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PubMedDate not supplied

[New developments in clinical neurophysiology: magnetoencephalography. Contributions of magnetoencephalography to the study of epilepsy].

INTRODUCTION: Magnetoencephalography (MEG) is a novel neurophysiological technique based on the detection of the tiny cerebral magnetic fields generated by the intracellular electrical currents. DEVELOPMENT: It offers several theoretical advantages to electroencephalography, like the transparency of the skull and soft tissues to the magnetic signal and the sensitivity to tangential fields generated in the cerebral sulci. Both properties allow an easier and more accurate modelling of the intracerebral sources. Furthermore, both techniques are complementary. On the other hand, its cost is the most limiting factor for its routine implementation in clinical practice. MEG is fully integrated with neuroimaging giving rise to the term magnetic source imaging. Integration with other neuroimaging modalities such us functional magnetic resonance imaging constitutes one of the major developments for the future. CONCLUSION: In this review, we present an overview of the physiological basis and technical aspects of magnetoencephalography, its comparison with electroencephalography, and its increasing number of clinical applications in the study of the different epilepsy syndromes as well as its role in epilepsy surgery.

Electroencephalography↗
PubMed2006

Revisiting the role of magnetoencephalography in epilepsy.

PURPOSE OF REVIEW: This review considers the current role of magnetoencephalography in clinical epileptology. RECENT FINDINGS: While magnetoencephalography and electroencephalography complement each other for interictal spike detection, magnetoencephalography is more sensitive in neocortical epilepsy. In temporal lobe epilepsy, magnetoencephalography can attribute epileptic activity to subcompartments of the temporal lobe and differentiate between patients with mesial, lateral and diffuse seizure onsets. In extratemporal epilepsy, magnetoencephalography provides unique information in nonlesional cases and helps to define the relationship of epileptic activity with respect to lesions and eloquent cortex. Magnetoencephalography also contributes to the clinical decision process in patients with cortical dysplasias, Landau-Kleffner syndrome and recurrent seizures after prior epilepsy surgery. Magnetoencephalography-guided re-evaluation of magnetic resonance imaging helps to reveal previously unrecognized lesions. In a presurgical setting interictal magnetoencephalography was superior to scalp electroencephalography. Complete resection of the magnetoencephalography-defined irritative zone has prognostic implications on postoperative seizure control. Magnetoencephalography can reliably localize sensorimotor and language cortex. Disadvantages of this technique include the difficulties in obtaining ictal recordings and the considerable costs involved. SUMMARY: Magnetoencephalography has been developed to a valuable noninvasive tool in clinical epileptology. The development of approaches which take into account both magnetoencephalography and electroencephalography simultaneously should provide more useful information in the future.

Brain Mapping↗
PubMed2000

Quantification and reproducibility of tracking cortical extent of activation by use of functional MR imaging and magnetoencephalography.

BACKGROUND AND PURPOSE: Functional MR imaging and magnetoencephalography are commonly used to study normal cortical sensory and cognitive processing as well as a variety of disease states. The usefulness of these techniques is dependent on the reproducibility and sensitivity to change of derived measures of brain function. The purpose of this study was to compare the efficacy of functional MR imaging and magnetoencephalography as measures of the extent of cortical activity in response to a graded stimulus. METHODS: Five participants underwent functional MR imaging and magnetoencephalography involving stimulation of one, two, three, and four digits of the left hand. Measurements of activation were repeated three times per participant. The cortical extent of activation was assessed for functional MR imaging by observing the number of "activated" pixels and the "amount of activation": the product of the number of activated pixels and the mean signal change. Activation was quantified for magnetoencephalography as the magnitude of the evoked magnetic field peak and as the strength of the modeled current source, Q. RESULTS: For functional MR imaging, the number of activated pixels tended to increase with the increasing number of stimulated digits. High intra- and interparticipant variability (66% and 85% variation, respectively) did not, however, allow statistical resolution of this trend. The amount of activation was similarly variable (interparticipant, 89%). Magnetoencephalography was more robust regarding quantification. The evoked field amplitude varied linearly with the number of digits stimulated; intra- and interparticipant variability was 18% and 41%, respectively, permitting resolution of significant differences between any combination of stimulated digits, except two versus three (P < .05). CONCLUSION: Although functional MR imaging and magnetoencephalography show measurable evoked responses with somatosensory stimulation, in this study, functional MR imaging did not permit robust quantification of increasing cortical areas of activation.

Cerebral Cortex↗
PubMed2003

Magnetoencephalography in pediatric neurology and in epileptic syndromes.

