Idiopathic/genetic generalized epilepsy (IGE/GGE) is characterized by seizures, which start and r... more Idiopathic/genetic generalized epilepsy (IGE/GGE) is characterized by seizures, which start and rapidly engage widely distributed networks, and result in symptoms such as absences, generalized myoclonic and primary generalized tonic-clonic seizures. Although routine magnetic resonance imaging is apparently normal, many studies have reported structural alterations in IGE/GGE patients using diffusion tensor imaging and voxel-based morphometry. Changes have also been reported in functional networks during generalized spike wave discharges. However, network function in the resting-state without epileptiforme discharges has been less well studied. We hypothesize that resting-state networks are more representative of the underlying pathophysiology and abnormal network synchrony. We studied functional network connectivity derived from whole-brain magnetoencephalography recordings in thirteen IGE/GGE and nineteen healthy controls. Using graph theoretical network analysis, we found a widespr...
Dynamic causal modeling (DCM) is a method to non-invasively assess effective connectivity between... more Dynamic causal modeling (DCM) is a method to non-invasively assess effective connectivity between brain regions. 'Musicogenic epilepsy' is a rare reflex epilepsy syndrome in which seizures can be elicited by musical stimuli and thus represents a unique possibility to investigate complex human brain networks and test connectivity analysis tools. We investigated effective connectivity in a case of musicogenic epilepsy using DCM for fMRI, high-density (hd-) EEG and MEG and validated results with intracranial EEG recordings. A patient with musicogenic seizures was examined using hd-EEG/fMRI and simultaneous '256-channel hd-EEG'/'whole head MEG' to characterize the epileptogenic focus and propagation effects using source analysis techniques and DCM. Results were validated with invasive EEG recordings. We recorded one seizure with hd-EEG/fMRI and four auras with hd-EEG/MEG. During the seizures, increases of activity could be observed in the right mesial temporal re...
Electroencephalography (EEG) and magnetoencephalography (MEG) are widely used to localize brain a... more Electroencephalography (EEG) and magnetoencephalography (MEG) are widely used to localize brain activity and their spatial resolutions have been compared in several publications. While most clinical studies demonstrated higher accuracy of MEG source localization, simulation studies suggested a more accurate EEG than MEG localization for the same number of channels. However, studies comparing real MEG and EEG data with equivalent number of channels are scarce. We investigated 14 right-handed healthy subjects performing a motor task in MEG, high-density-(hd-) EEG and fMRI as well as a somatosensory task in MEG and hd-EEG and compared source analysis results of the evoked brain activity between modalities with different head models. Using individual head models, hd-EEG localized significantly closer to the anatomical reference point obtained by fMRI than MEG. Source analysis results were least accurate for hd-EEG based on a standard head model. Further, hd-EEG and MEG localized more medially than fMRI. Localization accuracy of electric source imaging is dependent on the head model used with more accurate results obtained with individual head models. If this is taken into account, EEG localization can be more accurate than MEG localization for the same number of channels.
Episodic memory processes can be investigated using different functional MRI (fMRI) paradigms. Th... more Episodic memory processes can be investigated using different functional MRI (fMRI) paradigms. The purpose of the present study was to examine correlations between neuropsychological memory test scores and BOLD signal changes during fMRI scanning using three different memory tasks. Twenty-eight right-handed healthy subjects underwent three paradigms, (a) a word pair, (b) a space-labyrinth, and (c) a face-name association paradigm. These paradigms were compared for their value in memory quantification and lateralization by calculating correlations between the BOLD signals in the mesial temporal lobe and behavioral data derived from a neuropsychological test battery. As expected, group analysis showed left-sided activation for the verbal, a tendency to right-sided activation for the spatial, and bilateral activation for the face-name paradigm. No linear correlations were observed between neuropsychological data and activation in the temporo-mesial region. However, we found significant u-shaped correlations between behavioral memory performance and activation in both the verbal and the face-name paradigms, that is, BOLD signal changes were greater not only among participants who performed best on the neuropsychological tests, but also among the poorest performers. The figural learning task did not correlate with the activations in the space-labyrinth paradigm at all. We interpreted the u-shaped correlations to be due to compensatory hippocampal activations associated with low performance when people try unsuccessfully to remember presented items. Because activation levels did not linearly increase with memory performance, the latter cannot be quantified by fMRI alone, but only be used in conjunction with neuropsychological testing.
