Recording temporal lobe epileptic activity with MEG in a light-weight magnetic shield

Abstract

Objective To assess the interictal epileptic discharges (IEDs) detection rate of magnetoencephalography (MEG) recordings performed in a new light-weight magnetic shielding (LMSR) concept in a large group of consecutive patients with presumed mesiotemporal lobe epilepsy (MTLE). Methods Thirty-eight patients (23 women; age range: 6–63 years) with presumed MTLE were prospectively studied. MEG investigations were performed with the 306-channel Elekta Neuromag ® MEG-system installed in a normal hospital environment into a LMSR (MaxShield, Elekta Oy). Equivalent current dipoles (ECD, g/% >80%) corresponding to epileptic events were fitted to each patient's spherical head model at IEDs onset and peak and then superimposed on the patient's co-registered MRI. Results IEDs were observed in 26 out of 38 patients (68.4%). Temporal ECDs were mesial in 14 patients, anterior in 23 patients and posterior in 8 patients. Interestingly, in 6 patients, ECDs fitted at spike-onset were localized in the hippocampus while at the peak of the spike, they had an anterior temporal location. Conclusions MEG using LMSR provides adequate signal to noise ratio (SNR) to allow reliable detection and localization of single epileptic abnormalities on continuous MEG data in 68% of patients with presumed MTLE. Moreover, mesial temporal epileptic sources were detected in 54% of patients with abnormal MEG. The SNR of MEG data acquired using the LMSR is therefore suitable for the non-invasive localization of epileptic foci in patients with MTLE. The use of LMSR, which are cheaper and smaller than conventional MSR, should facilitate the development of MEG in clinical environments.