Interictal spike localization for epilepsy surgery using magnetoencephalography beamforming

Rui Li; Chris Plummer; Simon J Vogrin; William P Woods; Levin Kuhlmann; Ray Boston; David T J Liley; Mark J Cook; David B Grayden

doi:10.1016/j.clinph.2020.12.019

Interictal spike localization for epilepsy surgery using magnetoencephalography beamforming

Clin Neurophysiol. 2021 Apr;132(4):928-937. doi: 10.1016/j.clinph.2020.12.019. Epub 2021 Feb 3.

Authors

Rui Li¹, Chris Plummer², Simon J Vogrin², William P Woods³, Levin Kuhlmann⁴, Ray Boston⁵, David T J Liley⁶, Mark J Cook⁷, David B Grayden⁸

Affiliations

¹ Department of Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia. Electronic address: ruil3@student.unimelb.edu.au.
² Department of Medicine, The University of Melbourne, Fitzroy, VIC, Australia; Department of Neurology, St. Vincent's Hospital, Fitzroy, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
³ School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
⁴ Faculty of Information Technology, Monash University, Clayton, VIC 3168, Australia.
⁵ Department of Medicine, The University of Melbourne, Fitzroy, VIC, Australia; Department of Clinical Studies, New Bolton Centre, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
⁶ Department of Medicine, The University of Melbourne, Fitzroy, VIC, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia.
⁷ Department of Medicine, The University of Melbourne, Fitzroy, VIC, Australia; Department of Neurology, St. Vincent's Hospital, Fitzroy, VIC, Australia; Graeme Clark Institute for Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia.
⁸ Department of Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia; Department of Medicine, The University of Melbourne, Fitzroy, VIC, Australia; Graeme Clark Institute for Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia.

PMID: 33636608
DOI: 10.1016/j.clinph.2020.12.019

Abstract

Objective: Magnetoencephalography (MEG) kurtosis beamforming is an automated localization method for focal epilepsy. Visual examination of virtual sensors, which are source activities reconstructed by beamforming, can improve performance but can be time-consuming for neurophysiologists. We propose a framework to automate the method and evaluate its effectiveness against surgical resections and outcomes.

Methods: We retrospectively analyzed MEG recordings of 13 epilepsy surgery patients who had one-year minimum post-operative follow-up. Kurtosis beamforming was applied and manual inspection was confined to morphological clusters. The region with the Maximum Interictal Spike Frequency (MISF) was validated against prospectively modelled sLORETA solutions and surgical resections linked to outcome.

Results: Our approach localized spikes in 12 out of 13 patients. In eight patients with Engel I surgical outcomes, beamforming MISF regions were concordant with surgical resection at overlap level for five patients and at lobar level for three patients. The MISF regions localized to spike onset and propagation modelled by sLORETA in two and six patients, respectively.

Conclusions: Automated beamforming using MEG can predict postoperative seizure freedom at the lobar level but tends to localize propagated MEG spikes.

Significance: MEG beamforming may contribute to non-invasive procedures to predict surgical outcome for patients with drug-refractory focal epilepsy.

Keywords: Beamforming; Epilepsy surgery; Interictal spikes; MEG; Source localization.

MeSH terms

Adult
Brain / physiopathology
Brain / surgery*
Epilepsy / physiopathology
Epilepsy / surgery*
Female
Humans
Magnetoencephalography
Male
Retrospective Studies
Seizures / physiopathology
Seizures / surgery*