Integrative laterality mapping with MEG and fMRI for presurgical evaluation in epilepsy

Abstract

In cases of temporal lobe epilepsy, seizures are often controlled by anterior temporal lobe resection. However, an assessment of the impact of surgery on language is required. Currently-used assessments are either non-specific within regions or use functional magnetic resonance imaging (fMRI), which can suffer signal distortion in the temporal lobes due to the presence of airways. Magnetoencephalography (MEG) shows a complimentary sensitivity, but has not been used for laterality assessment. We present a method that combines fMRI with MEG for optimized sensitivity. MEG activation maps were generated using a beamformer, showing activity in the anterior temporal lobes and lateral occipital cortex. fMRI showed activation in medial temporal lobe regions, the frontal poles and the hippocampus, an area of clinical concern during surgical planning. The present study introduces a method for integrating MEG and fMRI activation to create high-resolution laterality maps in regions of concern for epilepsy.