Abstract
Magnetoencephalography (MEG) is clinically used to localize interictal spikes in discrete brain areas of epilepsy patients through the equivalent current dipole (ECD) method, but does not account for the temporal dynamics of spike activity. Recent studies found that interictal spike propagation beyond the temporal lobe may be associated with worse postsurgical outcomes, but studies using whole-brain data such as in MEG remain limited. In this pilot study, we developed a tool that visualizes the spatiotemporal dynamics of interictal MEG spikes normalized to spike-free sleep activity to assess their onset and propagation patterns in patients with temporal lobe epilepsy (TLE). We extracted interictal source data containing focal epileptiform activity in awake and asleep states from seven patients whose MEG ECD clusters localized to the temporal lobe and normalized the data against spike-free sleep recordings. We calculated the normalized activity over time per cortical label, confirmed maximal activity at onset, and mapped the activity over a 10 ms interval onto each patient’s brain using a custom-built Multi-Modal Visualization Tool. The onset of activity in all patients appeared near the clinically determined epileptogenic zone. By 10 ms, four of the patients had propagated source activity restricted to within the temporal lobe, and three had propagated source activity spread to extratemporal regions. Using this tool, we show that noninvasively identifying the onset and propagation of interictal spike activity in MEG can be achieved, which may help provide further insight into epileptic networks and guide surgical planning and interventions in patients with TLE.
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De-identified data not published within this manuscript will be shared with any qualified investigator upon reasonable written request.
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Acknowledgements
The authors thank Callisto Cordray for her technical assistance in the acquisition of recordings as well as for organizing and navigating the MMVT program files.
Funding
OT received salary and research support from the NIH P20GM130447 Cognitive Neuroscience and Development of Aging (CONDA) Award. VG received research funding from the NIH P20GM130447 Cognitive Neuroscience and Development of Aging (CoNDA) Award.
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DZ, VG, and NP wrote the main manuscript text, prepared the figures, and reviewed and revised. All authors reviewed the manuscript.
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N.P. and S.S. are co-founders and shareholders of FIND Surgical Sciences Inc, a startup implementing a clinical decision support platform for epilepsy. All other authors report no competing interests.
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The Institutional Review Board of the University of Nebraska Medical Center provided ethical approval, including waiver of informed consent, for the retrospective collection of electronic health record, imaging, and neurophysiologic data for all of the patients in this study (IRB #0714-21-EP).
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Zhou, D.J., Gumenyuk, V., Taraschenko, O. et al. Visualization of the Spatiotemporal Propagation of Interictal Spikes in Temporal Lobe Epilepsy: A MEG Pilot Study. Brain Topogr 37, 116–125 (2024). https://doi.org/10.1007/s10548-023-01017-z
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DOI: https://doi.org/10.1007/s10548-023-01017-z