Magnetoencephalography for Epilepsy Presurgical Evaluation.

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. 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.

Corrigendum: The role of the piriform cortex in temporal lobe epilepsy: A current literature review.

[This corrects the article DOI: 10.3389/fneur.2022.1042887.].

The role of the piriform cortex in temporal lobe epilepsy: A current literature review.

Temporal lobe epilepsy is the most common form of focal epilepsy and can have various detrimental consequences within many neurologic domains. Recent evidence suggests that the piriform cortex may also be implicated in seizure physiology. The piriform cortex is a primary component of the olfactory network and is located at the junction of the frontal and temporal lobes, wrapping around the entorhinal sulcus. Similar to the hippocampus, it is a tri-layered allocortical structure, with connections to many adjacent regions including the orbitofrontal cortex, amygdala, peri- and entorhinal cortices, and insula. Both animal and human studies have implicated the piriform cortex as a critical node in the temporal lobe epilepsy network. It has additionally been shown that resection of greater than half of the piriform cortex may significantly increase the odds of achieving seizure freedom. Laser interstitial thermal therapy has also been shown to be an effective treatment strategy with recent evidence hinting that ablation of the piriform cortex may be important for seizure control as well. We propose that sampling piriform cortex in intracranial stereoelectroencephalography (sEEG) procedures with the use of a temporal pole or amygdalar electrode would be beneficial for further understanding the role of the piriform cortex in temporal lobe epilepsy.

Running-down phenomenon captured with chronic electrocorticography.

The running-down phenomenon refers to 2 analogous but distinct entities that may be seen after epilepsy surgery. The first is clinical, and denotes a progressive diminution in seizures after epilepsy surgery in which the epileptogenic zone could not be completely removed (Modern Problems of Psychopharmacology 1970;4:306, Brain 1996:989). The second is electrographic, and refers to a progressive deactivation of a secondary seizure focus after removal of the primary epileptogenic zone. This progressive decrease in epileptiform activity may represent a reversal of secondary epileptogenesis, where a primary epileptogenic zone is postulated to activate epileptiform discharges at a second site and may become independent.3 The electrographic running-down phenomenon has been reported in only limited numbers of patients, using serial postoperative routine scalp electroencephalography (EEG) (Arch Neurol 1985;42:318). We present what is, to our knowledge, the most detailed demonstration of the electrographic running-down phenomenon in humans, made possible by chronic electrocorticography (ECoG). Our patient's left temporal seizure focus overlapped with language areas, limiting the resection to a portion of the epileptogenic zone, followed by implantation of a direct brain-responsive neurostimulator (RNS System, NeuroPace Inc.) to treat residual epileptogenic tissue. Despite the limited extent of the resection, the patient remains seizure-free more than 2 years after surgery, with the RNS System recording ECoG without delivering stimulation. We reviewed the chronic recordings with automated spike detection and inspection of electrographic episodes marked by the neurostimulator. These recordings demonstrate progressive diminution in spiking and rhythmic discharges, consistent with an electrographic running-down phenomenon.

Eye closure causes widespread low-frequency power increase and focal gamma attenuation in the human electrocorticogram.

OBJECTIVE: We sought to characterize the effects of eye closure on EEG power using electrocorticography (ECoG). Specifically, we sought to elucidate the anatomical areas demonstrating an eye closure effect, and at which frequencies this effect occurs. METHODS: ECoG was recorded from 32 patients undergoing invasive monitoring for seizure focus localization. Patients were instructed to close and open their eyes repeatedly. ECoG power was compared in the epochs following eye closure and opening, for various frequency bands and brain regions. RESULTS: We found that at low frequencies, eye closure causes widespread power increases involving all lobes of the brain. This effect was significant not only in the α (8-12 Hz) band but in the δ (2-4 Hz), θ (4-8 Hz), and ß (15-30 Hz) bands as well. At high frequencies, eye closure causes comparatively focal power decreases over occipital cortex and frontal Brodmann areas 8 and 9. CONCLUSIONS: Eye closure (1) affects a broad range of frequencies outside the α band and (2) involves a distributed network of neural activity in anatomical areas outside visual cortex. SIGNIFICANCE: This study constitutes the first large-scale, systematic application of ECoG to study eye closure, which is shown to influence a broad range of frequencies and brain regions.

PyParse: a semiautomated system for scoring spoken recall data.

Studies of human memory often generate data on the sequence and timing of recalled items, but scoring such data using conventional methods is difficult or impossible. We describe a Python-based semiautomated system that greatly simplifies this task. This software, called PyParse, can easily be used in conjunction with many common experiment authoring systems. Scored data is output in a simple ASCII format and can be accessed with the programming language of choice, allowing for the identification of features such as correct responses, prior-list intrusions, extra-list intrusions, and repetitions.

Temporal associative processes revealed by intrusions in paired-associate recall.

Although much is known about the factors that influence the acquisition and retention of individual paired associates, the existence of temporally defined associations spanning multiple pairs has not been demonstrated. We report two experiments in which subjects studied randomly paired nouns for a subsequent cued recall test. When subjects recalled nontarget items, their intrusions tended to come from nearby pairs. This across-pair contiguity effect was graded, spanning noncontiguously studied word pairs. The existence of such long-range temporally defined associations lends further support to contextual-retrieval models of episodic association.

Lure similarity affects visual episodic recognition: detailed tests of a noisy exemplar model.

Summed-similarity models of visual episodic recognition memory successfully predict the variation in false alarm rates across different test items. With data averaged across subjects, Kahana and Sekuler demonstrated that subjects' performance appears to change along with the mean similarity among study items; with high interstimulus similarity, subjects were less likely to commit false alarms to similar lures. We examined this effect in detail by systematically varying the coordinates of study and test items along a critical stimulus dimension and measuring memory performance at each point. To reduce uncontrolled variance associated with individual differences in vision, the coordinates of study and test items were scaled according to each subject's discrimination threshold. Fitting each of four summed-similarity models to the individual subjects' data demonstrated a clear superiority for models that take account of interitem similarity on a trialwise basis.

PyEPL: a cross-platform experiment-programming library.

PyEPL (the Python Experiment-Programming Library) is a Python library which allows cross-platform and object-oriented coding of behavioral experiments. It provides functions for displaying text and images onscreen, as well as playing and recording sound, and is capable of rendering 3-D virtual environments forspatial-navigation tasks. It is currently tested for Mac OS X and Linux. It interfaces with Activewire USB cards (on Mac OS X) and the parallel port (on Linux) for synchronization of experimental events with physiological recordings. In this article, we first present two sample programs which illustrate core PyEPL features. The examples demonstrate visual stimulus presentation, keyboard input, and simulation and exploration of a simple 3-D environment. We then describe the components and strategies used in implementing PyEPL.