Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Midori Nakajima, Simeon Wong, Elysa Widjaja, Shiro Baba, Tohru Okanishi, Lynne Takada, Yosuke Sato, Hiroki Iwata, Maya Sogabe, Hikaru Morooka, Robyn Whitney, Yuki Ueda, Tomoshiro Ito, Kazuyori Yagyu, Ayako Ochi, O. Carter Snead, James T. Rutka, James M. Drake, Sam Doesburg, Fumiya Takeuchi, Hideaki Shiraishi, Hiroshi Otsubo
ObjectiveTo investigate whether advanced dynamic statistical parametric mapping (AdSPM) using magnetoencephalography (MEG) can better localize focal cortical dysplasia at bottom of sulcus (FCDB).MethodsWe analyzed 15 children with diagnosis of FCDB in surgical specimen and 3 T MRI by using MEG. Using AdSPM, we analyzed a ±50 ms epoch relative to each single moving dipole (SMD) and applied summation technique to estimate the source activity. The most active area in AdSPM was defined as the location of AdSPM spike source. We compared spatial congruence between MRI-visible FCDB and (1) dipole cluster in SMD method; and (2) AdSPM spike source.ResultsAdSPM localized FCDB in 12 (80%) of 15 children whereas dipole cluster localized six (40%). AdSPM spike source was concordant within seizure onset zone in nine (82%) of 11 children with intracranial video EEG. Eleven children with resective surgery achieved seizure freedom with follow-up period of 1.9 ± 1.5 years. Ten (91%) of them had an AdSPM spike source in the resection area.ConclusionAdSPM can noninvasively and neurophysiologically localize epileptogenic FCDB, whether it overlaps with the dipole cluster or not.SignificanceThis is the first study to localize epileptogenic FCDB using MEG.
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