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Presurgical electromagnetic functional brain mapping in refractory focal epilepsy

Präoperative elektromagnetische funktionelle Hirnkartierung bei refrakträrer fokaler Epilepsie

  • Leitthema
  • Published:
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Abstract

Background

Electroencephalography (EEG) and magnetoencephalography (MEG) are neurophysiological methods used to investigate noninvasively the spatial, temporal, and spectral dynamics of human brain functions.

Objectives

This article reviews data on the use of EEG and MEG for presurgical functional brain mapping in patients with refractory focal epilepsy. The focus is on the localization of the primary sensorimotor (SM1) cortex as well as the verbal language and episodic memory functions.

Material and methods

The English literature was reviewed based on a PubMed search. Relevant references in the selected papers were also included.

Results

Presurgical MEG functional localization of the SM1 cortex generally overlaps with intracranial mapping. MEG allows for determination of hemispheric verbal (receptive and expressive) language dominance in neurosurgical patients with a high degree of concordance with the intracarotid amobarbital test. MEG represents an interesting technique for assessing postoperative memory outcome in patients with mesial temporal lobe epilepsy. Very few studies have evaluated the yield of EEG in these three clinical indications. High-density EEG might be a promising technique that needs further validation.

Conclusion

MEG is a validated and robust technique for noninvasive functional mapping of the SM1 cortex and verbal language hemispheric dominance in patients with refractory focal epilepsy. Current data also suggest that MEG is a promising technique for assessing the hemispheric dominance of memory function. Further studies are needed to assess the clinical added value of high-density EEG in these clinical indications.

Zusammenfassung

Hintergrund

Elektroenzephalographie (EEG) und Magnetenzephalographie (MEG) sind neurophysiologische Methoden, die für die nichtinvasive Untersuchung der räumlichen, zeitlichen und spektralen Dynamik der menschlichen Hirnfunktion eingesetzt werden.

Zielsetzung

Der vorgestellte Artikel bietet einen Überblick über die Anwendung von EEG und MEG für das prächirurgische funktionelle Mapping bei Patienten mit refraktärer fokaler Epilepsie. Der Fokus liegt auf der Lokalisation des primären sensomotorischen Kortex (SM1) sowie der verbalen Sprach- und episodischen Gedächtnisfunktion.

Material und Methoden

Auf einer PubMed-Suche basierend wurden entsprechende Artikel in englischer Sprache ausgewertet. Darüber hinaus wurden relevante Zitate in den ausgewählten Artikeln in die Auswertung einbezogen.

Ergebnisse

Die prächirurgische funktionelle Lokalisation des SM1-Kortex mittels MEG überlappt i. Allg. mit den Ergebnissen des intrakraniellen Mappings. Die MEG ermöglicht die Bestimmung der hemisphärischen (rezeptiven und expressiven) Sprachdominanz neurochirurgischer Patienten mit einem hohen Grad an Konkordanz mit dem Intrakarotis-Amobarbital-Test (Wada-Test). MEG-Untersuchungen sind auch für die Evaluation der postoperativen Gedächtnisfunktion bei Patienten mit mesialer Temporallappenepilepsie interessant. In sehr wenigen Studien wurde bisher der Nutzen des EEG im Rahmen dieser 3 Indikationen untersucht. Die High-Density-EEG stellt eine vielversprechende Technik dar, die jedoch weitere Validierung benötigt.

Schlussfolgerungen

Die MEG ist eine validierte und robuste Technik für die nichtinvasive funktionelle Lokalisation des SM1-Kortex sowie der verbalen hemisphärischen Sprachdominanz bei Patienten mit refraktären fokalen Epilepsien. Die Studienlage weist zudem darauf hin, dass die MEG eine vielversprechende Technik zur Bestimmung der hemisphärischen Gedächtnisdominanz darstellen könnte. Weitere Untersuchungen zum zusätzlichen Nutzen der High-Density-EEG im Rahmen dieser Indikationen sind erforderlich.

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Funding

T. Coolen is a Clinical Master Specialist Applicant to a PhD at the Fonds de la Recherche Scientifique (FRS-FNRS, Brussels, Belgium). A.M. Dumitrescu benefits from financial support of the Fonds Erasme (Research Convention “Les Voies du Savoir”, Brussels, Belgium). M. Bourguignon is supported by the program Attract of Innoviris (grant 2015-BB2B-10), by the Spanish Ministry of Economy and Competitiveness (grant PSI2016-77175-P), and by the Marie Skłodowska-Curie Action of the European Commission (grant 743562). X. De Tiège is Postdoctorate Clinical Master Specialist at the FRS-FNRS. The MEG project at the CUB Hôpital Erasme is financially supported by the Fonds Erasme (Research Convention “Les Voies du Savoir”).

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Authors and Affiliations

  1. Laboratoire de Cartographie fonctionnelle du Cerveau, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium

    Tim Coolen, Alexandru M. Dumitrescu, Mathieu Bourguignon, Vincent Wens, Charline Urbain & Xavier De Tiège

  2. Laboratoire Cognition Langage et Développement, UNI—ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium

    Mathieu Bourguignon

  3. Brain and Language, BCBL, Basque Center on Cognition, 20009, San Sebastian, Spain

    Mathieu Bourguignon

  4. Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium

    Charline Urbain

  5. Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles, 808 Lennik Street, 1070, Brussels, Belgium

    Vincent Wens & Xavier De Tiège

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  1. Tim Coolen
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Correspondence to Xavier De Tiège.

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X. De Tiège is a consultant for Elekta MEGIN. T. Coolen, A.M. Dumitrescu, M. Bourguignon, V. Wens and C. Urbain declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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T. Coolen and A.M. Dumitrescu contributed equally to this work.

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Coolen, T., Dumitrescu, A.M., Bourguignon, M. et al. Presurgical electromagnetic functional brain mapping in refractory focal epilepsy. Z. Epileptol. 31, 203–212 (2018). https://doi.org/10.1007/s10309-018-0189-7

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  • DOI: https://doi.org/10.1007/s10309-018-0189-7

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