OBJECTIVE:The spatio-temporal propagation of the Interictal Epileptiform Discharges (IEDs) can reveal mesial temporal lobe (mTL) involvement in focal temporal seizures. We investigated whether simultaneous recording with magnetoencephalography (MEG), electroencephalography (EEG), and Foramen Ovale Electrodes (FOE) recording improve the definition of the Epileptogenic Zone (EZ) in temporal lobe epilepsies with uncertain lateralization. METHODS:Sixteen patients with drug-resistant epilepsy, suspected mTL involvement, and inconclusive lateralizing signs underwent simultaneous MEG, EEG, and FOE recordings. IEDs were localized using sub-averaging and hierarchical clustering of source maps to identify consistent spatiotemporal propagation patterns. Based on MEG data, patients were classified as having "good" (unilateral, localized EZ) or "poor" surgical candidacy. These classifications were compared to FOE-EEG assessments. MEG accuracy was then evaluated in relation to surgical outcomes (Engel class > I = poor outcome). RESULTS:All patients showed mTL involvement. In seven patients, MEG revealed primary mTL activation; in nine, mTL involvement was secondary. The agreement between MEG-based and FOE-based surgical eligibility in the patients with good or poor sbad surgical eligibility and in the entire sample was 87.5%, 75.0% and 81.3%, respectively. The accuracy of MEG-based analysis in identifying suitable candidates for the surgery was 85.7%. SIGNIFICANCE:Simultaneous MEG/EEG/FOE recordings enhance characterization of IED propagation, offering complementary insight into mTL involvement. This multimodal approach improves localization of the EZ and helps predict surgical outcomes in drug-resistant mTLE, particularly in cases with ambiguous lateralization.

OBJECTIVE:Lafora disease (LD) and Unverricht-Lundborg disease (EPM1A) are the most common forms of progressive myoclonic epilepsy and are frequently associated with photosensitivity and photic reflex myoclonus (PRM). This study aimed to characterize the photoparoxysmal response (PPR), evaluate the effect of blue lenses, and explore the neural networks underlying PPR and PRM in both conditions. METHODS:Twenty-six patients with LD and 51 with EPM1A were included. PPR was assessed on the first available electroencephalogram (EEG), including background activity and the presence and distribution of interictal epileptiform discharges, which were compared between groups. A subset of patients underwent back-averaging analysis using 1-Hz flash stimuli as triggers, allowing identification of the principal components of flash-evoked responses. RESULTS:PPR was detected in 85% of LD patients and 33% of EPM1A patients (p < .001). Compared with EPM1A, LD patients more often showed focal seizures with visual symptoms, slower EEG background activity, and a higher presence of focal epileptiform abnormalities over the posterior regions. In both groups, PPR was mainly Waltz type 4 at 14-15 Hz and was associated with PRM in approximately half of the cases. However, in LD, the PPR latency from stimulus onset was shorter, and sensitivity to blue lenses was significantly lower. Compared with healthy controls, both patient groups exhibited increased amplitude and prolonged latency of the flash-evoked responses. SIGNIFICANCE:Photosensitivity is more frequent and severe in LD than in EPM1A and is associated with electrophysiological markers of occipital cortex hyperexcitability. The shorter PPR latency in LD suggests an intrinsic predisposition to generate PPR immediately after visual input, possibly related to a lack of inhibitory mechanisms. The frequent occurrence of PRM in both conditions reflects aberrant large-scale network dynamics involving cortical and subcortical structures rather than pure occipital cortex dysfunction.

Wearable electroencephalography (EEG) enables brain monitoring in real-world environments beyond clinical settings; however, the relaxed constraints of the acquisition setup often compromise signal quality. This review examines methods for artifact detection and for the identification of artifact categories (e.g., ocular) and specific sources (e.g., eye blink) in wearable EEG. A systematic search was conducted across six databases using the query: (“electroencephalographic” OR “electroencephalography” OR “EEG”) AND (“Artifact detection” OR “Artifact identification” OR “Artifact removal” OR “Artifact rejection”) AND “wearable”. Following PRISMA guidelines, 58 studies were included. Artifacts in wearable EEG exhibit specific features due to dry electrodes, reduced scalp coverage, and subject mobility, yet only a few studies explicitly address these peculiarities. Most pipelines integrate detection and removal phases but rarely separate their impact on performance metrics, mainly accuracy (71%) when the clean signal is the reference and selectivity (63%), assessed with respect to physiological signal. Wavelet transforms and ICA, often using thresholding as a decision rule, are among the most frequently used techniques for managing ocular and muscular artifacts. ASR-based pipelines are widely applied for ocular, movement, and instrumental artifacts. Deep learning approaches are emerging, especially for muscular and motion artifacts, with promising applications in real-time settings. Auxiliary sensors (e.g., IMUs) are still underutilized despite their potential in enhancing artifact detection under ecological conditions. Only two studies addressed artifact category identification. A mapping of validated pipelines per artifact type and a survey of public datasets are provided to support benchmarking and reproducibility.