In recent years, great advances in the knowledge of neuromagnetism have permitted the application of Superconducting Quantum Interference Devices to the pathophysiologic study of the human brain. In particular, in pediatric neurology, the integration of biomagnetism with magnetic resonance imaging and other techniques for medical imaging have allowed for precise neuromagnetic measurements of the human brain. The more frequently used technique is magnetoencephalography. Recent data have illustrated the usefulness of magnetoencephalography in mapping activity of sensory and motor areas and in studying the spatiotemporal pattern of brain activation specific to somatosensory function. Moreover, magnetoencephalography is an important tool to localize epileptic activity; magnetic source imaging superimposes magnetoencephalographic localizations on the magnetic resonance imaging and yields improved spatial resolution as compared with surface electroencephalography. The role of magnetoencephalography in evaluating patients with epilepsy continues to evolve; in fact, it seems to be very useful in the localization of the epileptogenic zone in patients with partial epilepsy. This application of magnetoencephalography is essential in the selection of epileptic children candidates to surgical treatment of seizures.

Brain Mapping↗
PubMed1995

Functional localization by magnetoencephalography.

Magnetoencephalography combines the attributes of real-time millisecond temporal resolution with precise anatomic localization. In addition to characterizing spontaneous epileptiform discharges and slow wave activity, magnetoencephalography may be used to map sensorimotor, auditory, and visual functions. Magnetoencephalography functional data are registered to three-dimensional magnetic resonance imaging to provide a useful way to analyze the relationship of structure to function and to assist in surgical planning. Magnetoencephalography is noninvasive and can be done with rapid turn-around time, but it is expensive and is not optimal for all brain areas or functions. Future integration and cross-analysis of magnetoencephalography with other functional mapping modalities will likely prove to be complementary and of even greater use.

Auditory Cortex↗
PubMed2006

Auditory cortical responses evoked by pure tones in healthy and sensorineural hearing loss subjects: functional MRI and magnetoencephalography.

BACKGROUND: Blood oxygen level dependent functional magnetic resonance imaging (fMRI) and magnetoencephalography are new techniques of brain functional imaging which can provide the information of excitation of neurons by measure the changes of hemodynamics and electrophysiological data of local brain tissue. The purpose of this study was to study functional brain areas evoked by pure tones in healthy and sensorineural hearing loss subjects with these techniques and to compare the differences between the two groups. METHODS: Thirty healthy and 30 sensorineural hearing loss subjects were included in this study. In fMRI, block-design paradigm was used. During the active epoch the participants listened to 1000 Hz, sound pressure level 140 dB pure tones at duration 500 ms, interstimulus interval 1000 ms, which presented continuously via a magnetic resonance-compatible audio system. None stimulus was executed in control epoch. In magnetoencephalography study, every subject received stimuli of 1000 Hz tone bursts delivered to the bilateral ear at duration 8 ms, interstimulus intervals 1000 ms. Sound pressure level in healthy subjects was 30 dB; in sensorineural hearing loss subjects was 20 dB above everyone's hearing threshold respectively. All subjects were examined with 306-channel whole-scalp neuromagnetometer. RESULTS: In fMRI, all subjects showed significant activations in bilateral Heschl's gyri, anterior pole of planum temporale, planum temporale, precentral gyri, postcentral gyri, supramarginal gyri, superior temporal gyri, inferior frontal gyri, occipital lobes and cerebellums. The healthy subjects had more intensive activation in bilateral Heschl's gyri, anterior pole of planum temporale, inferior frontal gyri, left superior temporal gyri and right planum temporale than the hearing loss subjects. But in precentral gyri, postcentral gyri and occipital lobes, the activation is more intensive in the hearing loss subjects. In magnetoencephalography study, both in the hearing loss and the healthy subjects, the most evident audio evoked fields activated by pure tone were N100m, which located precisely on the Heschl's gyrus. Compared with the hearing loss subjects, N100m of the healthy subjects was stronger and had longer latencies in right hemisphere. CONCLUSIONS: Under proper pure tone stimulus the activation of auditory cortex can be elicited both in the healthy and the sensorineural hearing loss subjects. Either at objective equivalent stimuli or at subjectively perceived equivalent stimuli, the auditory responses were more intensive in healthy subjects than hearing loss subjects. The tone stimuli were processed in a network in human brain and there was an intrinsic relation between the auditory and visual cortex. Blood oxygen level dependent fMRI and magnetoencephalography could reinforce each other.

