Key technologies for intelligent brain-computer interaction based on magnetoencephalography / 生物医学工程学杂志

Brain-computer interaction (BCI) is a transformative human-computer interaction, which aims to bypass the peripheral nerve and muscle system and directly convert the perception, imagery or thinking activities of cranial nerves into actions for further improving the quality of human life. Magnetoencephalogram (MEG) measures the magnetic field generated by the electrical activity of neurons. It has the unique advantages of non-contact measurement, high temporal and spatial resolution, and convenient preparation. It is a new BCI driving signal. MEG-BCI research has important brain science significance and potential application value. So far, few documents have elaborated the key technical issues involved in MEG-BCI. Therefore, this paper focuses on the key technologies of MEG-BCI, and details the signal acquisition technology involved in the practical MEG-BCI system, the design of the MEG-BCI experimental paradigm, the MEG signal analysis and decoding key technology, MEG-BCI neurofeedback technology and its intelligent method. Finally, this paper also discusses the existing problems and future development trends of MEG-BCI. It is hoped that this paper will provide more useful ideas for MEG-BCI innovation research.

Promising Neuroimaging Biomarkers in Depression

The neuroimaging has been applied in the study of pathophysiology in major depressive disorder (MDD). In this review article, several kinds of methodologies of neuroimaging would be discussed to summarize the promising biomarkers in MDD. For the magnetic resonance imaging (MRI) and magnetoencephalography field, the literature review showed the potentially promising roles of frontal lobes, such as anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC). In addition, the limbic regions, such as hippocampus and amygdala, might be the potentially promising biomarkers for MDD. The structures and functions of ACC, DLPFC, OFC, amygdala and hippocampus might be confirmed as the biomarkers for the prediction of antidepressant treatment responses and for the pathophysiology of MDD. The functions of cognitive control and emotion regulation of these regions might be crucial for the establishment of biomarkers. The near-infrared spectroscopy studies demonstrated that blood flow in the frontal lobe, such as the DLPFC and OFC, might be the biomarkers for the field of near-infrared spectroscopy. The electroencephalography also supported the promising role of frontal regions, such as the ACC, DLPFC and OFC in the biomarker exploration, especially for the sleep electroencephalogram to detect biomarkers in MDD. The positron emission tomography (PET) and single-photon emission computed tomography (SPECT) in MDD demonstrated the promising biomarkers for the frontal and limbic regions, such as ACC, DLPFC and amygdala. However, additional findings in brainstem and midbrain were also found in PET and SPECT. The promising neuroimaging biomarkers of MDD seemed focused in the fronto-limbic regions.

Neural mechanisms of visual feature binding / 生理学报

Integrating different visual features into a coherent object is a central challenge for the visual system, which is referred as the binding problem. Firstly, this review introduces the conception of the binding problem and the theoretical and empirical controversies regarding whether and how the binding processes are implemented in visual system. Although many neurons throughout the visual hierarchy are known to code multiple features, feature binding is recruited by visual system. Feature misbinding (or illusory conjunction) is probably the most striking evidence for the existence of the binding mechanism. Next, this review summarizes some critical issues in feature binding literature, including early binding theories, late binding theories, neural synchrony theory, the feature integration theory and re-entry processing theory. Feature binding is not a fully automatic or bottom-up processing. Reentrant connection from higher visual areas to early visual cortex (top-down processes) plays a critical role in feature binding, especially in active feature binding (i.e. feature misbinding). In addition, with electrophysiology, electroencephalography (EEG), magnetoencephalography (MEG) and transcranial electric stimulation (tEs) approaches, recent studies explored both correlational and causal relations between brain oscillations and feature binding, suggesting that brain oscillations are of great importance for feature binding. Finally, this review discusses some potential problems and open questions associated with visual feature binding mechanisms which need to be addressed in future studies.

The neural encoding of continuous speech - recent advances in EEG and MEG studies / 生理学报

Speech comprehension is a central cognitive function of the human brain. In cognitive neuroscience, a fundamental question is to understand how neural activity encodes the acoustic properties of a continuous speech stream and resolves multiple levels of linguistic structures at the same time. This paper reviews the recently developed research paradigms that employ electroencephalography (EEG) or magnetoencephalography (MEG) to capture neural tracking of acoustic features or linguistic structures of continuous speech. This review focuses on two questions in speech processing: (1) The encoding of continuously changing acoustic properties of speech; (2) The representation of hierarchical linguistic units, including syllables, words, phrases and sentences. Studies have found that the low-frequency cortical activity tracks the speech envelope. In addition, the cortical activities on different time scales track multiple levels of linguistic units and constitute a representation of hierarchically organized linguistic units. The article reviewed these studies, which provided new insights into the processes of continuous speech in the human brain.

