Camera-based Prospective Motion Correction in Paediatric Epilepsy Patients Enables EEG-fMRI Localization Even in High-motion States

TY - JOUR

T1 - Camera-based Prospective Motion Correction in Paediatric Epilepsy Patients Enables EEG-fMRI Localization Even in High-motion States

AU - Steinbrenner, Mirja

AU - McDowell, Amy

AU - Centeno, Maria

AU - Moeller, Friederike

AU - Perani, Suejen

AU - Lorio, Sara

AU - Maziero, Danilo

AU - Carmichael, David W.

N1 - Funding Information: This work was supported by funding from EPSRC [EP/M001393/1] and core funding from the Wellcome/EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z]. M.S. was supported by a Research grant of the Epilepsy Academy Berlin-Bethel body of the v. Bodelschwinghschen Stiftungen, Germany, and since January 2021 has been a Fellow of the Charité BIH Digital Clinician Scientist Program, Berlin, Germany. Publisher Copyright: © 2023, The Author(s).

PY - 2023/5

Y1 - 2023/5

N2 - Background: EEG-fMRI is a useful additional test to localize the epileptogenic zone (EZ) particularly in MRI negative cases. However subject motion presents a particular challenge owing to its large effects on both MRI and EEG signal. Traditionally it is assumed that prospective motion correction (PMC) of fMRI precludes EEG artifact correction. Methods: Children undergoing presurgical assessment at Great Ormond Street Hospital were included into the study. PMC of fMRI was done using a commercial system with a Moiré Phase Tracking marker and MR-compatible camera. For retrospective EEG correction both a standard and a motion educated EEG artefact correction (REEGMAS) were compared to each other. Results: Ten children underwent simultaneous EEG-fMRI. Overall head movement was high (mean RMS velocity < 1.5 mm/s) and showed high inter- and intra-individual variability. Comparing motion measured by the PMC camera and the (uncorrected residual) motion detected by realignment of fMRI images, there was a five-fold reduction in motion from its prospective correction. Retrospective EEG correction using both standard approaches and REEGMAS allowed the visualization and identification of physiological noise and epileptiform discharges. Seven of 10 children had significant maps, which were concordant with the clinical EZ hypothesis in 6 of these 7. Conclusion: To our knowledge this is the first application of camera-based PMC for MRI in a pediatric clinical setting. Despite large amount of movement PMC in combination with retrospective EEG correction recovered data and obtained clinically meaningful results during high levels of subject motion. Practical limitations may currently limit the widespread use of this technology.

AB - Background: EEG-fMRI is a useful additional test to localize the epileptogenic zone (EZ) particularly in MRI negative cases. However subject motion presents a particular challenge owing to its large effects on both MRI and EEG signal. Traditionally it is assumed that prospective motion correction (PMC) of fMRI precludes EEG artifact correction. Methods: Children undergoing presurgical assessment at Great Ormond Street Hospital were included into the study. PMC of fMRI was done using a commercial system with a Moiré Phase Tracking marker and MR-compatible camera. For retrospective EEG correction both a standard and a motion educated EEG artefact correction (REEGMAS) were compared to each other. Results: Ten children underwent simultaneous EEG-fMRI. Overall head movement was high (mean RMS velocity < 1.5 mm/s) and showed high inter- and intra-individual variability. Comparing motion measured by the PMC camera and the (uncorrected residual) motion detected by realignment of fMRI images, there was a five-fold reduction in motion from its prospective correction. Retrospective EEG correction using both standard approaches and REEGMAS allowed the visualization and identification of physiological noise and epileptiform discharges. Seven of 10 children had significant maps, which were concordant with the clinical EZ hypothesis in 6 of these 7. Conclusion: To our knowledge this is the first application of camera-based PMC for MRI in a pediatric clinical setting. Despite large amount of movement PMC in combination with retrospective EEG correction recovered data and obtained clinically meaningful results during high levels of subject motion. Practical limitations may currently limit the widespread use of this technology.

KW - Drug-resistant epilepsy

KW - EEG-fMRI

KW - Pediatric epilepsy

KW - Prospective motion correction

UR - http://www.scopus.com/inward/record.url?scp=85150435521&partnerID=8YFLogxK

U2 - 10.1007/s10548-023-00945-0

DO - 10.1007/s10548-023-00945-0

M3 - Article

AN - SCOPUS:85150435521

SN - 0896-0267

VL - 36

SP - 319

EP - 337

JO - Brain topography

JF - Brain topography

IS - 3

ER -