Musicogenic epilepsy (ME) is characterized by seizures triggered by music. The epileptogenic focus in this rare reflex epilepsy is often in the temporal lobe, although the precise localization is still unclear. A correlation between ME and the presence of GAD65 antibodies indicates a potential immunological pathogenic mechanism. We evaluated a 32-year-old woman with drug-resistant temporal lobe epilepsy as a candidate for epilepsy surgery. In the absence of clear clinical lateralizing signs, video-EEG monitoring with intracranial electrodes inserted through the foramen ovale was performed to record from the amygdalo-hippocampal regions. The foramen ovale electrodes revealed bilateral, asynchronous, and independent seizure onsets in the mesial temporal regions triggered by music. Testing for GAD65 antibodies confirmed high-titer positivity. The efficacy of epilepsy surgery in antiGAD65-positive ME patients remains limited. We highlight the use of semi-invasive recording with foramen ovale electrodes in ME, as it can reveal bilateral seizures of mesial origin that contraindicate surgery and support the consideration of immunotherapy options. PLAIN LANGUAGE SUMMARY: Musicogenic epilepsy is a type of epilepsy in which music triggers seizures. Our understanding of its origin and cause is still limited. We assessed a patient with music-induced seizures to see if surgery was an option. Since noninvasive tests before surgery were not clear, we used a minimally invasive method with electrodes inserted through a small opening in the skull called the foramen ovale to record the seizures. Thus, we found that the seizures started independently from both temporal lobes, contraindicating epilepsy surgery. We also found high levels of GAD65 antibodies indicating an immunological pathogenic mechanism.

In this study, we compared the effects promoted by a brief single session of crochet in a group of skilled knitters (CRO) and a control group (CRT) on the Attentional Network Test (ANT) and the whole brain Functional Connectivity (FC) revealed by Magnetoencephalography (MEG). Data revealed that crochet determined a significant effect (before, T0, vs after, T1, the crochet session) on reaction times (for all cue and stimulus types), improving alertness and orienting networks (but not executive control) only in the CRO group. Data of FC are coherent with the behavioural ones. We observed that the Betweenness Centrality maximum (BCmax) index in the beta band significantly increased, and global FC in the alpha band significantly increased at T1 for the CRO group but not for the CTR group. Increased global BCmax in the beta band after the crochet activity correlated with better performance (reduced reaction times), suggesting that the brain has become more efficiently integrated, thus increasing the information exchange between different brain areas. Decreased global FC in the alpha band may reflect a transition from a quiet, global rest to a condition of increased alertness and readiness to stimuli. Finally, we discuss the hypothesis that these results could be the reinforcement of connections between motor and attentional networks promoted by learning the complex motor skills of crochet.

Background/Objectives: Subcortical local field potentials (LFPs) provide a valuable in vivo window into the neurophysiology of the dystonia network. These signals can be recorded through Deep Brain Stimulation (DBS) devices and combined with whole-head techniques such as magnetoencephalography (MEG) to study cortical–subcortical interactions. However, simultaneous LFP-MEG acquisition poses challenges, including interference from the DBS device and synchronization issues. We present preliminary data on the feasibility and signal quality of concurrent LFP and MEG recordings in dystonia patients. Methods: We assessed simultaneous MEG-LFP recordings in 11 patients with inherited or idiopathic dystonia who underwent bilateral DBS lead implantation in the Globus Pallidus Internus (GPi). Two synchronization strategies were tested: (1) the Tapping method, using an accelerometer placed on the DBS device, and (2) the Stimulation method, which generated detectable artifacts during sham stimulation. Results: Both methods successfully aligned MEG and LFP signals with a mean temporal delay of 91 ± 22 ms for the Tapping method and 288 ± 166 ms for the Stimulation method. Post-implantation signal-to-noise ratio analysis revealed slight degradation but no significant impact on MEG quality (gradiometers: −0.12 ± 1.85 dB; magnetometers: −0.47 ± 2.03 dB). Conclusions: Simultaneous MEG-LFP recordings in dystonic patients are feasible, yielding high-quality signals, and reliable synchronization. Temporal alignment improved with practice, suggesting a short learning curve. This method opens new opportunities to study cortical-subcortical dynamics and strengthens the potential of combining MEG-LFP approaches for investigating dystonia.

