Magnetospinography visualizes electrophysiological activity in the cervical spinal cord

Visualization of radial nerve activity at the upper arm using magnetoneurography

Objective

To evaluate the function of the radial nerve in the upper arm using Magnetoneurography (MNG).

Methods

Eight asymptomatic male volunteers (age 25-63 years) and one 67-year-old female patient with radial nerve palsy were included. The radial nerve was electrically stimulated in the right wrist, and the evoked magnetic field was recorded using a 132-channel bio-magnetometer system with a superconducting quantum interference device positioned below the upper arm. The measurements were divided into distal and proximal sessions because of the extensive range of the nerve.

Results

MNG recorded the radial nerve's evoked magnetic field in all cases, and the neural activity of the radial nerve at the upper arm was visualized using reconstructed currents. The mean conduction velocity calculated from the peak latency of the inward currents was 43.9 m/s for distal measurements and 57.9 m/s for proximal measurements. A 67-year-old female patient with radial nerve palsy had a disappearance of the reconstructed inward current and conduction disturbance of the axonal current, facilitating the identification of the lesion site.

Conclusions

MNG allowed visualization of the radial nerve activity in the upper arm and facilitated the identification of the lesion site in a patient with radial nerve palsy.

Significance

This method could be a useful diagnostic tool for patients with radial nerve palsy.

Towards non-invasive imaging through spinal-cord generated magnetic fields

Non-invasive imaging of the human spinal cord is a vital tool for understanding the mechanisms underlying its functions in both healthy and pathological conditions. However, non-invasive imaging presents a significant methodological challenge because the spinal cord is difficult to access with conventional neurophysiological approaches, due to its proximity to other organs and muscles, as well as the physiological movements caused by respiration, heartbeats, and cerebrospinal fluid (CSF) flow. Here, we discuss the present state and future directions of spinal cord imaging, with a focus on the estimation of current flow through magnetic field measurements. We discuss existing cryogenic (superconducting) and non-cryogenic (optically-pumped magnetometer-based, OPM) systems, and highlight their strengths and limitations for studying human spinal cord function. While significant challenges remain, particularly in source imaging and interference rejection, magnetic field-based neuroimaging offers a novel avenue for advancing research in various areas. These include sensorimotor processing, cortico-spinal interplay, brain and spinal cord plasticity during learning and recovery from injury, and pain perception. Additionally, this technology holds promise for diagnosing and optimizing the treatment of spinal cord disorders.

A multichannel electrophysiological approach to noninvasively and precisely record human spinal cord activity

The spinal cord is of fundamental importance for integrative processing in brain-body communication, yet routine noninvasive recordings in humans are hindered by vast methodological challenges. Here, we overcome these challenges by developing an easy-to-use electrophysiological approach based on high-density multichannel spinal recordings combined with multivariate spatial-filtering analyses. These advances enable a spatiotemporal characterization of spinal cord responses and demonstrate a sensitivity that permits assessing even single-trial responses. To furthermore enable the study of integrative processing along the neural processing hierarchy in somatosensation, we expand this approach by simultaneous peripheral, spinal, and cortical recordings and provide direct evidence that bottom-up integrative processing occurs already within the spinal cord and thus after the first synaptic relay in the central nervous system. Finally, we demonstrate the versatility of this approach by providing noninvasive recordings of nociceptive spinal cord responses during heat-pain stimulation. Beyond establishing a new window on human spinal cord function at millisecond timescale, this work provides the foundation to study brain-body communication in its entirety in health and disease.

Imaging protocols for non-traumatic spinal cord injury: current state of the art and future directions

INTRODUCTION

Non-traumatic spinal cord injury (NTSCI) is a term used to describe damage to the spinal cord from sources other than trauma. Neuroimaging techniques such as computerized tomography (CT) and magnetic resonance imaging (MRI) have improved our ability to diagnose and manage NTSCIs. Several practice guidelines utilize MRI in the diagnostic evaluation of traumatic and non-traumatic SCI to direct surgical intervention.

AREAS COVERED

The authors review practices surrounding the imaging of various causes of NTSCI as well as recent advances and future directions for the use of novel imaging modalities in this realm. The authors also present discussions around the use of simple radiographs and advanced MRI modalities in clinical settings, and briefly highlight areas of active research that seek to advance our understanding and improve patient care.

