Magnetoencephalography (MEG) in Epilepsy and Neurosurgery

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Background

Magnetoencephalography (MEG) is a powerful neurophysiological imaging technique, with wide ranging applications in the fields of neuroscience and medicine. Its current principal clinical use is in the fields of epilepsy and neurosurgery; specifically, it is routinely used to estimate the epileptogenic zone (EZ) and map functionally eloquent cortex.

There is strong evidence in the literature for the use of MEG in presurgical evaluation of patients with drug-resistant epilepsy, especially in determining good candidates for epilepsy surgery and intracranial EEG (ICEEG) study, guiding the placement of invasive electrodes to improve the yield of ICEEG, and estimating the location and extent of the EZ to aid in determining the resection margins. Clinical value of MEG in other areas of epilepsy management and surgery is less established. However, some research results suggest that MEG may facilitate the study of various aspects of the disease and be used in the diagnosis and characterization of epilepsy types, in the monitoring of treatment response and predicting treatment outcome.

Regarding the mapping of functionally eloquent cortex, there is strong research and clinical evidence supporting the use of MEG for the assessment of the hemispheric dominance of language function, and localization of primary sensorimotor cortex. These procedures are in routine clinical use in many epilepsy centers. The evidence for the MEG-based localization of receptive and expressive language functions, while existent, is not as strong, and is only seldom used in clinical practice to provide supporting information. Currently, only few MEG studies have been conducted on presurgical mapping of memory function, providing preliminary evidence on its clinical utility. Functional mapping of visual and auditory cortex is used mostly in basic research studies and is of limited clinical value.

For this Research Topic, we solicit original research articles, review papers, case reports and opinion pieces within the scope of “MEG in epilepsy and neurosurgery.” We welcome contributions from different clinical MEG centers regarding their routine practice and results. We also seek articles concerning the novel and emerging applications of MEG, such as estimation of EZ based on high frequency oscillations, pathological slow wave activity, phase-amplitude coupling and other measures as well as ictal MEG for localization of seizure onset zone; advanced mapping of functionally eloquent cortex; application of distributed source analysis methods and beamformers; MEG source connectivity-based approaches; and other emerging applications of MEG in epilepsy (e.g. diagnosing epilepsy type, monitoring treatment response and predicting its outcome, and others). Methods papers aimed at increasing the productivity and efficiency of MEG in epilepsy, such as automatic detection and classification of epileptiform discharges and other relevant signal features, automatic selection and clustering of dipoles and other methods, are also welcome. We also seek papers on application of emerging MEG instrumentation (e.g. wearable devices) in epilepsy.

We hope that this collection of articles will demonstrate the true potential of MEG, emphasizing its unique added value in epilepsy presurgical evaluation, further promote and optimize the clinical use of MEG, and point to future research opportunities beyond the current status and scope.

Keywords: magnetoencephalography, MEG; magnetic source imaging, MSI, epilepsy, epilepsy surgery, functional cortical mapping, neurosurgery

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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