Acoustic Stimulation↗
PubMed2006

How do brain tumors alter functional connectivity? A magnetoencephalography study.

OBJECTIVE: This study was undertaken to test the hypothesis that brain tumors interfere with normal brain function by disrupting functional connectivity of brain networks. METHODS: Functional connectivity was assessed by computing the synchronization likelihood in a broad band (0.5-60Hz) or in the gamma band (30-60Hz) between all pairwise combinations of magnetoencephalography signals. Magnetoencephalography recordings were made at rest in 17 brain tumor patients and 15 healthy control subjects. For a given threshold of synchronization likelihood values, graphs of the suprathreshold connections between each magnetoencephalography channel and the others channels were built. RESULTS: In some regions, a variable number of channels without connectivity (missing connective points) at this threshold was found. The number of missing connective points was higher in patients with brain tumors than in control subjects (p < 0.0001, broad and gamma band) and was higher for left-sided than right-sided tumors (p = 0.008, broad band; p < 0.0001, gamma band). Individual results analysis indicates that the majority of brain tumor patients display several regions with missing connective point alterations in the affected and in the contralateral hemisphere. INTERPRETATION: Our findings suggest that brain tumors induce a loss of functional connectivity that affects multiple brain regions, and that left side brain tumors have the more severe consequences in this respect.

Adult↗
PubMed1994

Magnetoencephalography in studies of human cognitive brain function.

Magnetoencephalography provides a new dimension to the functional imaging of the brain. The cerebral magnetic fields recorded noninvasively enable the accurate determination of locations of cerebral activity with an uncompromized time resolution. The first whole-scalp sensor arrays have just recently come into operation, and significant advances are to be expected in both neurophysiological and cognitive studies, as well as in clinical practice. However, although the accuracy of locating isolated sources of brain activity has improved, identification of multiple simultaneous sources can still be a problem. Therefore, attempts are being made to combine magnetoencephalography with other brain-imaging methods to improve spatial localization of multiple sources and, simultaneously, to achieve a more complete characterization of different aspects of brain activity during cognitive processing. Owing to its good time resolution and considerably better spatial accuracy than that provided by EEG, magnetoencephalography holds great promise as a tool for revealing information-processing sequences of the human brain.

Brain↗
PubMed2006

Language lateralization in magnetoencephalography: two tasks to investigate hemispheric dominance.

Hemispheric specialization for language has been the focus of many studies, mainly using functional magnetic resonance imaging. Here, we used magnetoencephalography to investigate hemispheric dominance and time-dependent aspects of cortical language processing. We implemented a verb generation task and a newly designed vowel identification task. Eleven healthy adults were investigated. By using oscillatory magnetoencephalography spectral analysis, significant hemispheric differences were found for both tasks in cerebral language areas. Robust left-lateralization in frontal brain regions was observed with the verb generation task, confirming previous functional magnetic resonance imaging and magnetoencephalography studies. Our new vowel identification task yields significant left-lateralization in posterior language regions, making this silent and child-friendly task a valuable alternative for non-invasive language assessment in difficult populations.

Brain↗
PubMed1997

Magnetoencephalography may help to improve functional MRI brain mapping.

The validity of functional magnetic resonance imaging (FMRI) brain maps with respect to the sites of neuronal activation is still unknown. One source of localization error may be pixels with large signal amplitudes, since such pixels may be expected to overlie large vessels, running remote from the centre of neuronal activation. In this study, magnetoencephalography was used to determine the centre of neuronal activation in a simple finger tapping task. The localization accuracy of conventional FMRI depending on FMRI signal enhancement was investigated relative to the magnetoencephalography reference. The results show a deterioration of FMRI localization with increasing signal amplitude related to increased contributions from large vessels. We conclude that FMRI data analysis should exclude large signal amplitudes and that magnetoencephalography may help to improve FMRI brain mapping results in a multimethod approach.

Adult↗
PubMed2005

Neurophysiologic findings of neuronal migration disorders: intrinsic epileptogenicity of focal cortical dysplasia on electroencephalography, electrocorticography, and magnetoencephalography.