To evaluate the hypothesis that the entire hippocampus might be affected by susceptibility artifa... more To evaluate the hypothesis that the entire hippocampus might be affected by susceptibility artifacts. Previous studies described susceptibility artifacts in the amygdala and the anterior hippocampus. We investigated 20 subjects with a verbal memory paradigm aiming at testing two different TEs (45 vs. 64 msec) at 1.5 T for hippocampal blood oxygenation level-dependent (BOLD) activity. T2* maps were calculated from the normalized mean echo-planar imaging (EPI) of the two echo times (TEs). Within the hippocampal region of interest (ROI), the amount of suprathreshold voxels was significantly higher at TE = 64 msec compared to TE = 45 msec. When corrected for multiple comparisons (family-wise error [FWE] in a small volume of interest, P < 0.05) we no longer found significant activations at TE = 45 msec, while a significant number of voxels remained after the small volume correction (P < 0.05, FWE) within the ROI at TE = 64 msec. Although a shorter TE demonstrates advantages, a TE of 45 msec leads to a significant loss of BOLD signal detection in memory functional magnetic resonance imaging (fMRI) studies when compared to 64 msec. We assume that the hippocampal region, even the anterior part, is not strongly affected by susceptibility gradients.
We previously reported nonlinear correlations between verbal episodic memory performance and BOLD... more We previously reported nonlinear correlations between verbal episodic memory performance and BOLD signal in memory fMRI in healthy subjects. The purpose of the present study was to examine this observation in patients with left mesial temporal lobe epilepsy (mTLE) who often experience memory decline and need reliable prediction tools before epilepsy surgery with hippocampectomy. Fifteen patients with left mTLE (18-57years, nine females) underwent a verbal memory fMRI paradigm. Correlations between BOLD activity and neuropsychological data were calculated for the i) hippocampus (HC) as well as ii) extrahippocampal mTL structures. Memory performance was systematically associated with activations within the right HC as well as with activations within the left extrahippocampal mTL regions (amygdala and parahippocampal gyrus). As hypothesized, the analyses revealed cubic relationships, with one peak in patients with marginal memory performance and another peak in patients with very good performance. The nonlinear correlations between memory performance and activations might reflect the compensatory recruitment of neural resources to maintain memory performance in patients with ongoing memory deterioration. The present data suggest an already incipient preoperative reorganization process of verbal memory in non-amnesic patients with left mTLE by simultaneously tapping the resources of the right HC and left extrahippocampal mTL regions. Thus, in the preoperative assessment, both neuropsychological performance and memory fMRI should be considered together.
Idiopathic/genetic generalized epilepsy (IGE/GGE) is characterized by seizures, which start and r... more Idiopathic/genetic generalized epilepsy (IGE/GGE) is characterized by seizures, which start and rapidly engage widely distributed networks, and result in symptoms such as absences, generalized myoclonic and primary generalized tonic-clonic seizures. Although routine magnetic resonance imaging is apparently normal, many studies have reported structural alterations in IGE/GGE patients using diffusion tensor imaging and voxel-based morphometry. Changes have also been reported in functional networks during generalized spike wave discharges. However, network function in the resting-state without epileptiforme discharges has been less well studied. We hypothesize that resting-state networks are more representative of the underlying pathophysiology and abnormal network synchrony. We studied functional network connectivity derived from whole-brain magnetoencephalography recordings in thirteen IGE/GGE and nineteen healthy controls. Using graph theoretical network analysis, we found a widespr...
Dynamic causal modeling (DCM) is a method to non-invasively assess effective connectivity between... more Dynamic causal modeling (DCM) is a method to non-invasively assess effective connectivity between brain regions. 'Musicogenic epilepsy' is a rare reflex epilepsy syndrome in which seizures can be elicited by musical stimuli and thus represents a unique possibility to investigate complex human brain networks and test connectivity analysis tools. We investigated effective connectivity in a case of musicogenic epilepsy using DCM for fMRI, high-density (hd-) EEG and MEG and validated results with intracranial EEG recordings. A patient with musicogenic seizures was examined using hd-EEG/fMRI and simultaneous '256-channel hd-EEG'/'whole head MEG' to characterize the epileptogenic focus and propagation effects using source analysis techniques and DCM. Results were validated with invasive EEG recordings. We recorded one seizure with hd-EEG/fMRI and four auras with hd-EEG/MEG. During the seizures, increases of activity could be observed in the right mesial temporal re...
