The overarching goal of this proposal is to use evidence-based methodology to evaluate Magnetoencephalography (MEG) as a clinical tool for evaluation and planning of surgical treatment for patients with epilepsy. In patients where interictal spikes or ictal activity are not detectable, we will evaluate protocols for localizing epileptic cortex during brief MEG exams, by 1) localizing abnormal high frequency oscillations and slow waves using advanced analysis methods (LCMV beamformer and MR-FOCUSS);and 2) withdrawal of a short-acting barbiturate or 3) withdrawal of vagus nerve stimulation. We will validate these advanced MEG analysis techniques and the existing single equivalent current dipole (ECD) method against electrocorticography (ECoG), and determine their sensitivities and specificities. To benefit patients with complex patterns of partial epilepsy, we will use MEG to study the timing and propagation of spikes, and use diffusion tensor imaging (DTI) tractography to identify the underlying network to distinguish multifocal epilepsy from unifocal epilepsy with consistent patterns of propagation. We will determine if MEG, alone, is sufficient to replace invasive intraoperative mapping for intractable epilepsy by comparison of simultaneous MEG and ECoG localizations of interictal spikes. Similarity and distribution of spike waveforms observed at the locations of the ECoG electrodes will be compared to MEG signals after a spatial filter (LCMV beamformer) has been applied. We will also validate the sensitivity and specificity of functional MEG language and memory imaging as a noninvasive alternative to the intracarotid amobarbital procedure (IAP, Wada test) by demonstrating that the spatial and temporal resolution provided by MEG is necessary to image the sequence and evolution of cortical source activity involved in language and memory;specifically 1) that MEG language and memory laterality indices agree with those from the Wada test;2) that MEG language and memory imaging agrees with direct electro-cortical stimulation mapping (DECS);and 3) that MEG language imaging protocols are reliable (testing intrasubject reproducibility). We will determine the sensitivity and specificity of advanced analytical methods by comparison with the established ECD fit (when feasible) and semiology to electrocorticography. We will accomplish these goals by means of examining a set of readily testable hypotheses. Thus the completion of the proposed studies will establish MEG as a useful and reliable diagnostic tool.

Public Health Relevance

The overall goal of this proposal is to extend MEG as a clinical tool for evaluating and planning treatment for patients with epilepsy. The objective of this study is to establish MEG as a reliable clinical diagnostic tool.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS030914-14
Application #
7897859
Study Section
Special Emphasis Panel (ZRG1-SBIB-U (92))
Program Officer
Babcock, Debra J
Project Start
1993-01-01
Project End
2012-06-30
Budget Start
2010-07-01
Budget End
2012-06-30
Support Year
14
Fiscal Year
2010
Total Cost
$718,662
Indirect Cost
Name
Henry Ford Health System
Department
Type
DUNS #
073134603
City
Detroit
State
MI
Country
United States
Zip Code
48202
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Elisevich, Kost; Shukla, Neetu; Moran, John E et al. (2011) An assessment of MEG coherence imaging in the study of temporal lobe epilepsy. Epilepsia 52:1110-9
Hsieh, Li; Young, Richard A; Bowyer, Susan M et al. (2009) Conversation effects on neural mechanisms underlying reaction time to visual events while viewing a driving scene: fMRI analysis and asynchrony model. Brain Res 1251:162-75
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Babajani-Feremi, Abbas; Soltanian-Zadeh, Hamid; Moran, John E (2008) Integrated MEG/fMRI model validated using real auditory data. Brain Topogr 21:61-74
Wilson, Tony W; Leuthold, Arthur C; Moran, John E et al. (2007) Reading in a deep orthography: neuromagnetic evidence for dual-mechanisms. Exp Brain Res 180:247-62
Balakrishnan, Guruswamy; Grover, Kavita M; Mason, Karen et al. (2007) A retrospective analysis of the effect of general anesthetics on the successful detection of interictal epileptiform activity in magnetoencephalography. Anesth Analg 104:1493-7, table of contents
Grover, K M; Bowyer, S M; Rock, J et al. (2006) Retrospective review of MEG visual evoked hemifield responses prior to resection of temporo-parieto-occipital lesions. J Neurooncol 77:161-6

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