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Purpose of the Review: Magnetoencephalography (MEG) is a functional neuroimaging technique that records neurophysiology data with millisecond temporal resolution and localizes it with subcentimeter accuracy. Its capability to provide high resolution in both of these domains makes it a powerful tool both in basic neuroscience as well as clinical applications. In neurology, it has proven useful in its ability to record and localize epileptiform activity. Epilepsy workup typically begins with scalp electroencephalography (EEG), but in many situations, EEG-based localization of the epileptogenic zone is inadequate. The complementary sensitivity of MEG can be crucial in such cases, and MEG has been adopted at many centers as an important resource in building a surgical hypothesis. In this paper, we review recent work evaluating the extent of MEG influence of presurgical evaluations, novel analyses of MEG data employed in surgical workup, and new MEG instrumentation that will likely affect the field of clinical MEG. Recent Findings: MEG consistently contributes to presurgical evaluation and these contributions often change the plan for epilepsy surgery. Extensive work has been done to develop new analytic methods for localizing the source of epileptiform activity with MEG. Systems using optically pumped magnetometry (OPM) have been successfully deployed to record and localize epileptiform activity. Summary: MEG remains an important noninvasive tool for epilepsy presurgical evaluation. Continued improvements in analytic methodology will likely increase the diagnostic yield of the test. Novel instrumentation with OPM may contribute to this as well, and may increase accessibility of MEG by decreasing cost. [ABSTRACT FROM AUTHOR]

Magnetoencephalography (MEG) source estimation of brain electromagnetic fields is an ill-posed problem. A virtual MEG helmet (VMH), can be constructed by recording in different head positions and then transforming the multiple head-MEG coordinates into one head frame (i.e., as though the MEG helmet was moving while the head remained static). The constructed VMH has sensors placed in various distances and angles, thus improving the spatial sampling of neuromagnetic fields. VMH has been previously shown to increase total information in comparison to a standard MEG helmet. The aim of this study was to examine whether VMH can improve source estimation accuracy. To this end, controlled simulations were carried out, in which the source characteristics are predefined. A series of VMHs were constructed by applying two or three translations and rotations to a standard 248 channel MEG array. In each simulation, the magnetic field generated by 1 to 5 dipoles was forward projected, alongside noise components. The results of this study showed that at low noise levels (e.g., averaged data of similar signals), VMHs can significantly improve the accuracy of source estimations, compared to the standard MEG array. Moreover, when utilizing a priori information, tailoring the constructed VMHs to specific sets of postulated neuronal sources can further improve the accuracy. This is shown to be a robust and stable method, even for proximate locations. Overall, VMH may add significant precision to MEG source estimation, for research and clinical benefits, such as in challenging epilepsy cases, aiding in surgical design. [ABSTRACT FROM AUTHOR]

Magnetoencephalography (MEG) source estimation of brain electromagnetic fields is an ill-posed problem. A virtual MEG helmet (VMH), can be constructed by recording in different head positions and then transforming the multiple head-MEG coordinates into one head frame (i.e., as though the MEG helmet was moving while the head remained static). The constructed VMH has sensors placed in various distances and angles, thus improving the spatial sampling of neuromagnetic fields. VMH has been previously shown to increase total information in comparison to a standard MEG helmet. The aim of this study was to examine whether VMH can improve source estimation accuracy. To this end, controlled simulations were carried out, in which the source characteristics are predefined. A series of VMHs were constructed by applying two or three translations and rotations to a standard 248 channel MEG array. In each simulation, the magnetic field generated by 1 to 5 dipoles was forward projected, alongside noise components. The results of this study showed that at low noise levels (e.g., averaged data of similar signals), VMHs can significantly improve the accuracy of source estimations, compared to the standard MEG array. Moreover, when utilizing a priori information, tailoring the constructed VMHs to specific sets of postulated neuronal sources can further improve the accuracy. This is shown to be a robust and stable method, even for proximate locations. Overall, VMH may add significant precision to MEG source estimation, for research and clinical benefits, such as in challenging epilepsy cases, aiding in surgical design.