Electroencephalography (EEG) and magnetoencephalography (MEG) are widely used to localize brain a... more Electroencephalography (EEG) and magnetoencephalography (MEG) are widely used to localize brain activity and their spatial resolutions have been compared in several publications. While most clinical studies demonstrated higher accuracy of MEG source localization, simulation studies suggested a more accurate EEG than MEG localization for the same number of channels. However, studies comparing real MEG and EEG data with equivalent number of channels are scarce. We investigated 14 right-handed healthy subjects performing a motor task in MEG, high-density-(hd-) EEG and fMRI as well as a somatosensory task in MEG and hd-EEG and compared source analysis results of the evoked brain activity between modalities with different head models. Using individual head models, hd-EEG localized significantly closer to the anatomical reference point obtained by fMRI than MEG. Source analysis results were least accurate for hd-EEG based on a standard head model. Further, hd-EEG and MEG localized more medially than fMRI. Localization accuracy of electric source imaging is dependent on the head model used with more accurate results obtained with individual head models. If this is taken into account, EEG localization can be more accurate than MEG localization for the same number of channels.
Episodic memory processes can be investigated using different functional MRI (fMRI) paradigms. Th... more Episodic memory processes can be investigated using different functional MRI (fMRI) paradigms. The purpose of the present study was to examine correlations between neuropsychological memory test scores and BOLD signal changes during fMRI scanning using three different memory tasks. Twenty-eight right-handed healthy subjects underwent three paradigms, (a) a word pair, (b) a space-labyrinth, and (c) a face-name association paradigm. These paradigms were compared for their value in memory quantification and lateralization by calculating correlations between the BOLD signals in the mesial temporal lobe and behavioral data derived from a neuropsychological test battery. As expected, group analysis showed left-sided activation for the verbal, a tendency to right-sided activation for the spatial, and bilateral activation for the face-name paradigm. No linear correlations were observed between neuropsychological data and activation in the temporo-mesial region. However, we found significant u-shaped correlations between behavioral memory performance and activation in both the verbal and the face-name paradigms, that is, BOLD signal changes were greater not only among participants who performed best on the neuropsychological tests, but also among the poorest performers. The figural learning task did not correlate with the activations in the space-labyrinth paradigm at all. We interpreted the u-shaped correlations to be due to compensatory hippocampal activations associated with low performance when people try unsuccessfully to remember presented items. Because activation levels did not linearly increase with memory performance, the latter cannot be quantified by fMRI alone, but only be used in conjunction with neuropsychological testing.
To evaluate the hypothesis that the entire hippocampus might be affected by susceptibility artifa... more To evaluate the hypothesis that the entire hippocampus might be affected by susceptibility artifacts. Previous studies described susceptibility artifacts in the amygdala and the anterior hippocampus. We investigated 20 subjects with a verbal memory paradigm aiming at testing two different TEs (45 vs. 64 msec) at 1.5 T for hippocampal blood oxygenation level-dependent (BOLD) activity. T2* maps were calculated from the normalized mean echo-planar imaging (EPI) of the two echo times (TEs). Within the hippocampal region of interest (ROI), the amount of suprathreshold voxels was significantly higher at TE = 64 msec compared to TE = 45 msec. When corrected for multiple comparisons (family-wise error [FWE] in a small volume of interest, P < 0.05) we no longer found significant activations at TE = 45 msec, while a significant number of voxels remained after the small volume correction (P < 0.05, FWE) within the ROI at TE = 64 msec. Although a shorter TE demonstrates advantages, a TE of 45 msec leads to a significant loss of BOLD signal detection in memory functional magnetic resonance imaging (fMRI) studies when compared to 64 msec. We assume that the hippocampal region, even the anterior part, is not strongly affected by susceptibility gradients.
We previously reported nonlinear correlations between verbal episodic memory performance and BOLD... more We previously reported nonlinear correlations between verbal episodic memory performance and BOLD signal in memory fMRI in healthy subjects. The purpose of the present study was to examine this observation in patients with left mesial temporal lobe epilepsy (mTLE) who often experience memory decline and need reliable prediction tools before epilepsy surgery with hippocampectomy. Fifteen patients with left mTLE (18-57years, nine females) underwent a verbal memory fMRI paradigm. Correlations between BOLD activity and neuropsychological data were calculated for the i) hippocampus (HC) as well as ii) extrahippocampal mTL structures. Memory performance was systematically associated with activations within the right HC as well as with activations within the left extrahippocampal mTL regions (amygdala and parahippocampal gyrus). As hypothesized, the analyses revealed cubic relationships, with one peak in patients with marginal memory performance and another peak in patients with very good performance. The nonlinear correlations between memory performance and activations might reflect the compensatory recruitment of neural resources to maintain memory performance in patients with ongoing memory deterioration. The present data suggest an already incipient preoperative reorganization process of verbal memory in non-amnesic patients with left mTLE by simultaneously tapping the resources of the right HC and left extrahippocampal mTL regions. Thus, in the preoperative assessment, both neuropsychological performance and memory fMRI should be considered together.
Uploads
Papers