Resting-State Electroencephalography (EEG) Functional Connectivity Analysis / 대한소아신경학회지

Advances in network science and computer engineering have enabled brain connectivity analysis using clinical big data such as brain magnetic resonance imaging (MRI), electroencephalography (EEG), or magnetoencephalography (MEG). Resting-state functional connectivity analysis aims to reveal the characteristics of functional brain network in various diseases and normal brain maturation using resting-state EEG. Simplified sequence of resting-state functional connectivity analysis methods will be reviewed in this article. The outcomes from EEG resting-state connectivity analysis are comprised of connectivity itself of the specific condition and the network topology measure which describe the characteristics of specific connectivity. An increasing number of studies report the differences in the functional connection itself, global network measures including segregation (connectedness), integration (efficiency), and importance of specific nodes (centrality or node degree). Several issues that are relevant in the resting-state connectivity analysis are obtaining good quality EEG for analysis, consideration of particular features of EEG signal, understanding different types of association measures, and statistics for comparison of connectivities. Well-designed and carefully analyzed EEG resting-state connectivity analysis can provide useful information for patient care in pediatric neurology.

A wearable system for adaptation to left–right reversed audition tested in combination with magnetoencephalography

Exposure of humans to unusual spaces is effective to observe the adaptive strategy for an environment. Though adaptation to such spaces has been typically tested with vision, little has been examined about adaptation to left–right reversed audition, partially due to the apparatus for adaptation. Thus, it is unclear if the adaptive effects reach early auditory processing. Here, we constructed a left–right reversed stereophonic system using only wearable devices and asked two participants to wear it for 4 weeks. Every week, the magnetoencephalographic responses were measured under the selective reaction time task, where they immediately distinguished between sounds delivered to either the left or the right ear with the index finger on the compatible or incompatible side. The constructed system showed high performance in sound localization and achieved gradual reduction of a feeling of strangeness. The N1m intensities for the response-compatible sounds tended to be larger than those for the response-incompatible sounds until the third week but decreased on the fourth week, which correlated with the initially shorter and longer reaction times for the compatible and incompatible conditions, respectively. In the second week, disruption of the auditory-motor connectivity was observed with the largest N1m intensities and the longest reaction times, irrespective of compatibility. In conclusion, we successfully produced a high-quality space of left–right reversed audition using our system. The results suggest that a 4-week exposure to the reversed audition causes optimization of the auditory-motor coordination according to the new rule, which eventually results in the modulation of early auditory processing.

MEG and EEG dipole clusters from extended cortical sources

Data from magnetoencephalography (MEG) and electroencephalography (EEG) suffer from a rather limited signal-to-noise-ratio (SNR) due to cortical background activities and other artifacts. In order to study the effect of the SNR on the size and distribution of dipole clusters reconstructed from interictal epileptic spikes, we performed simulations using realistically shaped volume conductor models and extended cortical sources with different sensor configurations. Head models and cortical surfaces were derived from an averaged magnetic resonance image dataset (Montreal Neurological Institute). Extended sources were simulated by spherical patches with Gaussian current distributions on the folded cortical surface. Different patch sizes were used to investigate cancellation effects from opposing walls of sulcal foldings and to estimate corresponding changes in MEG and EEG sensitivity distributions. Finally, white noise was added to the simulated fields and equivalent current dipole reconstructions were performed to determine size and shape of the resulting dipole clusters. Neuronal currents are oriented perpendicular to the local cortical surface and show cancellation effects of source components on opposing sulcal walls. Since these mostly tangential aspects from large cortical patches cancel out, large extended sources exhibit more radial components in the head geometry. This effect has a larger impact on MEG data as compared to EEG, because in a spherical head model radial currents do not yield any magnetic field. Confidence volumes of single reconstructed dipoles from simulated data at different SNRs show a good correlation with the extension of clusters from repeated dipole reconstructions. Size and shape of dipole clusters reconstructed from extended cortical sources do not only depend on spike and timepoint selection, but also strongly on the SNR of the measured interictal MEG or EEG data. In a linear approximation the size of the clusters is proportional to the inverse SNR.