IntroductionExperimental evidence shows that the sensorimotor system is not only involved in performing actions but also in observing and understanding them, even when verbally described. The involvement of the sensorimotor system in processing action related language material is known as embodiment. Following this approach, language items presented in L1 and L2 should affect motor activity in the same manner.MethodsThis study aimed to investigate the involvement of motor system during the processing of L2 items in a combined behavioral and MEG study. Healthy Italian native speakers performed a semantic decision task on hand and foot actions presented by means of pictures or verbs expressed in English as L2.ResultsResults showed slower hand reaction times and weaker suppression of Beta band power during the processing of hand-related pictures and verbs, as compared to foot-related pictures and verbs, thus suggesting shared neural mechanisms for semantic processing of visually and verbally presented items.DiscussionThis in line with a similar study where Italian verbs were used as language items. However, while no dissimilarity was found in the modulation of the motor system during the processing of verbs presented in L1 and pictures depicting actions in the same category, here, when processing L2 verbs, reaction times were slower than when processing visually presented actions, thus implying an additional cost for processing L2 as compared to L1 verbal items.ConclusionWe argue that these findings support embodiment, in that they can be explained by a similar, although stronger involvement of the sensorimotor system during the processing of L2 verbal items.

We illustrate the improvement provided by Rieman-nian geometry in terms of inter-subject generalization within an electroencephalography (EEG)-based assessment of Mindfulness- based treatments for chronic migraine patients. Using Rieman-nian geometry, the EEG signal is projected into the manifold of symmetric positive-definite matrices, e.g., covariance or co- spectral matrices, providing robustness against the high variabil-ity typical of EEG. In particular, Riemannian Co-Registration (RCoR) optimally transforms the subject's co-spectral matrices to minimize their distance from a global geometric mean, thus defining a co-registration in Riemannian space. So far Rieman-nian approaches have been used mainly in motor imagery and emotion recognition studies. In the present work, we identify EEG features associated with a non-pharmacological treatment applied to patients with migraine. Twelve subjects with high- frequency migraine without aura received Mindfulness treatment. The signal was recorded in pre- and post-treatment conditions using a wearable and wireless 8 channEIS- EEG system. Features were extracted from five frequency bands and eight channEIS. A permutation t-test was conducted on both co-registered and raw EEG data to determine which of the 48 input features were statistically significant in discriminating post-treatment from pre-treatment conditions. RCoR increased the number of statistically significant features by a factor of three in the delta, theta, alpha, and high beta bands, revealing additional effects in the frontal region, previously not observed. At this preliminary stage, these features appear promising, as they align with the expected effects of the Mindfulness protocol in migraine patients.

OBJECTIVE:This study explores the utility of various evoked fields in elucidating the pathophysiology of Friedreich's ataxia (FA) and potentially contributing to developing more targeted diagnostic and therapeutic strategies. METHODS:Thirty-seven patients with FA aged 27.6 ± 7.4 years and a control group of 17 healthy subjects were enrolled in the study. The neuromagnetic response to auditory, tactile, visual, somatosensory, auditory and tactile oddball stimulation were acquired. For all the components of interest, latency and amplitude were measured and correlated with clinical data. RESULTS:Neuromagnetic responses were identifiable in more than 90% of cases. A significant response delay was observed in all tested modalities (auditory, somatosensory, tactile and visual responses). P300 responses were comparable in patients and healthy subjects. Latencies of visual and auditory responses correlated with SARA scores. Moreover, latencies of auditory responses correlated with disease onset age, whereas latencies of visual responses correlated with disease severity. CONCLUSIONS:Auditory and visual responses correlated with the severity of the disease, whereas alterations in somatosensory responses represent an intrinsic characteristic of the disease. SIGNIFICANCE:In FA the study of evoked visual fields could provide a possible biomarker of disease progression and treatment efficacy.