We define specific neurophysiologic characteristics for focal cortical dysplasia, a neuronal migration disorder. We reviewed data from published reports and our patients with focal cortical dysplasia. Our patients underwent preoperative scalp video-electroencephalography (EEG), magnetic resonance imaging (MRI), magnetoencephalography, and intraoperative or extraoperative electrocorticography monitoring. Scalp EEG showed trains of rhythmic epileptiform spike or sharp waves. Positive spikes correlated with early seizure onset, MRI lesion around the rolandic fissure, hemiparesis, and a less favorable outcome. Interictal electrocorticography showed continuous epileptogenic discharges: repetitive electrographic seizures and bursting discharges or continuous or quasicontinuous rhythmic spiking. Ictal electrocorticography showed paroxysmal fast and/or repetitive spiking. Magnetoencephalography showed clustered spike sources within and extending from the lesion. Cortical stimulation gave more frequent, lower-threshold afterdischarges and higher-threshold primary motor function. Focal cortical dysplasias are highly and intrinsically epileptogenic. For surgical seizure control, EEG, electrocorticography, and magnetoencephalography must delineate the intrinsic epileptogenic zone within and extending from the focal cortical dysplasia identified by MRI.

Brain Mapping↗
PubMed2001

Fetal magnetoencephalography: a non-invasive method for the assessment of fetal neuronal maturation.

OBJECTIVE: To assess the maturation of auditory evoked cortical responses in the human fetus using fetal magnetoencephalography. DESIGN: Prospective case series over a three-year period. SETTING: Antenatal clinics, university hospital. POPULATION: Singleton pregnancies at 29-40 weeks of gestation. METHODS: We used a 31-channel-SQUID-biomagnetometer in a magnetically-shielded room to perform fetal magnetoencephalography. To record auditory evoked fields from the fetal brain we applied 500 monotonal bursts generated by a computerised sound generator directly to the maternal abdominal wall near the fetal head. The continuously recorded data sets were analysed stepwise using a specially developed heart artefact rejection software, Fourier filtering, principle component analysis and half split analysis of the averaged data. RESULTS: In 36 of 64 examinations we detected signals of auditory evoked fields comparable to the P2m component in adults. The earliest recording succeeded in the 29th gestational week. The latencies of the auditory evoked responses declined during the third trimester from 300 ms to nearly 150 ms at term. The maturation of different components of the auditory evoked field could be demonstrated from the 31st gestational week onwards. CONCLUSION: The maturation of a fetal auditory cortical function using fetal magnetoencephalography could be assessed directly for the first time. We believe that this method will add information to current indirect methods of assessing the normal maturation of the human fetal brain.

Brain↗
PubMed1987

Magnetoencephalography and epilepsy research.

Magnetoencephalography is the detection of the magnetic field distribution across the surface of the head, which is generated by a neuronal discharge within the brain. Magnetoencephalography is used in clinical epilepsy to localize the epileptogenic region prior to its surgical removal. A discussion of the instrumentation based on the superconducting quantum interference device that is used for detecting the magnetic field distribution, the analytical techniques, current research, and future directions of magnetoencephalography in epilepsy research is presented.

Electroencephalography↗
PubMed1989

Neocortical propagation in temporal lobe spike foci on magnetoencephalography and electroencephalography.

Propagation of the neuronal population of the interictal epileptic spike was quantified in 5 patients with complex partial epilepsy arising from temporal lobe using electroencephalography and magnetoencephalography. During the spike complex in each patient there was a spike at the deep sphenoidal electrode and a spike at the superficial scalp electrode on spontaneous electroencephalography. In each patient the sphenoidal spike had a different peak latency than the scalp spike, consistent with spike propagation. Electroencephalography was used to trigger two magnetoencephalographic averages of stereotyped spikes during the sphenoidal peak and the scalp peak. Magnetoencephalography discriminated the centers of two cortical spike populations at different latencies, showing deeper localization with sphenoidal trigger and more superficial localization with scalp trigger in each patient (p less than 0.05). Latency differences and propagation distances of spikes were consistent with the conduction velocity of corticocortical fibers. Noninvasive estimates of the cortical surface area of the spikes agreed with estimates obtained by electrocorticography over temporal neocortex. These findings indicate propagation of neuronal populations active during human interictal spikes between deep and superficial cortex of temporal lobe, likely by monosynaptic or oligosynaptic pathways. This interictal system appears to be partly independent of the hippocampal interictal system in complex partial epilepsy.

Cerebral Cortex↗
PubMed2001

New approach to localize speech relevant brain areas and hemispheric dominance using spatially filtered magnetoencephalography.