Statistical non-parametric mapping in sensor space

Establishing the significance of observed effects is a preliminary requirement for any meaningful interpretation of clinical and experimental Electroencephalography or Magnetoencephalography (MEG) data. We propose a method to evaluate significance on the level of sensors whilst retaining full temporal or spectral resolution. Input data are multiple realizations of sensor data. In this context, multiple realizations may be the individual epochs obtained in an evoked-response experiment, or group study data, possibly averaged within subject and event type, or spontaneous events such as spikes of different types. In this contribution, we apply Statistical non-Parametric Mapping (SnPM) to MEG sensor data. SnPM is a non-parametric permutation or randomization test that is assumption-free regarding distributional properties of the underlying data. The method, referred to as Maps SnPM, is demonstrated using MEG data from an auditory mismatch negativity paradigm with one frequent and two rare stimuli and validated by comparison with Topographic Analysis of Variance (TANOVA). The result is a time- or frequency-resolved breakdown of sensors that show consistent activity within and/or differ significantly between event or spike types. TANOVA and Maps SnPM were applied to the individual epochs obtained in an evoked-response experiment. The TANOVA analysis established data plausibility and identified latencies-of-interest for further analysis. Maps SnPM, in addition to the above, identified sensors of significantly different activity between stimulus types.

Functional Neuroimaging in Neuro-Otology / 대한평형의학회지

Neuro-otologic symptoms such as dizziness, hearing loss, or tinnitus give rise to peripheral change-induced neuroplasticity or central pathology-induced structural or functional changes. In this regard, functional neuroimaging modalities such as positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), quantitative electroencephalography (qEEG), or functional near infrared spectroscopy have provided researchers with possibility to observe neuro-otologic disease-induced central functional changes. Among these methods, PET and fMRI are advantageous over qEEG or MEG with regard to spatial resolution, while qEEG and MEG are advantageous over PET or fMRI with regard to temporal resolution. Also, fMRI or MEG is not suitable for patients with implanted devices, whereas PET is not ideal for repetitive measures due to radiation hazard. In other words, as these modalities are complementary to one another, researchers should choose optimum imaging modality on a case by case basis. Hereinafter, representative functional neuroimaging modalities and their application to neuro-otologic research will be summarized.

Functional Imaging of Tinnitus / 한양의대학술지

Tinnitus is an auditory phantom characterized by the perception of sound without the presence of an external acoustical source. The peripheral auditory system is considered to contribute to the initiation of tinnitus but only explains the severity and distress level to a limited degree. The neuropsychological models of tinnitus have been developed to explain the pathophysiology of tinnitus as a malfunctioning feedforward/feedback signal in the central neural system including the auditory brainstem, limbic system, auditory cortices, and other anatomical features. Functional neuroimaging techniques have been introduced in recent decades and have provided non-invasive tools to assess the working human brain in vivo. Researchers have found these techniques valuable in examining the neural correlates of tinnitus and have been able to not only support the neuropsychological model but to expand it. Though neuroimaging studies on tinnitus only began in 1990s, they have been increasing exponentially in number. In this review, we investigate the current state of functional neuroimaging studies on tinnitus in humans. The characteristics of commonly used functional neuroimaging techniques including positron emission tomography (PET), functional magnetic resonance imaging (fMRI), electroencephalography (EEG) and magnetoencephalography (MEG) are also discussed. We briefly review recent studies on the tinnitus-brain relationship that have used those research tools.