Magnetoencephalography (MEG) is a neuroimaging technique that measures the magnetic fields of the brain outside of the head. In the past, the most suitable magnetometer for MEG was the superconducting quantum interference device (SQUID), but in recent years, a new type has also been used, the optically pumped magnetometer (OPM). OPMs can be configured to measure multiple directions of magnetic field simultaneously. This work explored whether combining multiple directions of the magnetic field lowers the source localization error of brain sources under various conditions of noise. We simulated dipolar-like sources for multiple configurations of both SQUID- and OPM-MEG systems. To test the performance of a given layout, we calculated the average signal-to-noise ratio and the root mean square of the simulated magnetic field; furthermore, we evaluated the performance of the dipole fit. The results showed that the field direction normal to the scalp yields a higher signal-to-noise ratio and that ambient noise has a much lower impact on its localization error; therefore, this is the optimal choice for source localization when only one direction of magnetic field can be measured. For a low number of OPMs, combining multiple field directions greatly improves the source localization results. Lastly, we showed that MEG sensors that can be placed closer to the brain are more suitable for localizing deeper sources. [ABSTRACT FROM AUTHOR]

Objective: To evaluate a novel analysis method (SAMepi) in the localization of interictal epileptiform magnetoencephalographic (MEG) activity in parietal lobe epilepsy (PLE) patients in comparison with equivalent current dipole (ECD) analysis. Methods: We analyzed the preoperative interictal MEG of 17 operated PLE patients utilizing visual analysis and: (1) ECD with a spherical conductor model; (2) ECD with a boundary element method (BEM) conductor model; and (3) SAMepi – a kurtosis beamformer method. Localization results were compared between the three methods, to the location of the resection and to the clinical outcome. Results: Fourteen patients had an epileptiform finding in the visual analysis; SAMepi detected spikes in 11 of them. A unifocal finding in both the ECD and in the SAMepi analysis was associated with a better chance of seizure-freedom (p = 0.02). There was no significant difference in the distances from the unifocal MEG localizations to the nearest border of the resection between the different analysis methods. Conclusions: Localizations of unifocal interictal spikes detected by SAMepi did not significantly differ from the conventional ECD localizations. Significance: SAMepi – a novel semiautomatic analysis method – is useful in localizing interictal epileptiform MEG activity in the presurgical evaluation of parietal lobe epilepsy patients.

Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG. [ABSTRACT FROM AUTHOR]

Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG.

Magnetoencephalography (MEG) measures magnetic fields in the vicinity of the subject's head. Due to the nature of the magnetic field, it is not the same when measured in different directions. This raises the question, in which direction to place the sensors to measure the largest possible signals. Now that optically pumped magnetometers (OPMs) are being used in MEG, this question is even more relevant since they can be placed arbitrarily on the subject's head. In this work we made a numerical simulation to check how the noise of spontaneous brain activity affects signal-to-noise ratio of different SQUID MEG sensor configurations and different components of OPM MEG system. [ABSTRACT FROM AUTHOR]

The success of stereoelectroencephalographic (SEEG) investigations depends crucially on the hypotheses on the putative location of the seizure onset zone. This information is derived from non-invasive data either based on visual analysis or advanced source localization algorithms. While source localization applied to interictal spikes recorded on scalp is the classical method, it does not provide unequivocal information regarding the seizure onset zone. Raw ictal activity contains a mixture of signals originating from several regions of the brain as well as EMG artifacts, hampering direct input to the source localization algorithms. We therefore introduce a methodology that disentangles the various sources contributing to the scalp ictal activity using independent component analysis and uses equivalent current dipole localization as putative locus of ictal sources. We validated the results of our analysis pipeline by performing long-term simultaneous scalp – intracerebral (SEEG) recordings in 14 patients and analyzing the wavelet coherence between the independent component encoding the ictal discharge and the SEEG signals in 8 patients passing the inclusion criteria. Our results show that invasively recorded ictal onset patterns, including low-voltage fast activity, can be captured by the independent component analysis of scalp EEG. The visibility of the ictal activity strongly depends on the depth of the sources. The equivalent current dipole localization can point to the seizure onset zone (SOZ) with an accuracy that can be as high as 10 mm for superficially located sources, that gradually decreases for deeper seizure generators, averaging at 47 mm in the 8 analyzed patients. Independent component analysis is therefore shown to have a promising SOZ localizing value, indicating whether the seizure onset zone is neocortical, and its approximate location, or located in mesial structures. That may contribute to a better crafting of the hypotheses used as basis of the stereo-EEG implantations.

