Neuroscience Research Center, Jane and John Justin Institute for Mind Health, Cook Children's Health Care System; Department of Bioengineering, University of Texas at Arlington.
Neuroscience Research Center, Jane and John Justin Institute for Mind Health, Cook Children's Health Care System.
J Vis Exp. 2024 Sep 20(211). doi: 10.3791/66494.
For children with drug-resistant epilepsy (DRE), seizure freedom relies on the delineation and resection (or ablation/disconnection) of the epileptogenic zone (EZ) while preserving the eloquent brain areas. The development of a reliable and noninvasive localization method that provides clinically useful information for the localization of the EZ is, therefore, crucial to achieving successful surgical outcomes. Electric and magnetic source imaging (ESI and MSI) have been increasingly utilized in the presurgical evaluation of these patients showing promising findings in the delineation of epileptogenic as well as eloquent brain areas. Moreover, the combination of ESI and MSI into a single solution, namely electromagnetic source imaging (EMSI), performed on simultaneous high-density electroencephalography (HD-EEG) and magnetoencephalography (MEG) recordings has shown higher source localization accuracy than either modality alone. Despite these encouraging findings, such techniques are performed in only a few tertiary epilepsy centers, are rarely recorded simultaneously, and are underutilized in pediatric cohorts. This study illustrates the experimental setup for recording simultaneous MEG and HD-EEG data as well as the methodological framework for analyzing these data aiming to localize the irritative zone, the seizure onset zone, and eloquent brain areas in children with DRE. More specifically, the experimental setups are presented for (i) recording and localizing interictal and ictal epileptiform activity during sleep and (ii) recording visual-, motor-, auditory-, and somatosensory-evoked responses and mapping relevant eloquent brain areas (i.e., visual, motor, auditory, and somatosensory) during visuomotor task, as well as auditory and somatosensory stimulations. Detailed steps of the data analysis pipeline are further presented for performing EMSI as well as individual ESI and MSI using equivalent current dipole (ECD) and dynamic statistical parametric mapping (dSPM).
对于耐药性癫痫 (DRE) 患儿，癫痫发作的自由依赖于癫痫灶 (EZ) 的描绘和切除（或消融/断开），同时保留语言区域。因此，开发一种可靠的、非侵入性的定位方法，为 EZ 的定位提供临床有用的信息，对于实现成功的手术结果至关重要。电和磁源成像 (ESI 和 MSI) 已越来越多地用于这些患者的术前评估，在描绘致痫和语言相关脑区方面显示出有前途的结果。此外，将 ESI 和 MSI 组合成一个单一的解决方案，即电磁源成像 (EMSI)，在同时进行高密度脑电图 (HD-EEG) 和脑磁图 (MEG) 记录时，其源定位准确性高于单独使用任何一种模态。尽管有这些令人鼓舞的发现，但这些技术仅在少数三级癫痫中心进行，很少同时记录，并且在儿科患者中未得到充分利用。本研究说明了记录同时进行的 MEG 和 HD-EEG 数据的实验设置，以及分析这些数据的方法框架，旨在定位 DRE 儿童的刺激性区域、癫痫发作起始区域和语言相关脑区。更具体地说，介绍了以下实验设置：（i）记录和定位睡眠期间的间发性和发作性癫痫样活动，以及（ii）记录视觉、运动、听觉和体感诱发反应，并在视动任务期间映射相关语言相关脑区（即视觉、运动、听觉和体感），以及听觉和体感刺激。还进一步介绍了执行 EMSI 以及使用等效电流偶极子 (ECD) 和动态统计参数映射 (dSPM) 进行个体 ESI 和 MSI 的数据分析管道的详细步骤。
