Biomedical subjects
Publications and source records attributed to K Abraham-Fuchs.
Considerations which have lead to the design of the Siemens biomagnetic multichannel system are discussed. Algorithms developed for data evaluation include removal of periodic signals, averaging of sporadic events, and separation of background activity. Means are described to fuse biomagnetic locations with three-dimensional medical images.
It was our purpose to assess the clinical relevance of noninvasive magnetocardiographic localization of accessory pathways. Nine patients with Wolff-Parkinson-White (WPW) syndrome were studied. For all of them the site of the accessory pathway was known from invasive catheter mapping. A 37-SQUID (superconducting quantum interference device) sensor multichannel system (KRENIKON) was used, allowing synchronous registration with all channels. The site of the electrophysiological activity at the beginning of the delta wave was determined. Magnetic resonance images of the heart were obtained to correlate the biomagnetically localized activity with the anatomy. Magnetocardiographic localization of the bypass tract corresponded with catheter mapping with a spatial difference of 0-5 cm, 1.8 cm on the average, compared to the results obtained by catheter mapping. Thus, magnetocardiography is a promising new method for noninvasive localization of accessory pathways in WPW patients. This may streamline further invasive procedures.
Electrophysiological examinations provide the basis for a deeper pathophysiological understanding of focal epileptic activity. In addition to electroencephalography, magnetoencephalography from field measurements is now available for biomagnetic diagnosis. As magnetoencephalography (MEG) is basically better suited for the localization of focal epileptic activity than EEG, an increase in MEG measurements has taken place over the last years. In this study we discuss magnetic source localization which was combined with anatomical 3-D-MR-images and compared with the results of EEG-registration carried out simultaneously and with other investigative procedures of presurgical diagnosis. The results of investigation show that simultaneous magnetic field measurements over one hemisphere of the skull allow localization of sources both in the temporal lobe and in deeper areas of the brain. Furthermore, propagation of epileptic activity can be registered not only in neighbouring areas of the epileptogenic source but also in regions localized deeper in the temporal lobe. This opens new possibilities for presurgical evaluation as well as an understanding of partial and generalized epilepsies. The results of investigation show primary focal epileptic activity neocortex laterally or surrounding a mesio-temporal lesion in all investigated patients with partial (temporal, frontal) and secondary generalized epilepsies. Furthermore, a pattern of propagation of focal epileptic activity which is directed from neocortical-lateral to mediobasal-limbic brain structures is found in most of these patients.
A combined correlation analysis of temporal and spatial patterns in a biomagnetic multichannel recording is proposed to extract patterns of transient, randomly repetitive physiological events from biomagnetic data sets with a low signal-to-noise ratio. This method is especially sensitive in the differentiation of signals from different source propagation pathways. The recognition and subsequent averaging of spike events in the MEG of an epileptic patient by this method is shown to provide an essential improvement in the signal-to-noise ratio. The source localisation from the averaged data showed electrical activity which propagated from the primary epileptogenic focus to distant parts of the brain.
Initial results of magnetic source localization by means of multichannel recording using a 10 or a 31 channel system are reported. Simultaneous magnetoencephalographic (MEG) and electroencephalographic (EEG) (scalp, sphenoidal and foramen oval) recording, as well as magnetic resonance imaging (MRI) with a fixed head position, permits the projection of brain structures and the source localized from MEG into a three-dimensional coordinate system. From 8 patients investigated it can be clearly seen that the method is of diagnostic relevance for patients with temporal lobe epilepsy. Results are demonstrated for 3 patients with interesting findings concerning the anatomical correlation with source localization. The findings indicate that MRI-correlated magnetic source localization by means of multichannel recordings provides important advantages in epilepsy research. (1) Increased precision permits noninvasive localization. Deeper sources in the temporal lobe are localized from MEG combined with scalp or minor invasive EEG. (2) Investigation time is considerably shortened. (3) Single events can be localized for supplementary presurgical information concerning the three-dimensional anatomical localization of focal epileptic activity in the brain.
The authors designed a multichannel system for noninvasive measurement of the extremely weak magnetic fields generated by the brain and the heart. It uses a flat array of 37 superconducting magnetic field-sensing coils connected to sophisticated superconducting quantum interference devices. To prevent interference from external electromagnetic fields, the system is operated inside a shielded room. Complete sets of coherent data, even from spontaneous events, can be recorded. System performance was evaluated with phantom measurements and evoked-response studies. A spatial resolution of a few millimeters and a temporal resolution of a millisecond were obtained. First results in patients with partial epilepsy and investigations of the cardiac conductive pathway indicate that biomagnetism is now ready for a systematic clinical evaluation. Interpretation of measurements was facilitated by highlighting biomagnetically localized electrical activity in three-dimensional digital magnetic resonance images.
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A method has been developed to eliminate disturbing magnetic signals in the biomagnetic localization of arrhythmogenic sources in the heart. The procedure consists of two steps: Superimposed background activity of the heart is eliminated by subtraction of a template of pure background activity. Systematic and electronic offset is subsequently eliminated by baseline-correction during periods of zero activity. The method was applied to several kinds of arrhythmias. It was demonstrated that elimination of background activity is the prerequesite for exact localization and that the proposed procedure yields correct results.
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Ictal and interictal epileptic activity was recorded for the first time by multichannel magnetoencephalography (MEG) in three patients with partial epilepsy. Pre- and intra-operative localization of the epileptogenic region was compared. The interictal epileptic activity was localized at the same region of the temporal or frontal lobe as the ictal activity. Main zones of ictal activity were shown to evolve from the tissue at the centers of interictal activity. Pre- and intra-operative electrocorticography (ECoG) as well as postoperative outcome confirmed localization in the temporal and frontal lobe. Results also correlated with findings from scalp EEG, interictal and ictal single photon emission computed tomography (SPECT), positron emission tomography (PET), and magnetic resonance imaging (MRI). Combined multichannel MEG/EEG recording permitted dipole localization of interictal and ictal activity.