Utilização dos serviços de atendimento odontológico hospitalar sob sedação e/ou anestesia geral por pessoas com necessidades especiais no SUS-MG, Brasil / Availability of hospital dental care services under sedation or general anesthesia for individuals with special needs in the Unified Health System for the State of Minas Gerais (SUS-MG), Brazil

O presente estudo identificou as características demográficas dos indivíduos e assistenciais do tratamento odontológico sob sedação e/ou anestesia geral em ambiente hospitalar no SUS-MG. Foram avaliadas todas as Autorizações de Internações Hospitalares (AIH) para o procedimento Tratamento Odontológico para Pacientes com Necessidades Especiais, de julho de 2011 a junho de 2012. Foram mensuradas variáveis demográficas e assistenciais dos atendimentos. Foram calculadas as taxas de internações por 10.000 habitantes e a cobertura assistencial realizada no estado de Minas Gerais e em cada uma das Regiões Ampliadas de Saúde. A análise descritiva das variáveis foi feita por meio de cálculo da frequência e medidas de tendência central e variabilidade. Foram avaliadas todas as 1.063 AIH pagas no período estudado, que representaram uma taxa de 0,54 internações por 10.000 habitantes. A maioria dos indivíduos era adulta, do sexo masculino, com diagnóstico de transtornos mentais ou comportamentais e residente em 27,7% dos municípios de Minas Gerais. Os procedimentos foram realizados em 39 municípios e a cobertura assistencial foi igual a 1,58%. O estudo revelou um perfil clássico do paciente atendido. Dificuldades em se estabelecer uma rede de atenção à saúde bucal foram identificadas.

This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.

Functional Neuroimaging of Tinnitus: State-of-the-Art / 대한이비인후과학회지

Non-pulsatile subjective tinnitus is a phantom sound percept without any objective physical sound source. Recent advances in tinnitus research have suggested central rather than peripheral changes as the culprit of tinnitus perception. Moreover, researchers have shown that these central functional changes can be observed not only in the auditory cortex but also in non-auditory regions such as the frontal, parietal, and limbic areas in patients with tinnitus. In this regard, functional neuroimaging modalities such as positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and quantitative electroencephalography (qEEG) provided researchers with a window into the cerebral cortical activity orchestrating tinnitus. Among these methods, qEEG and MEG are advantageous over PET or fMRI with regard to temporal resolution, while PET and fMRI are advantageous over qEEG or MEG with regard to spatial resolution. In other words, there is no gold standard functional neuroimaging modality in the field of tinnitus, but these four modalities are complementary to one another. In this review article, these four representative functional neuroimaging modalities and their application to tinnitus research will be introduced. Moreover, future direction of functional neuroimaging research on the pathophysiology of tinnitus will be discussed briefly.

A Feature Extraction Method for Brain Computer Interface Based on Multivariate Empirical Mode Decomposition / 生物医学工程学杂志

This paper presents a feature extraction method based on multivariate empirical mode decomposition (MEMD) combining with the power spectrum feature, and the method aims at the non-stationary electroencephalogram (EEG) or magnetoencephalogram (MEG) signal in brain-computer interface (BCI) system. Firstly, we utilized MEMD algorithm to decompose multichannel brain signals into a series of multiple intrinsic mode function (IMF), which was proximate stationary and with multi-scale. Then we extracted and reduced the power characteristic from each IMF to a lower dimensions using principal component analysis (PCA). Finally, we classified the motor imagery tasks by linear discriminant analysis classifier. The experimental verification showed that the correct recognition rates of the two-class and four-class tasks of the BCI competition III and competition IV reached 92.0% and 46.2%, respectively, which were superior to the winner of the BCI competition. The experimental proved that the proposed method was reasonably effective and stable and it would provide a new way for feature extraction.

A novel method of multi-channel feature extraction combining multivariate autoregression and multiple-linear principal component analysis / 生物医学工程学杂志

Brain-computer interface (BCI) systems identify brain signals through extracting features from them. In view of the limitations of the autoregressive model feature extraction method and the traditional principal component analysis to deal with the multichannel signals, this paper presents a multichannel feature extraction method that multivariate autoregressive (MVAR) model combined with the multiple-linear principal component analysis (MPCA), and used for magnetoencephalography (MEG) signals and electroencephalograph (EEG) signals recognition. Firstly, we calculated the MVAR model coefficient matrix of the MEG/EEG signals using this method, and then reduced the dimensions to a lower one, using MPCA. Finally, we recognized brain signals by Bayes Classifier. The key innovation we introduced in our investigation showed that we extended the traditional single-channel feature extraction method to the case of multi-channel one. We then carried out the experiments using the data groups of IV-III and IV - I. The experimental results proved that the method proposed in this paper was feasible.