EXPERT OPINION

Although several obstacles must be overcome, it appears highly likely that novel quantitative imaging features and advancements in artificial intelligence (AI) as well as machine learning (ML) will revolutionize degenerative cervical myelopathy (DCM) care by providing earlier diagnosis, accurate localization, monitoring for deterioration and neurological recovery, outcome prediction, and standardized practice. Some intriguing findings in these areas have been published, including the identification of possible serum and cerebrospinal fluid biomarkers, which are currently in the early phases of translation.

Concurrent spinal and brain imaging with optically pumped magnetometers

BACKGROUND

The spinal cord and its interactions with the brain are fundamental for movement control and somatosensation. However, brain and spinal electrophysiology in humans have largely been treated as distinct enterprises, in part due to the relative inaccessibility of the spinal cord. Consequently, there is a dearth of knowledge on human spinal electrophysiology, including the multiple pathologies that affect the spinal cord as well as the brain.

NEW METHOD

Here we exploit recent advances in the development of wearable optically pumped magnetometers (OPMs) which can be flexibly arranged to provide coverage of both the spinal cord and the brain in relatively unconstrained environments. This system for magnetospinoencephalography (MSEG) measures both spinal and cortical signals simultaneously by employing custom-made scanning casts.

RESULTS

We evidence the utility of such a system by recording spinal and cortical evoked responses to median nerve stimulation at the wrist. MSEG revealed early (10 - 15 ms) and late (>20 ms) responses at the spinal cord, in addition to typical cortical evoked responses (i.e., N20).

COMPARISON WITH EXISTING METHODS

Early spinal evoked responses detected were in line with conventional somatosensory evoked potential recordings.

CONCLUSION

This MSEG system demonstrates the novel ability for concurrent non-invasive millisecond imaging of brain and spinal cord.

Assessing ulnar neuropathy at the elbow using magnetoneurography

OBJECTIVE

To measure neuromagnetic fields of ulnar neuropathy patients at the elbow after electrical stimulation and evaluate ulnar nerve function at the elbow with high spatial resolution.

METHODS

A superconducting quantum interference device magnetometer system recorded neuromagnetic fields of the ulnar nerve at the elbow after electrical stimulation at the wrist in 16 limbs of 16 healthy volunteers and 21 limbs of 20 patients with ulnar neuropathy at the elbow. After artifact removal, neuromagnetic field signals were processed into current distributions, which were superimposed onto X-ray images for visualization.

RESULTS

Based on the results in healthy volunteers, conduction velocity of 30 m/s or 50% attenuation in current amplitude was set as the reference value for conduction disturbance. Of the 21 patient limbs, 15 were measurable and lesion sites were detected, whereas 6 limbs were unmeasurable due to weak neuromagnetic field signals. Seven limbs were deemed normal by nerve conduction study, but 5 showed conduction disturbances on magnetoneurography.

CONCLUSIONS

Measuring the magnetic field after nerve stimulation enabled visualization of neurophysiological activity in patients with ulnar neuropathy at the elbow and evaluation of conduction disturbances.

SIGNIFICANCE

Magnetoneurography may be useful for assessing lesion sites in patients with ulnar neuropathy at the elbow.

SQUID magnetoneurography: an old-fashioned yet new tool for noninvasive functional imaging of spinal cords and peripheral nerves

We are engaged in the development and clinical application of a neural magnetic field measurement system that utilizes biomagnetic measurements to observe the activity of the spinal cord and peripheral nerves. Unlike conventional surface potential measurements, biomagnetic measurements are not affected by the conductivity distribution within the body, making them less influenced by the anatomical structure of body tissues. Consequently, functional testing using biomagnetic measurements can achieve higher spatial resolution compared to surface potential measurements. The neural magnetic field measurement, referred to as magnetoneurography, takes advantage of these benefits to enable functional testing of the spinal cord and peripheral nerves, while maintaining high spatial resolution and noninvasiveness. Our magnetoneurograph system is based on superconducting quantum interference devices (SQUIDs) similar to the conventional biomagnetic measurement systems. Various design considerations have been incorporated into the SQUID sensor array structure and signal processing software to make it suitable for detecting neural signal propagation along spinal cord and peripheral nerve. The technical validation of this system began in 1999 with a 3-channel SQUID system. Over the course of more than 20 years, we have continued technological development through medical-engineering collaboration, and in the latest prototype released in 2020, neural function imaging of the spinal cord and peripheral nerves, which could also be applied for the diagnosis of neurological disorders, has become possible. This paper provides an overview of the technical aspects of the magnetoneurograph system, covering the measurement hardware and software perspectives for providing diagnostic information, and its applications. Additionally, we discuss the integration with a helium recondensing system, which is a key factor in reducing running costs and achieving practicality in hospitals.

