Simultaneous MEG and EEG to detect ripples in people with focal epilepsy

Objective: We studied ripples (80-250 Hz) simultaneously recorded in electroencephalography (EEG) and magnetoencephalography (MEG) to evaluate the differences. Methods: Simultaneous EEG and MEG were recorded in 30 patients with drug resistant focal epilepsy. Ripples were automatically detected and visually checked in virtual channels throughout the cortex. The number and location of ripples in EEG and MEG were compared to each other and to a region of interest (ROI) defined by clinically available information. Results: Eleven patients showed ripples in both MEG and EEG, 11 only in EEG and one only in MEG. Twenty-four percent of the ripples occurred simultaneously in EEG and MEG, 71% only in EEG, and 5% only in MEG. Three patients without spikes in EEG showed EEG ripples. Ripple localization was concordant with the ROI in 80% of patients with MEG ripples, as opposed to 62% full or partial concordance for EEG ripples. With the optimal threshold for localizing the ROI, sensitivity and specificity were more than 80%. Conclusions: Ripples in MEG are less frequent but more specific and sensitive for the region of interest than ripples in EEG. Ripples in EEG can exist without spikes in the EEG. Significance: Ripples in MEG and EEG provide complementary information. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.