the pros and cons of eeg and meg source imagingaz9194.vo.msecnd.net/pdfs/111201/501.02.pdfthe pros...
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![Page 1: The Pros and Cons of EEG and MEG Source Imagingaz9194.vo.msecnd.net/pdfs/111201/501.02.pdfThe Pros and Cons of EEG and MEG Source Imaging 12-6-2011 John S. Ebersole, M.D. The University](https://reader031.vdocuments.us/reader031/viewer/2022020108/5abd49037f8b9a3a428b9273/html5/thumbnails/1.jpg)
The Pros and Cons of
EEG and MEG Source Imaging 12-6-2011
John S. Ebersole, M.D.
The University of Chicago
Illinois MEG Center
Alexian Brothers Medical Center
American Epilepsy Society | Annual Meeting
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Disclosure
Compumedics USA Speaker
American Epilepsy Society | Annual Meeting
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Learning Objectives
• Identify the biophysical properties of EEG and MEG that contribute to their relative abilities
to record epileptiform brain activity.
• Determine how these strengths and weaknesses affect the overall clinical
usefulness of EEG and MEG source imaging.
American Epilepsy Society | Annual Meeting
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Background 1
Localization of the epileptogenic focus is
the critical and rate-limiting step in an
evaluation for epilepsy surgery.
A variety of non-invasive localization
techniques are currently available –
MRI, PET, SPECT, fMRI, MEG, EEG
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Background 2
Only EEG and MEG are:
Direct measures of epileptic pathophysiology
Performed in real time with msec resolution
Provide temporal sequencing of activity, e.g.
propagation
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Biophysics of
EEG and MEG Fields
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Sources of Magnetic
Fields
Basic Principles of MEG
Orientation of
Neurons
Skin
Skull
CSF
Cortex Active neurons
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EEG Sensitivity
EEG requires >10 sq cm
EEG visualizes gyral and unopposed fissural sources, small sulcal sources cancel
EEG dipoles are deep to source cortex
For large sources, EEG favors center of activity
EEG is sensitive to all source orientations, but radial more so than tangential
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A B
D
C
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C A B
D
C
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MEG Sensitivity
MEG requires 4-6 sq cm
MEG visualizes large unopposed sulci, fissures,
and tangential planes
MEG dipoles more accurately reflect source
depth
For large sources, MEG can favor an edge
Sensitive to a tangential source orientation
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MEG and EEG Fields
EEG field orientation is the same as the
generator pyramidal cells
MEG field orientation is orthogonal to that of
the generator pryramidal cells
MEG field maxima are closer together than
associated EEG field maxima
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MEG/EEG Complements
Volume conductor effects - + MEG
Spatial sampling - + MEG
Temporal sampling - + EEG
Source area - + MEG
Radial sensitivity - + EEG
Tangential sensitivity - + MEG
Deep source sensitivity - + EEG
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Source Reconstruction
3D reconstruction of cortical sources of EEG or MEG requires a biophysical model
Multiple models:
Simple, point source – dipole
(unrealistic, easy to use and interpret)
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Source Reconstruction
3D reconstruction of cortical sources of EEG
or MEG requires a biophysical model
Multiple models:
Complex, extended source – current density
(pseudo-realistic, needs “thresholding”)
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MEG vs. EEG
Most patients have both EEG spikes and
MEG spikes
Their dipole source models commonly differ
by:
Orientation – radial vs tangential dominant
Location – mm vs cm
Timing – either can lead or lag
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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Practice Parameters
When the MEG and EEG fields are
synchronous, source characterization must
be a synthesis of MEG’s more accurate
dipole location and EEG’s more complete
dipole orientation.
When spike/seizure fields are radial there will
likely be no model-worthy MEG field.
EEG source modeling should be performed
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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MEG/EEG Interpretation Scenarios
MEG EEG Synchrony Interpret: EEG adds
Tan Tan Sync nothing
Tan - - nothing
Tan Rad Sync radial comp
- Rad - location and orient *
Tan Rad MEG leads rad comp of propag
Tan Rad EEG leads origin and rad comp *
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Practice Parameter
When MEG and EEG fields are asynchronous,
dipole models of the leading field define
source origin, while those of the lagging field
help to characterize propagation.
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MEG/EEG Interpretation Scenarios
In 2 of 6 scenarios, MEG provides superior or
the only localization of the spike source
In 2 of 6 scenarios, EEG provides superior or
the only localization of spike origin
In 2 of 6 scenarios, MEG and EEG each add
to the completeness/accuracy of the spike
interpretation
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Bottom Line Comparison
MEG sees a window of brain activity (tangential fields) with more sensitivity and clarity than EEG
Localization of that activity with source models is
more accurate than with EEG EEG sees a more complete picture of brain activity
(tangential and radial), but less clearly than MEG Localization with EEG source models is less
precise, but orientation information is more complete than MEG
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Conclusion
MEG and EEG strengths are complementary
and compensate for the weaknesses
of the other technology!