Presurgical evaluation of pharmacoresistant focal epilepsy is one of the main clinical applications of MEG. A growing body of evidence demonstrates that MEG source analysis provides additional clinical value which results in higher and more robust seizure freedom rates even in the long-term. However, there are still open questions which range from clinical issues to methodological problems, which cannot be answered by the clinical community alone.  
The symposium reviews the role of MEG in epilepsy and summarizes current evidence. Clinical issues in adult and childhood epilepsy are discussed which are insufficiently addressed by current available methodology, e.g. patients with no or not enough epileptic activity for reliable results, multifocal activity and complex propagation phenomena. Controversies are discussed, such as the value of ictal versus interictal MEG results and the necessity for inverse models beyond the dipole. Novel methods at the verge to enter the clinical routine are summarized, e.g. connectivity based methods, as well as the use of non-spike markers for the epileptic network.

Speakers:
Stefan Rampp M.D., University Hospital Erlangen, Germany. “Value of MEG in adult epilepsy”
Hiroshi Otsubo PhD., University of Toronto, Canada ”Value of MEG in childhood epilepsy”
Ritva Paetau MD., Helsinki University Central Hospital, Finland. “Ictal MEG: Viability and added value”
Hideaki Shiraishi M.D., Hokkaido University Hospital, Japan. “Source analysis in epilepsy: Beyond the dipole”

Presurgical identification of brain areas responsible for language represents one of the more challenging objectives of the pre-surgical work-up. MEG methods are still being developed to reliably identify language areas non-invasively. In addition to the identification of the so called “language dominant” hemisphere and classical Broca / Wernicke language areas, new protocols are also needed to better characterize associated language networks and to review the validity of the lateralization assumption in young and/or developmentally delayed children.  Such protocols may not only be important to optimize post-surgical outcomes, but may provide new targets for therapy in clinical populations and may provide biomarkers for future clinical prognosis.
This symposium begins with an overview of current methods for reliable mapping of language areas with MEG and a reassessment of our assumptions regarding brain substrates of language execution. Next, we consider an example where multi-sensory integration of language and visual information can be used to model a higher-order language processing network known to be impaired in patients with Schizophrenia. An applied therapeutic clinical application follows in a population of patients with “writer’s cramp” of the larynx addressing impairment of articulation and speech production as an element of language functioning. Finally, we explore how interpretation of MEG can be augmented with advanced MRI and MRS measures to lead to plausible mechanistic interpretations with subsequent roles as “biological” markers for not only diagnosis, but also prognosis and stratification, targeting substrates and systems for intervention and monitoring the efficacy of such therapies.

Speakers:
Elizabeth Pang, Hospital for Sick Children, Toronto, Canada. “The primary sensory cortex and early language processing”
Julia Stephen, PhD., MRN Albuquerque, NM., USA. “How do unisensory deficits impact response within a multisensory world? “
John Houde, PhD., UCSF, CA, USA. “MEG correlates of Spasmodic Dysphonia? (Writer's cramp of the larynx)”
Tim Roberts PhD., CHOP, Philadelphia, PA., USA. “Multimodal and Developmental Studies of Auditory Processing in ASD and Related Genetic Disorders”

Somatosensory and motor responses (i.e., sensorimotor responses) are among the most well-studied signals of the human brain.  In addition to the measurement of resting mu (~11Hz) and beta rhythms (15-30Hz), a variety of different experimental paradigms are now available to identify these cortical areas and associated networks.  However, much less is known about how these sensorimotor signals change with development, and the clinical utility of these measures (in children and adults) is constantly evolving. As a result, researchers and clinicians now have numerous experimental choices available for robust assessment of sensorimotor responses, both for research as well as for pre and post surgical functional mapping.
In this symposium, we begin with a demonstration of how resting sensorimotor beta-band rhythms change over the life-span, and how these developmental trends have implications for both source localization methods as well as the interpretation of results. Next we learn how the measurement of sensorimotor responses can be used to gain insight into challenging clinical pediatric populations such as children with Friedreich’s Ataxia, and Cerebral Palsy. We next turn to a novel case demonstrating the dynamics of sensorimotor plasticity in a pediatric patient following bilateral hand transplantation. Finally, we explore the current and advanced clinical methods used for pre-surgical mapping of eloquent sensorimotor areas and preserving post-surgical function in the state-of-the-art clinical setting.

Speakers:
Elizabeth Heinrichs-Graham, PhD., University of Nebraska Medical Center. "Is an absolute level of cortical beta suppression required for proper movement?"
Gilles Naeije M.D., Université libre de Bruxelles, Belgium. “Investigation of proprioceptive pathways degeneration in Friedreich’s Ataxia using cortico-kinematic coherence”
Christos Papadelis, PhD., Boston Children's Hospital, Mass., USA “Multi-modal neuroimaging in cerebral palsy children to assess cortical reorganization in relation to upper limb function”
William Gaetz PhD., Children’s Hospital of Philadelphia, USA.  “Sensorimotor reorganization in a child with bilateral hand transplants”
Chun Kee Chung, M.D., Ph.D., Seoul National University, Korea. “Pre-surgical measurement of oscillatory activity in sensorimotor cortex"