Magnetoencephalography (MEG) is a neuroimaging technique that measures the magnetic fields of the brain outside of the head. In the past, the most suitable magnetometer for MEG was the superconducting quantum interference device (SQUID), but in recent years, a new type has also been used, the optically pumped magnetometer (OPM). OPMs can be configured to measure multiple directions of magnetic field simultaneously. This work explored whether combining multiple directions of the magnetic field lowers the source localization error of brain sources under various conditions of noise. We simulated dipolar-like sources for multiple configurations of both SQUID- and OPM-MEG systems. To test the performance of a given layout, we calculated the average signal-to-noise ratio and the root mean square of the simulated magnetic field; furthermore, we evaluated the performance of the dipole fit. The results showed that the field direction normal to the scalp yields a higher signal-to-noise ratio and that ambient noise has a much lower impact on its localization error; therefore, this is the optimal choice for source localization when only one direction of magnetic field can be measured. For a low number of OPMs, combining multiple field directions greatly improves the source localization results. Lastly, we showed that MEG sensors that can be placed closer to the brain are more suitable for localizing deeper sources.

Background: The purpose of this study is to clarify the source distribution patterns of magnetoencephalographic spikes correlated with postsurgical seizure-free outcome in pediatric patients with focal cortical dysplasia.Patients and Methods: Thirty-two patients with pathologically confirmed focal cortical dysplasia were divided into seizure-free and seizure-persistent groups according to their surgical outcomes based on Engel classification. In each patient, presurgical magnetoencephalography was reviewed. Dipole sources of magnetoencephalographic spikes were calculated according to a single dipole model. We obtained the following quantitative indices for evaluating dipole distribution: maximum distance over all pairs of dipoles, standard deviation of the distances between each dipole and the mean coordinate of all dipoles, average nearest neighbor distance, the rate of dipoles located within 10, 20, and 30 mm from the mean coordinate, and the rate of dipoles included in the resection. These indices were compared between the two patient groups.Results: Average nearest neighbor distance was significantly smaller in the seizure-free group than in the seizure-persistent group (P = 0.008). The rates of dipoles located within 10, 20, and 30 mm from the mean coordinate were significantly higher in the seizure-free group (P = 0.001, 0.001, 0.005, respectively). The maximum distance, standard deviation, and resection rate of dipoles did not show a significant difference between the two groups.Conclusions: A spatially restricted dipole distribution of magnetoencephalographic spikes is correlated with postsurgical seizure-free outcomes in patients with focal cortical dysplasia. The distribution can be assessed by quantitative indices that are clinically useful in the presurgical evaluation of these patients. [ABSTRACT FROM AUTHOR]

Objective We aimed to validate the usefulness of gradient magnetic-field topography (GMFT) for analysis of ictal magnetoencephalography (MEG) in patients with neocortical epilepsy. Methods We identified 13 patients presenting with an ictal event during preoperative MEG. We applied equivalent current dipole (ECD) estimation and GMFT to detect and localize the ictal MEG onset, and compared these methods with the ictal onset zone (IOZ) derived from chronic intracranial electroencephalography. The surgical resection areas and outcomes were also evaluated. Results GMFT detected and localized the ictal MEG onset in all patients, whereas ECD estimation showed localized ECDs in only 2. The delineation of GMFT was concordant with the IOZ at the gyral-unit level in 10 of 12 patients (83.3%). The detectability and precision of delineation of ictal MEG activity by GMFT were significantly superior to those of ECD ( p < 0.05 and p < 0.01, respectively). Complete resection of the IOZ in the concordant group provided seizure freedom in 3 patients, whereas seizures remained in 9 patients who had incomplete resections. Conclusions Because of its higher spatial resolution, GMFT of ictal MEG is superior to conventional ECD estimation in patients with neocortical epilepsy. Significance Ictal MEG study is a useful tool to estimate the seizure onset in patients with neocortical epilepsy. [ABSTRACT FROM AUTHOR]

We present a forward modeling solution in the form of an array response kernel for magnetoencephalography. We consider the case when the brain's anatomy is approximated by an ellipsoid and an equivalent current dipole model is used to approximate brain sources. The proposed solution includes the contributions up to the third-order ellipsoidal harmonic terms; hence, we compare this new approximation against the previously available one that only considered up to second-order harmonics. We evaluated the proposed solution when used in the inverse problem of estimating physiologically feasible visual evoked responses from magnetoencephalography data. Our results showed that the contribution of the third-order harmonic terms provides a more realistic representation of the magnetic fields (closer to those generated with a numerical approximation based on the boundary element method) and, subsecuently, the estimated equivalent current dipoles are a better fit to those observed in practice (e.g., in visual evoked potentials). Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]