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  Zoomed MRI guided by combined EEG/MEG source analysis: A multimodal approach for optimizing presurgical epilepsy work-up and its application in a multi-focal epilepsy patient case study

Aydin, Ü., Rampp, S., Wollbrink, A., Kugel, H., Cho, J.-H., Knösche, T. R., et al. (2017). Zoomed MRI guided by combined EEG/MEG source analysis: A multimodal approach for optimizing presurgical epilepsy work-up and its application in a multi-focal epilepsy patient case study. Brain Topography, 30(4), 417-433. doi:10.1007/s10548-017-0568-9.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0002-C762-F Version Permalink: http://hdl.handle.net/21.11116/0000-0004-E23A-C
Genre: Journal Article

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 Creators:
Aydin, Ü. 1, 2, Author
Rampp, S. 3, Author
Wollbrink, A. 1, Author
Kugel, H. 4, Author
Cho, Jae-Hyun5, Author              
Knösche, Thomas R.5, Author              
Grova, C. 2, 6, 7, Author
Wellmer, J. 8, Author
Affiliations:
1Institute for Biomagnetism und Biosignalanalysis, Münster University, Germany, ou_persistent22              
2Multimodal Functional Imaging Lab, Department of Physics and PERFORM Centre, Concordia University, Montreal, QC, Canada, ou_persistent22              
3Department of Neurosurgery, University Hospital Erlangen, Germany, ou_persistent22              
4Department of Clinical Radiology, University Hospital Münster, Germany, ou_persistent22              
5Methods and Development Group MEG and EEG - Cortical Networks and Cognitive Functions, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_persistent22              
6Multimodal Functional Imaging Lab, Department of Biomedical Engineering, McGill University, Montréal, QC, Canada, ou_persistent22              
7Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada, ou_persistent22              
8Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Germany, ou_persistent22              

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Free keywords: Combined EEG/MEG; Zoomed MRI; Epileptic activity; Source reconstruction; Realistic finite element head model; Skull conductivity calibration; Focal cortical dysplasia type IIb
 Abstract: In recent years, the use of source analysis based on electroencephalography (EEG) and magnetoencephalography (MEG) has gained considerable attention in presurgical epilepsy diagnosis. However, in many cases the source analysis alone is not used to tailor surgery unless the findings are confirmed by lesions, such as, e.g., cortical malformations in MRI. For many patients, the histology of tissue resected from MRI negative epilepsy shows small lesions, which indicates the need for more sensitive MR sequences. In this paper, we describe a technique to maximize the synergy between combined EEG/MEG (EMEG) source analysis and high resolution MRI. The procedure has three main steps: (1) construction of a detailed and calibrated finite element head model that considers the variation of individual skull conductivities and white matter anisotropy, (2) EMEG source analysis performed on averaged interictal epileptic discharges (IED), (3) high resolution (0.5 mm) zoomed MR imaging, limited to small areas centered at the EMEG source locations. The proposed new diagnosis procedure was then applied in a particularly challenging case of an epilepsy patient: EMEG analysis at the peak of the IED coincided with a right frontal focal cortical dysplasia (FCD), which had been detected at standard 1 mm resolution MRI. Of higher interest, zoomed MR imaging (applying parallel transmission, ‘ZOOMit’) guided by EMEG at the spike onset revealed a second, fairly subtle, FCD in the left fronto-central region. The evaluation revealed that this second FCD, which had not been detectable with standard 1 mm resolution, was the trigger of the seizures.

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Language(s): eng - English
 Dates: 2016-12-262017-04-252017-05-16
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1007/s10548-017-0568-9
PMID: 28510905
PMC: PMC5495874
Other: Epub 2017
 Degree: -

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Project name : -
Grant ID : WO1425/7-1
Funding program : -
Funding organization : German Research Foundation (DFG)
Project name : -
Grant ID : RA2062/1-1
Funding program : -
Funding organization : German Research Foundation (DFG)
Project name : -
Grant ID : K062-11
Funding program : FoRUM research Grant
Funding organization : Medical Faculty of Ruhr University Bochum
Project name : -
Grant ID : -
Funding program : -
Funding organization : Savoy foundation and FRQS (The Fonds de recherche du Québec – Santé) postdoctoral fellowships
Project name : -
Grant ID : -
Funding program : -
Funding organization : The Förderverein Ruhr-Epileptologie e.V
Project name : Advancing brain research in children’s developmental neurocognitive disorders / CHILDBRAIN
Grant ID : 641652
Funding program : Horizon 2020
Funding organization : European Commission (EC)

Source 1

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Title: Brain Topography
  Other : Brain Topogr.
Source Genre: Journal
 Creator(s):
Affiliations:
Publ. Info: New York, NY : Human Sciences Press
Pages: - Volume / Issue: 30 (4) Sequence Number: - Start / End Page: 417 - 433 Identifier: ISSN: 0896-0267
CoNE: https://pure.mpg.de/cone/journals/resource/954925560559