Trained first in Neurology and Child Neurology and then in Clinical Neurophysiology in Rome, Italy where he was responsible for the EMG service and of the pre-surgical evaluation of paediatric epilepsy. After this he received post-doctoral training in Zurich with Prof. Dietrich Lehmann, where he was introduced to topographic and source analysis of high-density EEG. He was involved in the first clinical MEG recordings in Rome in 1981 with pioneers at the National Research Council Solid State Physics laboratory. He became Consultant Clinical Neurophysiologist at the Birmingham Children’s Hospital in 1998 where he continues to work. After having taken the post of Professor of Child Neurology at Tor Vergata University in Rome form 2001 until 2004, he became Professor of Clinical Neurophysiology at Aston University in 2004 and Director of the MRI research centre. He is now Emeritus Professor at Aston, after taking early retirement in 2020 to focus on the rapidly expanding stereo-EEG and presurgical assessment service within the CESS programme at BCH. He has been awarded more than £2M in research grants, most of which to develop MEG and fMRI as clinical imaging tool and has authored over 150 publications.

Advances MEG in presurgical evaluation of drug resistant epilepsy at Aston University: from analysis strategies to neurophysiological biomarkers.

Stefano Seri, Andrew Lawley

A recent survey of European MEG centres confirmed that its acceptance as viable diagnostic tool still lags behind the evidence supporting its value as functional brain mapping tool (De Tiege X, et al., 2017).  This somewhat maps the on-going gap between evidence of efficacy of surgical treatment as an option for drug-resistant epilepsy and its uptake worldwide. One of the main challenges our community faces if this gap is to be reduced is educational, to referring clinicians, trainees in neurology and clinical neurophysiology and scientists/technical staff. These include the understanding of the processes involved in reconstructing sources from scalp magnetic fields (Hall et al., 2018), recognition of artefacts in signal and source space (Bagic et al., 2020), interpretation of findings and reporting (Burgess R, 2020).  In this presentation, based on the 20-year experience and over 100 patients per year investigated at the Aston University Wellcome MEG Laboratory, we aim to cover the main evidence supporting the use of MEG to localise the irritative zone, its spatial correlation with seizure-onset zone, its support in formulating localising/lateralising hypotheses on the spatial extent of the seizure-onset zone and guiding intracranial recording strategy (Agirre-Arrizubieta Z, 2014) and finally the role of MEG in detecting non-invasively pathological HFO (Foley et al., 2021).  We will also present recent data from our group on the role of MEG in mapping eloquent cortex non-invasively (Foley, 2019; 2020), and its relationship with fMRI-base mapping and direct cortical stimulation.

1. Agirre-Arrizubieta Z, Thai NJ, Valentin A, Furlong PL, Seri S, Selway RP, Elwes RD, Alarcon G. The value of Magnetoencephalography to guide electrode implantation in epilepsy. Brain Topogr. 2014;27(1):197-207
2. Bagić, Anto I.*; Funke, Michael E.†; Kirsch, Heidi E.‡; Tenney, Jeffrey R.§; Zillgitt, Andrew J.‖; Burgess, Richard C. The 10 Common Evidence-Supported Indications for MEG in Epilepsy Surgery: An Illustrated Compendium, Journal of Clinical Neurophysiology: November 2020 - Volume 37 - Issue 6 - p 483-497 doi: 10.1097/WNP.0000000000000726
3. Burgess RC. MEG Reporting. J Clin Neurophysiol. 2020 Nov;37(6):545-553. doi: 10.1097/WNP.0000000000000700
4 De Tiege X, Lundqvist D, Beniczky S, Seri S, Paetau R. Current clinical magnetoencephalography practice across Europe: Are we closer to use MEG as an established clinical tool? Seizure. 2017;50:53-9
5. Foley E, Cross JH, Thai NJ, Walsh AR, Bill P, Furlong P, Wood AG, Cerquiglini A, Seri S. MEG Assessment of Expressive Language in Children Evaluated for Epilepsy Surgery. Brain Topogr. 2019;32(3):492-503.PMC6476853
6. Foley E, Quitadamo LR, Walsh AR, Bill P, Hillebrand A, Seri S. MEG detection of high frequency oscillations and intracranial-EEG validation in pediatric epilepsy surgery. Clin Neurophysiol. 2021;132(9):2136-45
7. Foley E, Wood AG, Furlong PL, Walsh AR, Kearney S, Bill P, Hillebrand A, Seri S. Mapping language networks and their association with verbal abilities in paediatric epilepsy using MEG and graph analysis. Neuroimage Clin. 2020;27:102265.PMC7226893
8. Hall MBH, Nissen IA, van Straaten ECW, Furlong PL, Witton C, Foley E, Seri S, Hillebrand A. An evaluation of kurtosis beamforming in magnetoencephalography to localize the epileptogenic zone in drug resistant epilepsy patients. Clin Neurophysiol. 2018;129(6):1221-9.PMC5953276