Wearable MEG for Improved Presurgical Mapping of Pediatric Language

For many patients with intractable epilepsy, brain surgery becomes a viable consideration to reduce the devastating consequences of seizures. Functional imaging with techniques such as magnetoencephalography (MEG) also allow delineation of “eloquent” cortex, such as anatomic areas supporting language function, to be spared during surgery. However, conventional MEG requires patients to hold still in order to get high quality functional maps, which is often challenging for pediatric patients. Further, conventional (cryogenic) MEG houses its detectors in a rigid (adult-sized) helmet, consequently leading to an increased distance between neural generators and magnetic field detectors, when used for pediatric patients. This distance leads to a loss of sensitivity (since magnetic fields fall off with the square of distance). Thus, current cryogenic MEG Is not ideally suited to the smaller, more movement-prone pediatric population. The current proposal uses an entirely new MEG technology, based on a device called an OPM (optically pumped magnetometer), which does not require cryogenic cooling and thus can be flexibly configured into a “wearable MEG” array. Since the detectors are effectively scalp-mounted, they have increased sensitivity. Since they are effectively rigidly-coupled to the head, they tolerate head motion. Combining these two attributes promises to ameliorate the above-described limitations to presurgical mapping of language function in the brains of pediatric epilepsy patients. The goal of this proposal is first to spatially validate the language map foci, compared to conventional MEG (in cases where conventional MEG is diagnostically successful) and secondly, to increase the diagnostic yield of functional brain mapping with MEG (by providing diagnostically interpretable maps in cases where conventional cryogenic MEG is equivocal or insufficient). 48 pediatric epilepsy patients (8-18years) undergoing conventional cryogenic MEG as a part of their clinical standard of care presurgical evaluation will be recruited to undergo an additional brief language mapping paradigm using the novel wearable MEG device. Statistical methods will address both spatial validation of language maps determined using wearable OPM-MEG as well as the degree to which diagnostic yield of evaluable language function maps is increased using wearable MEG compared to the current clinical, cryogenic, rigid-helmet (non-wearable) MEG standard. If successful, as anticipated, it is hoped that these data will pave the way for eventual clinical adoption of wearable MEG for presurgical functional mapping of language cortices in pediatric epilepsy patients who are candidates for neurosurgery, with concomitant improved in post-operative functional outcomes and, ultimately, quality of life. Project Number: 1R21NS145070-01A1 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Neurological Disorders and Stroke (NINDS) | Principal Investigator: Timothy Roberts (+1 co-PI) | Institution: CHILDREN'S HOSP OF PHILADELPHIA, PHILADELPHIA, PA | Award Amount: $219,658 | Activity Code: R21 | Study Section: Imaging Technology for Neuroscience Study Section[ITN] View on NIH RePORTER: https://reporter.nih.gov/project-details/11370761