EEG Source Imaging in Partial Epilepsy in Comparison with Presurgical Evaluation and Magnetoencephalography

BACKGROUND AND PURPOSE: The aim of this study was to determine the usefulness of three-dimensional (3D) scalp EEG source imaging (ESI) in partial epilepsy in comparison with the results of presurgical evaluation, magnetoencephalography (MEG), and electrocorticography (ECoG). METHODS: The epilepsy syndrome of 27 partial epilepsy patients was determined by presurgical evaluations. EEG recordings were made using 70 scalp electrodes, and the 3D coordinates of the electrodes were digitized. ESI images of individual and averaged spikes were analyzed by Curry software with a boundary element method. MEG and ECoG were performed in 23 and 9 patients, respectively. RESULTS: ESI and MEG source imaging (MSI) results were well concordant with the results of presurgical evaluations (in 96.3% and 100% cases for ESI and MSI, respectively) at the lobar level. However, there were no spikes in the MEG recordings of three patients. The ESI results were well concordant with MSI results in 90.0% of cases. Compared to ECoG, the ESI results tended to be localized deeper than the cortex, whereas the MSI results were generally localized on the cortical surface. ESI was well concordant with ECoG in 8 of 9 (88.9%) cases, and MSI was also well concordant with ECoG in 4 of 5 (80.0%) cases. The EEG single dipoles in one patient with mesial temporal lobe epilepsy were tightly clustered with the averaged dipole when a 3 Hz high-pass filter was used. CONCLUSIONS: The ESI results were well concordant with the results of the presurgical evaluation, MSI, and ECoG. The ESI analysis was found to be useful for localizing the seizure focus and is recommended for the presurgical evaluation of intractable epilepsy patients.

Inter-trial effect in luminance processing revealed by magnetoencephalography / Efecto inter-ensayo en el procesamiento de iluminación revelado por magnetoencefalografía

In this study, we examined whether luminance processing in the human visual system would exhibit any history effect (i.e., inter-trial modulation) in psychophysical and magnetoencephalographic experiments. A disk was presented against a black background at various luminance levels in a randomized order. During the MEG recording, participants were instructed to rate the brightness of the disk (magnitude estimation) and to report it aloud during inter-stimulus interval. The MEG results showed that the neuromagnetic activation around 200-220 ms after the stimulus onset in the left occipito-temporal regions at a given trial was weaker when the disk luminance in the immediately prior trial was higher. An inverse inter-trial effect was also observed in the psychophysical experiment. These findings suggest that the neuromagnetic activity reflects the inter-trial modulation of luminance processing that correlates with the subjective perception of brightness.

En este estudio, se examinó si el procesamiento de iluminación en el sistema visual humano exhibie algún efecto de historia (es decir, modulación inter-ensayo) en experimentos psicofísicos y de magnetoencefalografía (MEG). Un disco se presentó contra un fondo negro en varios niveles de iluminación en un orden aleatorio. Durante el registro de MEG, los participantes fueron instruidos para clasificar el brillo del disco (estimación de magnitud) y reportarlo durante el intervalo inter-ensayo. Los resultados de MEG mostraron que la activación neuromagnetica alrededor 200-220 ms después de la aparición de estímulo en las regiones occipito-temporal izquierda en un ensayo dade fue más débil cuando la iluminación de disco en el ensayo inmediatamente antes fue mayor. También se observó un efecto inverso inter-ensayo en el experimento psicofísico. Estos hallazgos sugieren que la actividad neuromagnética refleja la modulación inter-ensayo de procesamiento de iluminación que se correlaciona con la percepción subjetiva de brillo.

A gênese cerebral da imagem corporal: algumas considerações sobre o fenômeno dos membros fantasmas em ramachandran / The cerebral genesis of body image: some considerations about phantom-limbs in ramachandran

Os distúrbios da imagem do corpo, na forma conferida pelo fenômeno dos "membros fantasmas", tomaram grande parte dos estudos do neurologista indiano V. S. Ramachandran. Seu trabalho, por meio de testes psicofísicos e estudos de imagem funcional em pacientes com "membros fantasmas", demonstrou aquilo que ele denominou "plasticidade neural" ou "plasticidade cortical" em cérebros humanos adultos. Este artigo tem por objetivo analisar criticamente a construção da imagem do corpo, da interioridade e do self a partir das principais teses neurológicas de Ramachandran sobre o fenômeno dos "membros fantasmas". Defende-se a ideia de que, apesar de o autor apresentar novas modalidades de descrições subjetivas e narrativas da mente, a experiência subjetiva e a construção da imagem corporal também devem ser explicadas em termos da relação corpo-ambiente ou corpo-mundo, na qual se destaca o papel da linguagem e das narrativas de si.

