Page 178 - MEGIN Book Of Abstracts - 2023

tion onset (ROZ) using high-density EEG (HD-EEG) and Medicine Division, Pittsburgh, PA, USA; University of Pitts-
magnetoencephalography (MEG), and to estimate their burgh Comprehensive Epilepsy Center, Pittsburgh, PA, USA
prognostic value in pediatric epilepsy surgery.
ABSTRACT Surgery holds the best outcomes for
METHODS We retrospectively analyzed simultaneous drug-resistant epilepsy in children, making localization
HD-EEG and MEG data from 28 children with MRE who of a seizure focus essential. However, there is limited
underwent icEEG and epilepsy surgery. Using electric research on the contribution of magnetoencephalog-
and magnetic source imaging, we estimated virtual raphy and single-photon emission computed tomog-
sensors (VSs) at brain locations that matched the icEEG raphy (SPECT) to the presurgical evaluation of lesional
implantation. We detected ripples on VSs, defined the and nonlesional pediatric patients. This study proposed
virtual RZ and virtual ROZ, and estimated their distance to evaluate the concordance of SPECT and magnetoen-
from icEEG. We assessed the predictive value of resect- cephalography (MEG) to scalp electroencephalography
ing virtual RZ and virtual ROZ for postsurgical outcome. (EEG) to determine their effective contribution to the
Interictal spike localization on HD-EEG and MEG was presurgical evaluation. On review, MEG and SPECT
also performed and compared with ripples. studies for 28 drug-resistant epilepsy cases were com-
pleted at Children's Hospital of Pittsburgh from May
RESULTS We mapped ripple propagation in all patients 2012 to August 2018. Although not reaching statistical
with HD-EEG and in 27 (96%) patients with MEG. The significance, MEG had increased lobar concordance
distance from icEEG did not differ between HD-EEG and with EEG compared with SPECT (68% vs 46%). MEG
MEG when mapping the RZ (26-27mm, p = 0.6) or ROZ or SPECT results effectively provided localization data
(22-24mm, p = 0.4). Resecting the virtual ROZ, but not leading to 6 surgical evaluations and 3 resections with
virtual RZ or the sources of spikes, was associated with outcomes of Engel class I or II at 12 months. This study
good outcome for HD-EEG (p = 0.016) and MEG (p = suggests MEG and SPECT provide valuable localizing
0.047). information for presurgical epilepsy evaluation of chil-
dren with drug-resistant epilepsy.
INTERPRETATION HD-EEG and MEG can map interictal
ripples and their propagation onset (virtual ROZ). Non- Keywords: EEG, MEG, SPECT, children, drug-resistant epi-
invasively mapping the ripple onset may augment epi- lepsy, neuroimaging, seizures
lepsy surgery planning and improve surgical outcome
of children with MRE. ANN NEUROL 2021;89:911-925. Journal of child neurology (2021), Vol. 36, No. 8 (33663250)
(0 citations)
Annals of neurology (2021), Vol. 89, No. 5 (33710676) (15
citations)
Dynamic analysis on simultaneous iEEG-MEG data
via hidden Markov model (2021)
The Role of Magnetoencephalography and Single-
Photon Emission Computed Tomography in Zhang, Siqi; Cao, Chunyan; Quinn, Andrew;
Evaluation of Children With Drug-Resistant Epilepsy Vivekananda, Umesh; Zhan, Shikun; Liu, Wei; Sun,
(2021) Bomin; Woolrich, Mark; Lu, Qing; Litvak, Vladimir

Edmonds, Benjamin D; Welch, William; Sogawa, Yoshimi; Key Laboratory of Child Development and Learning Science
Mountz, James; Bagić, Anto; Patterson, Christina of Ministry of Education, School of Biological Sciences &
Medical Engineering, Southeast University, Nanjing 210096,
Division of Child Neurology, 6619UPMC Children's Hospital Jiangsu, China; Wellcome Centre for Human Neuroimag-
of Pittsburgh, Pittsburgh, Pennsylvania, USA; University of ing, UCL Institute of Neurology, 12 Queen Square, London
Pittsburgh Medical Center, Department of Radiology, Nuclear WC1N 3BG, UK; Department of Neurosurgery, affiliated Ruijin

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