Magnetoencephalography in Stroke Recovery and Rehabilitation

Magnetoencephalography (MEG) is a non-invasive neurophysiological technique used to study the cerebral cortex. Currently, MEG is mainly used clinically to localize epileptic foci and eloquent brain areas in order to avoid damage during neurosurgery. MEG might, however, also be of help in monitoring stroke recovery and rehabilitation. This review focuses on experimental use of MEG in neurorehabilitation. MEG has been employed to detect early modifications in neuroplasticity and connectivity, but there is insufficient evidence as to whether these methods are sensitive enough to be used as a clinical diagnostic test. MEG has also been exploited to derive the relationship between brain activity and movement kinematics for a motor-based brain-computer interface. In the current body of experimental research, MEG appears to be a powerful tool in neurorehabilitation, but it is necessary to produce new data to confirm its clinical utility

Multimodal imaging of language perception

This Thesis draws together several lines of research by examining language perception in the same individuals using three neuroimaging methods: magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG). The MEG experiments conducted in this Thesis demonstrated that neural processing of written and spoken words converges to the superior temporal cortex following initial modality-specific analysis. In both reading and speech perception, the superior temporal cortex is involved in processing word meaning at ∼250-450 ms in the left hemisphere and after ∼450 ms bilaterally. The data thus support a view of a largely shared semantic system in auditory and visual language perception, in line with the assumption that reading acquisition makes use of the neural systems originally developed for speech perception during evolution and in individual language development. The MEG experiments on reading morphologically complex words showed that the left superior temporal activation was enhanced for the morphologically complex words at ∼200-700 ms. The results suggest that the majority of inflected words in the highly inflected Finnish language are represented in a decomposed form and that the decomposition process requires additional neural resources. Only very high-frequency inflected words may acquire full-form representations. The MEG results on parafoveal preview in reading indicated that neural processing of written words in the left hemisphere is affected by a preview of words in the right visual field. The underlying neural mechanism may facilitate reading of connected text in natural conditions. In a direct comparison, MEG and fMRI showed diverging activation patterns in a reading task although the same individuals were performing the same task. Based on the similarity of the EEG responses recorded simultaneously with both MEG and fMRI, the participants were performing the task similarly during the two recordings. The divergent MEG and fMRI results cannot be attributed to differences in the experimental procedures or language since these factors were controlled. Rather, they are likely to reflect actual dissimilarities in the way neural activity in a high-level cognitive task is picked up by MEG evoked responses and fMRI signals

Language Mapping With Magnetoencephalography: An Update on the Current State of Clinical Research and Practice With Considerations for Clinical Practice Guidelines

Numerous studies have shown that language processing is not limited to a few brain areas. Visual or auditory stimuli activate corresponding cortical areas, then memory identifies the word or image, Wernicke\u27s and Broca\u27s areas support the processing for either reading/listening or speaking and many areas of the brain are recruited. Determining how a normal person processes language helps clinicians and scientist to understand how brain pathologies such as tumor or stroke can affect changes in language processing. Patients with epilepsy may develop atypical language organization. Over time, the chronic nature of epileptic activity, or changes from a tumor or stroke, can result in a shift of language processing area from the left to the right hemisphere, or re-routing of language pathways from traditional to non-traditional areas within the dominant left hemisphere. It is important to determine where these language areas are prior to brain surgery. MEG evoked responses reflecting cerebral activation of receptive and expressive language processing can be localized using several different techniques: Single equivalent current dipole, current distribution techniques or beamformer techniques. Over the past 20 years there have been at least 25 validated MEG studies that indicate MEG can be used to determine the dominant hemisphere for language processing. The use of MEG neuroimaging techniques is needed to reliably predict altered language networks in patients and to provide identification of language eloquent cortices for localization and lateralization necessary for clinical care

The relationship between MEG and fMRI

In recent years functional neuroimaging techniques such as fMRI, MEG, EEG and PET have provided researchers with a wealth of information on human brain function. However none of these modalities can measure directly either the neuro-electrical or neuro-chemical processes that mediate brain function. This means that metrics directly reflecting brain ‘activity’ must be inferred from other metrics (e.g. magnetic fields (MEG) or haemodynamics (fMRI)). To overcome this limitation, many studies seek to combine multiple complementary modalities and an excellent example of this is the combination of MEG (which has high temporal resolution) with fMRI (which has high spatial resolution). However, the full potential of multi-modal approaches can only be truly realised in cases where the relationship between metrics is known. In this paper, we explore the relationship between measurements made using fMRI and MEG. We describe the origins of the two signals as well as their relationship to electrophysiology. We review multiple studies that have attempted to characterise the spatial relationship between fMRI and MEG, and we also describe studies that exploit the rich information content of MEG to explore differing relationships between MEG and fMRI across neural oscillatory frequency bands. Monitoring the brain at “rest” has become of significant recent interest to the neuroimaging community and we review recent evidence comparing MEG and fMRI metrics of functional connectivity. A brief discussion of the use of magnetic resonance spectroscopy (MRS) to probe the relationship between MEG/fMRI and neurochemistry is also given. Finally, we highlight future areas of interest and offer some recommendations for the parallel use of fMRI and MEG