Cognitve workload associated with fine motor activity in neurosurgeons was monitored by using a wearable electroen-cephalographic (EEG) device. The most informative EEG features were selected by means of an explainable Artificial Intelligence (XAI) algorithm. XAI represents a promising novel approach in this application field and offers new opportunities for extracting information from EEG data beyond traditional statistical and Machine Learning-based methods. Six neurosurgeons performed the Purdue Pegboard Test (PPT) at two difficulty levels related to low or high cognitive load. EEG signals were acquired with an eight dry electrode device. Absolute powers in six different frequency bands of interest were explored. Three most involved EEG features resulted from SHapley Additive exPlanations (SHAP) methods, namely absolute power in delta band on C3 and Fz channels and the absolute power in theta band on Fz. Summary plots showed a decrease of the three identified EEG features in the high cognitive load task. These findings demonstrate the potential of Artificial Intelligence-supported wearable EEG solutions to monitor cognitive load over time, to track the cognitive load of trainee neurosurgeons and to design adaptive training courses.

Understanding electrophysiological brain activity in response to cognitive tasks is a key focus in neuroscience. Despite advances in brain data acquisition technologies, invasive methods remain the gold-standard to accurately localise electrophysiological activity, particularly in deep brain structures. This study aims to provide preliminary results to validate superconducting quantum interference device (SQUID)-based magnetoencephalography (sMEG) and optically pumped magnetometer-based (OPM)-MEG against previously described gold-standard intracranial electroencephalograpy (iEEG) in detecting hippocampal and visual cortex responses to uncertain visual stimuli. Using two well-established source reconstruction techniques - dynamic Statistical Parametric Mapping (dSPM) and Linearly Constrained Minimum Variance (LCMV) beamformer - this study compared results from time-frequency analysis across different acquisition methods. While hippocampal time-resolved spectral activity detected via dSPM source reconstruction in sMEG data was consistent with previous iEEG findings, other approaches yielded inconsistent results compared to iEEG. These preliminary findings contribute to the understanding of non-invasive detection of cortical and subcortical activity and underscore the need for further methodological improvements in the analysis of non-invasive neurophysiological data to achieve reliable detection and interpretation of brain activity.

This case report shows the importance of multimodal evaluation to formulate a proper diagnosis of negative motor seizures (NMSs). Only few reports in literature document NMSs with video-electroencephalographic (EEG) and electromyographic coregistration. A multimodal evaluation is crucial to exclude common mimics and propose correct therapy. We describe a case of a 62-year-old man with drug-resistant focal epilepsy and NMSs, evaluated with video-EEG recording with polygraphy, magnetoencephalography (MEG), and brain magnetic resonance imaging (MRI). Video-EEG monitoring showed 182 focal NMSs, with preserved awareness and comprehension. The patient reported complex paresthesia of the left hand followed by left facial grimace, left arm flaccid paralysis, and bradycardia. EEG showed ictal discharges in the right frontocentral region associated with sudden electromyographical silence in left limb muscles consistent with loss of tonic contraction from distal to proximal muscles of the arm. MEG localized the epileptic zone in the right opercular region, consistent with MRI evidence of type II cortical dysplasia in the right inferior frontal gyrus. Multimodal evaluation is essential to document the temporal relationship between ictal discharges, clinical onset of limb paresis, and electrophysiologic evidence of loss of tonic muscular contraction. It allows definition of the specific cortical area involved in NMSs, offering new insight into physiological brain functioning.

There is experimental evidence that the brain systems involved in action execution also play a role in action observation and understanding. Recently, it has been suggested that the sensorimotor system is also involved in language processing. Supporting results are slower response times and weaker motor-related MEG Beta band power suppression in semantic decision tasks on single action verbs labels when the stimulus and the motor response involve the same effector. Attenuated power suppression indicates decreased cortical excitability and consequent decreased readiness to act. The embodied approach forwards that the simultaneous involvement of the sensorimotor system in the processing of the linguistic content and in the planning of the response determines this language-motor interference effect. Here, in a combined behavioral and MEG study we investigated to what extent the processing of actions visually presented (i.e., pictures of actions) and verbally described (i.e., verbs in written words) share common neural mechanisms. The findings demonstrated that, whether an action is experienced visually or verbally, its processing engages the sensorimotor system in a comparable way. These results provide further support to the embodied view of semantic processing, suggesting that this process is independent from the modality of presentation of the stimulus, including language.