Localization of Interictal Epileptiform Activity Using Magnetoencephalography with Synthetic Aperture Magnetometry in Patients with a Vagus Nerve Stimulator

Frontiers in Neurology

Robert Joseph Kotloski¹  Jennifer Rebecca Stapleton-Kotloski²  Dwayne eGodwin²  Daniel E Couture²  Cormac A O'Donovan²  Cassandra eCornell²  Gautam ePopli²  Jane A Boggs² 

[1] University of Wisconsin School of Medicine and Public Health;Wake Forest University School of Medicine;William S Middleton Memorial Veterans Hospital;

关键词: Epilepsy;    Magnetoencephalography;    synthetic aperture magnetometry;    vagus nerve stimulator;    epilepsy surgical evaluation;   

DOI  :  10.3389/fneur.2014.00244

来源: DOAJ

【 摘 要 】

Magnetoencephalography (MEG) provides useful and non-redundant information in the evaluation of patients with epilepsy, and in particular during the pre-surgical evaluation of pharmaco-resistant epilepsy. Vagus nerve stimulation (VNS) is a common treatment for pharmaco-resistant epilepsy.However interpretation of MEG recordings from patients with a VNS is challenging due to the severe magnetic artifacts produced by the VNS. We used synthetic aperture magnetometry (g2) (SAM(g2), an adaptive beamformer that maps the excessive kurtosis, to map interictal spikes to the coregistered MRI image, despite the presence of contaminating VNS artifact. We present a series of eight patients with a VNS who underwent MEG recording. Localization of interictal epileptiform activity by SAM(g2) is compared to invasive electrophysiologic monitoring and other localizing approaches. While the raw MEG recordings were uninterpretable, analysis of the recordings with SAM(g2) identified foci of peak kurtosis and source signal activity that was unaffected by the VNS artifact. SAM(g2) analysis of MEG recordings in patients with a VNS produces interpretable results and expands the use of MEG for the pre-surgical evaluation of epilepsy.

【 授权许可】

Unknown