Network perspectives on epilepsy using EEG/MEG source connectivity

The evolution of EEG/MEG source connectivity is both, a promising, and controversial advance in the characterization of epileptic brain activity. In this narrative review we elucidate the potential of this technology to provide an intuitive view of the epileptic network at its origin, the different brain regions involved in the epilepsy, without the limitation of electrodes at the scalp level. Several studies have confirmed the added value of using source connectivity to localize the seizure onset zone and irritative zone or to quantify the propagation of epileptic activity over time. It has been shown in pilot studies that source connectivity has the potential to obtain prognostic correlates, to assist in the diagnosis of the epilepsy type even in the absence of visually noticeable epileptic activity in the EEG/MEG, and to predict treatment outcome. Nevertheless, prospective validation studies in large and heterogeneous patient cohorts are still lacking and are needed to bring these techniques into clinical use. Moreover, the methodological approach is challenging, with several poorly examined parameters that most likely impact the resulting network patterns. These fundamental challenges affect all potential applications of EEG/MEG source connectivity analysis, be it in a resting, spiking, or ictal state, and also its application to cognitive activation of the eloquent area in presurgical evaluation. However, such method can allow unique insights into physiological and pathological brain functions and have great potential in (clinical) neuroscience

Spatiotemporal techniques in multimodal imaging for brain mapping and epilepsy

Thesis (Ph.D.)--Boston UniversityThis thesis explored multimodal brain imaging using advanced spatiotemporal techniques. The first set of experiments were based on simulations. Much controversy exists in the literature regarding the differences between magnetoencephalography (MEG) and electroencephalography (EEG}, both practically and theoretically. The differences were explored using simulations that evaluated the expected signal-to-noise ratios from reasonable brain sources. MEG and EEG were found to be complementary, with each modality optimally suited to image activity from different areas of the cortical surface. Consequently, evaluations of epileptic patients and general neuroscience experiments will both benefit from simultaneously collected MEG/EEG. The second set of experiments represent an example of MEG combined with magnetic resonance imaging (MRI) and functional MRI (fMRI) applied to healthy subjects. The study set out to resolve two questions relating to shape perception. First, does the brain activate functional areas sequentially during shape perception, as has been suggested in recent literature? Second, which , if any, functional areas are active time-locked with reaction-time? The study found that functional areas are non-sequentially activated, and that area IT is active time-locked with reaction-time. These two points, coupled with the method for multimodal integration , can help further develop our understanding of shape perception in particular, and cortical dynamics in general for healthy subjects. Broadly, these two studies represent practical guidelines for epilepsy evaluations and brain mapping studies. For epilepsy studies, clinicians could combine MEG and EEG to maximize the probability of finding the source of seizures. For brain mapping in general, EEG, MEG, MRI and fMRI can be combined in the methods outlined here to obtain more sophisticated views of cortical dynamics

Sensorimotor Mapping With MEG: An Update on the Current State of Clinical Research and Practice With Considerations for Clinical Practice Guidelines

Published: November 2020In this article, we present the clinical indications and advances in the use of magnetoencephalography to map the primary sensorimotor (SM1) cortex in neurosurgical patients noninvasively. We emphasize the advantages of magnetoencephalography over sensorimotor mapping using functional magnetic resonance imaging. Recommendations to the referring physicians and the clinical magnetoencephalographers to achieve appropriate sensorimotor cortex mapping using magnetoencephalography are proposed. We finally provide some practical advice for the use of corticomuscular coherence, corticokinematic coherence, and mu rhythm suppression in this indication. Magnetoencephalography should now be considered as a method of reference for presurgical functional mapping of the sensorimotor cortex.X. De Ti ege is Post-doctorate Clinical Master Specialist at the Fonds de la Recherche Scientifique (FRS-FNRS, Brussels, Belgium). M. Bourguignon has been supported by the program Attract of Innoviris (Grant 2015-BB2B-10), by the Spanish Ministry of Economy and Competitiveness (Grant PSI2016- 77175-P), and by the Marie Sk1odowska-Curie Action of the European Commission (Grant 743562). H. Piitulainen has been supported by the Academy of Finland (Grants #266133 and #296240), the Jane and Aatos Erkko Foundation, and the Emil Aaltonen Foundation. The authors thank Professor Riitta Hari for her support in most of the research works published by the authors and presented in this article. The MEG project at the CUB H^opital Erasme is financially supported by the Fonds Erasme (Research convention “Les Voies du Savoir,” Fonds Erasme, Brussels, Belgium)