventional and sleep deprivation EEGs have proved normal. Sleep EEG shows sharp waves in left temporal region. MEG helps to localize interictal spike and spike-wave activity, as well as wide slow wave (2-7 Hz) activity areas. Craniotomy under analgesia and aware sedation conditions is carried out. Intrasurgery cortical electric stimulation assisted by neuronavigator causes a limited partial complex seizure which the patient recognizes to be exactly like his. Thus, MEG localization of the epileptogenic area is confirmed. Surgical resection of both the lesion and the epileptogenic area is carried out. The patient remains free from seizures 9 months after surgery. A control MEG study reveals no epileptogenic nor slow wave activity. CONCLUSION: in this particular case, MEG has proven to be a useful presurgical evaluation technique to localize epileptogenic activity, validated by intrasurgical cortical stimulation.

Adult↗

Correlations of hippocampal atrophy and focal low-frequency magnetic activity in Alzheimer disease: volumetric MR imaging-magnetoencephalographic study.

BACKGROUND AND PURPOSE: Patients with Alzheimer disease (AD) have more low-frequency activity on conventional EEG and increased focal magnetoencephalographic (MEG) dipole density (DD) in delta and theta bands. This activity concurs with atrophy and reduced metabolic and perfusion rates, particularly in temporoparietal structures. The relationship between functional and structural measures and their conjoined capability to improve the diagnosis of AD were assessed in this study. METHODS: Whole-head MEG recordings were obtained in 15 patients in whom the diagnosis of AD had been made and in 16 healthy control subjects during a resting condition. MR imaging volumetric data were also obtained; these included global cerebral, temporal lobe, and hippocampal volumes. RESULTS: DD in the delta and theta bands was enhanced in the AD group compared with the healthy control subjects. Slow-wave activity differed significantly between the groups in the temporoparietal regions of both hemispheres. Left hippocampal volume was correlated with left temporal and parietal delta DD and left temporal theta DD. A combination of left hippocampal volume and left temporal theta DD enabled correct classification in 87.1% of the patients with AD or control subjects. CONCLUSION: Results support the predominant role of temporoparietal hypofunction as defined by DD and hippocampal structural deficits shown on MR images in patients with AD. A multidisciplinary perspective of different techniques may improve our understanding of the disease and our diagnostic abilities.

Aged↗

Focal temporoparietal slow activity in Alzheimer's disease revealed by magnetoencephalography.

BACKGROUND: Patients suffering from Alzheimer's disease exhibit more activity in the conventional electroencephalographic delta and theta bands. This activity concurs with atrophy and reduced metabolic and perfusion rates, particularly in temporoparietal structures. METHODS: Whole-head magnetoencephalographic recordings were obtained from 15 patients diagnosed with Alzheimer's disease and 19 healthy control subjects during a resting condition. The generators of focal magnetic slow waves were located employing a single moving dipole model. RESULTS: Dipole density in the delta and theta bands was enhanced in the Alzheimer's disease group compared with healthy control subjects. Slow-wave activity differed significantly between groups in temporoparietal regions of both hemispheres. Right temporoparietal slow-wave activity covaried with cognitive performance, whereas left temporal delta activity varied with a functional status scale. CONCLUSIONS: Our results support the predominant role of the temporoparietal areas in the diagnosis of Alzheimer's disease. Magnetoencephalography and the source analysis of focal slow activity in particular provide interesting and potentially clinically useful tools to assess functional modifications of patients' brain and to evaluate its relationship with the cognitive status.

Aged↗

Spanish language mapping using MEG: a validation study.

The purpose of the present study was to compare magnetoencephalography (MEG) data with the results of the intracarotid amytal procedure (IAP). Twenty-one native Spanish-speaking patients with intractable epilepsy underwent MEG language mapping. A subset of 8 patients also underwent an IAP. With the exception of 2 patients who showed right hemisphere dominance, all other patients showed left hemisphere dominance for language on the MEG recording. The IAP findings were consistent with MEG results in 7 patients. The eighth patient who, according to the MEG data, had probable right hemisphere dominance for language did not show clear hemispheric specialization for language on the IAP and suffered a transient global aphasia following a right temporal lobotomy. These results suggests that MEG-based language mapping can play an important role in presurgical clinical evaluation.

Adult↗

Effects of surgical treatment on intellectual performance and memory in a Spanish sample of drug-resistant partial onset-temporal lobe epilepsy patients.

Knowledge of the effects of surgical treatment of epilepsy on mnesic functions has been steadily increasing in recent years. However, while some authors claim that this function remains seriously impaired after surgery, others argue that there is some recovery. In this study, we compare the pre- and post-operative results (one-year follow-up) of 55 patients (30 with right-temporal localization and 25 with left) suffering from drug-resistant partial-temporal epilepsy. Results of pre-surgical evaluation show that 42% of the patients had memory alterations of both verbal and visuo-spatial types, this group being made up of those patients that had been ill for longest (mean of 20 years). The remaining patients showed more specific deficits related to a particular type of information. Post-surgical results show that the general IQ increase was significant, even though no significant differences were found for general memory.Nevertheless, patients with right-temporal localization showed considerable improvement in verbal memory tasks (contralateral to the area operated on), while the performance of patients with left-temporal localization deteriorated slightly in these tasks (ipsilateral to the area operated on). In the visual memory tests no changes occurred in any of the groups.

Adult↗