We used a current localization by spatial filtering-technique to determine primary language areas with magnetoencephalography (MEG) using a silent reading and a silent naming task. In all cases we could localize the sensory speech area (Wernicke) in the posterior part of the left superior temporal gyrus (Brodmann area 22) and the motor speech area (Broca) in the left inferior frontal gyrus (Brodmann area 44). Left hemispheric speech dominance was determined in all cases by a laterality index comparing the current source strength of the activated left side speech areas to their right side homologous. In 12 cases we found early Wernicke and later Broca activation corresponding to the Wernicke-Geschwind model. In three cases, however, we also found early Broca activation indicating that speech-related brain areas need not necessarily be activated sequentially but can also be activated simultaneously. Magnetoencephalography can be a potent tool for functional mapping of speech-related brain areas in individuals, investigating the time-course of brain activation, and identifying the speech dominant hemisphere. This may have implications for presurgical planning in epilepsy and brain tumor patients.

Adult↗
PubMed2006

The role of magnetoencephalography in pediatric epilepsy surgery.

INTRODUCTION: Magnetoencephalography (MEG) is a new diagnostic imaging and brain mapping device that has been recently used in the context of pediatric epilepsy, epilepsy surgery, and neuronavigation. PRINCIPLES OF MAGNETOENCEPHALOGRAPHY: MEG allows for the placement of magnetic spike sources on a conventional magnetic resonance imaging scan, the so-called magnetic source imaging, so that the localization of epileptiform activity in a child can be determined. Considerable effort is placed on analyzing the configuration and number of spike waves by MEG that relate to a primary epileptiform discharge. Such MEG spike clusters are corroborated now by intraoperative invasive subdural grid monitoring that show good correlation in the majority of cases. Another important role of MEG relates to the mapping of critical regions of brain function using known paradigms for speech, motor, sensory, visual, and auditory brain cortex. FUTURE APPLICATIONS: When linked to standard neuronavigation devices, MEG brain mapping can be extremely helpful to the neurosurgeon approaching nonlesional epilepsy cases or lesional cases where the safest and most direct route to the surgical disease can be selected. As paradigms for brain mapping improve and as MEG software upgrades become more sensitive to analyzing all types of spike sources, MEG will play an increasingly important role in pediatric neurosurgery, especially for the child with intractable epilepsy.

Brain Mapping↗
PubMed2004

Integration of functional brain information into stereotactic irradiation treatment planning using magnetoencephalography and magnetic resonance axonography.

PURPOSE: To minimize the risk of neurologic deficit after stereotactic irradiation, functional brain information was integrated into treatment planning. METHODS AND MATERIALS: Twenty-one magnetoencephalography and six magnetic resonance axonographic images were made in 20 patients to evaluate the sensorimotor cortex (n = 15 patients, including the corticospinal tract in 6), visual cortex (n = 4), and Wernicke's area (n = 2). One radiation oncologist was asked to formulate a treatment plan first without the functional images and then to modify the plan after seeing them. The pre- and postmodification values were compared for the volume of the functional area receiving > or =15 Gy and the volume of the planning target volume receiving > or =80% of the prescribed dose. RESULTS: Of the 21 plans, 15 (71%) were modified after seeing the functional images. After modification, the volume receiving > or =15 Gy was significantly reduced compared with the values before modification in those 15 sets of plans (p = 0.03). No statistically significant difference was found in the volume of the planning target volume receiving > or =80% of the prescribed dose (p = 0.99). During follow-up, radiation-induced necrosis at the corticospinal tract caused a minor motor deficit in 1 patient for whom magnetic resonance axonography was not available in the treatment planning. No radiation-induced functional deficit was observed in the other patients. CONCLUSION: Integration of magnetoencephalography and magnetic resonance axonography in treatment planning has the potential to reduce the risk of radiation-induced functional dysfunction without deterioration of the dose distribution in the target volume.

Adult↗
PubMed1997

The bereitschaftspotential paradigm in investigating voluntary movement organization in humans using magnetoencephalography (MEG).

In 1965, Kornhuber and Deecke first described the bereitschaftspotential (BP), a paradigm for investigating the organization of voluntary movement in humans, using electroencephalography (EEG). This paradigm has since been used in many studies for investigating motor control in healthy humans and patients. Over the last years, the advantages of magnetoencephalography (MEG) have been applied to the BP paradigm by a number of researchers. The main advantage of magnetoencephalography over electroencephalography is that MEG has a higher localization accuracy. This is due to the fact that the different structures of the head (brain, liquor cerebrospinalis, skull and scalp) influence the magnetic fields less than the volume current flow that causes the EEG. Additionally, the MEG is reference free, so that the localization of sources with a given precision is easier for MEG than it is for EEG. The present protocol shows in detail how the bereitschaftspotential paradigm can be applied using MEG. Some additional paradigms for investigating motor plasticity, somatosensory gating, Parkinson disease, and the efference copy theory are suggested as well.

Adult↗