Page 201 - MEGIN Book Of Abstracts - 2023

IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; DINOGMI, Keywords: EEG-fMRI, Epilepsy surgery, HR-EEG, MEG, PET
University of Genoa, and Child Neuropsychiatry Unit, IRCCS
Istituto G. Gaslini, Genoa, Italy; Department of Health Sci- Clinical neurophysiology: official journal of the
ences, University of Milan and ASST Santi Paolo e Carlo, International Federation of Clinical Neurophysiology
Milan, Italy (2020), Vol. 131, No. 8 (32544836) (19 citations)

OBJECTIVE We evaluated four imaging techniques,
i.e. Electroencephalography (EEG)-functional Magnetic Detection of interictal epileptiform discharges: A
Resonance Imaging (MRI) (EEG-fMRI), High-resolution comparison of on-scalp MEG and conventional MEG
EEG (HR-EEG), Magnetoencephalography (MEG) and measurements (2020)
2-[18F]fluoro-2-deoxy-D-glucose positron emission
tomography (PET), for the identification of the epilep- Westin, Karin; Pfeiffer, Christoph; Andersen, Lau M;
togenic zone (EZ) in 41 patients with negative MRI, Ruffieux, Silvia; Cooray, Gerald; Kalaboukhov, Alexei;
candidate to neurosurgery. Winkler, Dag; Ingvar, Martin; Schneiderman, Justin;
Lundqvist, Daniel
METHODS For each technique, results were compared
to the Stereo-EEG. Diagnostic measures were calculated NatMEG, Department of Clinical Neuroscience, Karolinska
with respect to the post-surgical outcome, either for all Institute, Stockholm, Sweden; Clinical Neurophysiology,
the patients (39/41, two patients excluded) and for the Karolinska University Hospital, Stockholm, Sweden. Electronic
subgroup of patients with the EZ involving more than address: [email protected]; Department of Microtechnology
one lobe (20/41). and Nanoscience - MC2, Chalmers University of Technol-
ogy, Gothenburg, Sweden; Center of Functionally Integrative
RESULTS When considered individually, each func- Neuroscience (CFIN), Aarhus University, Aarhus, Denmark;
tional technique showed accuracy values ranging NatMEG, Department of Clinical Neuroscience, Karolinska
54,6%-63,2%, having PET, MEG and HR-EEG higher Institute, Stockholm, Sweden; MedTech West and the Institute
sensitivity, and EEG-fMRI higher specificity. In patients for Neuroscience and Physiology, Sahlgrenska Academy,
with multilobar epileptogenic zone, functional tech- University of Gothenburg, Gothenburg, Sweden
niques achieved the best accuracies (up to 80%) when
three techniques, including EEG-fMRI, were considered OBJECTIVE Conventional MEG provides an unsur-
together. passed ability to, non-invasively, detect epileptic
activity. However, highly resolved information on small
CONCLUSIONS The study highlights the accuracy of a neuronal populations required in epilepsy diagnostics
combination of functional imaging techniques in the is lost and can be detected only intracranially. Next-
identification of EZ in MRI negative focal epilepsy. The generation on-scalp magnetencephalography (MEG)
best diagnostic yield was obtained if the combination sensors aim to retrieve information unavailable to
of PET, MEG (or HR-EEG as alternative), EEG-fMRI were conventional non-invasive brain imaging techniques.
considered together. To evaluate the benefits of on-scalp MEG in epilepsy,
we performed the first-ever such measurement on an
SIGNIFICANCE The functional imaging techniques may epilepsy patient.
improve the presurgical workup of MRI negative focal
epilepsy, if epileptogenic zone involves more than one METHODS Conducted as a benchmarking study focus-
lobe. ing on interictal epileptiform discharge (IED) detect-
ability, an on-scalp high-temperature superconducting
quantum interference device magnetometer (high-Tc
SQUID) system was compared to a conventional,
low-temperature SQUID system. Co-registration of

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