The body image problems, as provided by "phantom limbs", took most studies of Indian neurologist V. S. Ramachandran. His work, through psychophysical tests and functional imaging studies in patients with "phantom limbs", demonstrated the "neural plasticity" or "cortical plasticity" in the adult human brain. This paper aims to examine the construction of body image, the inner life and the "self" from the Ramachandran neurological approaches on the phenomenon of "phantom limbs." We supports the idea that although the author presents new subjective and narrative descriptions of mind, the subjective experience and the construction of body image should also be explained in terms of the body-environment or body-world relationship, in which the role language and self-narratives stand out.

Magnetoencephalography in pediatric epilepsy / 소아과

Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data of MEG and electroencephalography are not mutually exclusive and it is recorded simultaneously and interpreted together. MEG has been shown to be useful in detecting the irritative zone in both lesional and nonlesional epilepsy surgery. It has provided valuable and additive information regarding the lesion that should be resected in epilepsy surgery. Better outcomes in epilepsy surgery were related to the localization of the irritative zone with MEG. The value of MEG in epilepsy surgery is recruiting more patients to epilepsy surgery and providing critical information for surgical planning. MEG cortical mapping is helpful in younger pediatric patients, especially when the epileptogenic zone is close to the eloquent cortex. MEG is also used in both basic and clinical research of epilepsy other than surgery. MEG is a valuable diagnostic modality for diagnosis and treatment, as well as research in epilepsy.

Magnetoencephalography Interictal Spike Clustering in Relation with Surgical Outcome of Cortical Dysplasia

OBJECTIVE: The aim of this study was to devise an objective clustering method for magnetoencephalography (MEG) interictal spike sources, and to identify the prognostic value of the new clustering method in adult epilepsy patients with cortical dysplasia (CD). METHODS: We retrospectively analyzed 25 adult patients with histologically proven CD, who underwent MEG examination and surgical resection for intractable epilepsy. The mean postoperative follow-up period was 3.1 years. A hierarchical clustering method was adopted for MEG interictal spike source clustering. Clustered sources were then tested for their prognostic value toward surgical outcome. RESULTS: Postoperative seizure outcome was Engel class I in 6 (24%), class II in 3 (12%), class III in 12 (48%), and class IV in 4 (16%) patients. With respect to MEG spike clustering, 12 of 25 (48%) patients showed 1 cluster, 2 (8%) showed 2 or more clusters within the same lobe, 10 (40%) showed 2 or more clusters in a different lobe, and 1 (4%) patient had only scattered spikes with no clustering. Patients who showed focal clustering achieved better surgical outcome than distributed cases (p=0.017). CONCLUSION: This is the first study that introduces an objective method to classify the distribution of MEG interictal spike sources. By using a hierarchical clustering method, we found that the presence of focal clustered spikes predicts a better postoperative outcome in epilepsy patients with CD.

Magnetoencephalography in Pediatric Lesional Epilepsy Surgery

This study was performed to assess the usefulness of magnetoencephalography (MEG) as a presurgical evaluation modality in Korean pediatric patients with lesional localization-related epilepsy. The medical records and MEG findings of 13 pediatric patients (6 boys and 7 girls) with localization-related epilepsy, who underwent epilepsy surgery at Seoul National University Children's Hospital, were retrospectively reviewed. The hemispheric concordance rate was 100% (13/13 patients). The lobar or regional concordance rate was 77% (10/13 patients). In most cases, the MEG spike sources were clustered in the proximity of the lesion, either at one side of the margin (nine patients) or around the lesion (one patient); clustered spike sources were distant from the lesion in one patient. Among the patients with clustered spike sources near the lesion, further extensions (three patients) and distal scatters (three patients) were also observed. MEG spike sources were well lateralized and localized even in two patients without focal epileptiform discharges in the interictal scalp electroencephalography. Ten patients (77%) achieved Engel class I postsurgical seizure outcome. It is suggested that MEG is a safe and useful presurgical evaluation modality in pediatric patients with lesion localization-related epilepsy.