Electric and Magnetic Source Imaging in Epilepsy: Anatomical Insights from Realistic Simulations

In realistic simulations of drug-resistant epilepsy, HD-EEG and MEG show modality-specific spike detectability, with MSI localizing tangential sources more accurately than ESI (p<0.001).

• Why it matters: Accurate noninvasive mapping of the epileptogenic focus is limited because ESI and MSI have different sensitivity profiles, so spikes detectable by one modality may be missed by the other.
• What they did: The study simulated HD-EEG and MEG from cortical, insular, and hippocampal sources with multiple orientations, using patient-derived intracranial EEG spike waveforms, and assessed spike sensitivity and localization with dipole scanning, dSPM, and LCMV.
• The result: EEG detected more spikes for radially oriented cortical sources at gyral crowns and sulcal bottoms (p<0.001), MEG detected more for tangential sources along sulcal walls (p<0.001), MSI localized tangential sources better than ESI (p<0.001), and EMSI improved detection over ESI (p<0.001) without improving localization over MSI.

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