Recent developments and future avenues for human corticospinal neuroimaging

Non-invasive neuroimaging serves as a valuable tool for investigating the mechanisms within the central nervous system (CNS) related to somatosensory and motor processing, emotions, memory, cognition, and other functions. Despite the extensive use of brain imaging, spinal cord imaging has received relatively less attention, regardless of its potential to study peripheral communications with the brain and the descending corticospinal systems. To comprehensively understand the neural mechanisms underlying human sensory and motor functions, particularly in pathological conditions, simultaneous examination of neuronal activity in both the brain and spinal cord becomes imperative. Although technically demanding in terms of data acquisition and analysis, a growing but limited number of studies have successfully utilized specialized acquisition protocols for corticospinal imaging. These studies have effectively assessed sensorimotor, autonomic, and interneuronal signaling within the spinal cord, revealing interactions with cortical processes in the brain. In this mini-review, we aim to examine the expanding body of literature that employs cutting-edge corticospinal imaging to investigate the flow of sensorimotor information between the brain and spinal cord. Additionally, we will provide a concise overview of recent advancements in functional magnetic resonance imaging (fMRI) techniques. Furthermore, we will discuss potential future perspectives aimed at enhancing our comprehension of large-scale neuronal networks in the CNS and their disruptions in clinical disorders. This collective knowledge will aid in refining combined corticospinal fMRI methodologies, leading to the development of clinically relevant biomarkers for conditions affecting sensorimotor processing in the CNS.

Evaluation of electrical activity at the carpal tunnel area in response to median nerve elbow stimulation using magnetoneurography

OBJECTIVE

To develop a magnetic field measurement method in the carpal tunnel area in response to electrical median nerve stimulation at the elbow and evaluate its usefulness.

METHODS

Five healthy subjects participated. The magnetic field recording evoked by median nerve electrical stimulation at the elbow with electrical intensity that minimized the pronator quadratus and flexor carpi radialis muscle response was measured with 132-channel superconducting quantum interference device magnetoneurography. The current distributions were reconstructed from magnetic fields with the spatial filter method. The magnetic fields evoked by electrical stimulation at the index distal interphalangeal joint were also measured.

RESULTS

After median nerve elbow stimulation, intra-axonal current and inward currents flowing perpendicularly to the nerve pathway were visualized. The mean ± SD inward current intensity at the center of the carpal tunnel area was significantly larger with elbow stimulation than with index distal interphalangeal joint stimulation: 1.11 ± 0.65 nAm versus 0.51 ± 0.15 nAm (p = 0.047).

CONCLUSIONS

Magnetic field measurement in the carpal tunnel area with adjusted submaximal stimulation at the elbow can detect larger signals compared with digit stimulation.

SIGNIFICANCE

This method has the potential to be more useful for the examination of carpal tunnel syndrome patients.

Visualization of axonal and volume currents in median nerve compound action potential using magnetoneurography

OBJECTIVE

Reconstruct compound median nerve action currents using magnetoneurography to clarify the physiological characteristics of axonal and volume currents and their relationship to potentials.

METHODS

The median nerves of both upper arms of five healthy individuals were investigated. The propagating magnetic field of the action potential was recorded using magnetoneurography, reconstructed into a current, and analyzed. The currents were compared with the potentials recorded from multipolar surface electrodes.

RESULTS

Reconstructed currents could be clearly visualized. Axonal currents flowed forward or backward in the axon, arcing away from the depolarization zone, turning about the subcutaneous volume conductor, and returning to the depolarization zone. The zero-crossing latency of the axonal current was approximately the same as the peak of its volume current and the negative peak of the surface electrode potential. Volume current waveforms were proportional to the derivative of axonal ones.

CONCLUSIONS

Magnetoneurography allows the visualization and quantitative evaluation of action currents. The currents in axons and in volume conductors could be clearly discriminated with good quality. Their properties were consistent with previous neurophysiological findings.

SIGNIFICANCE

Magnetoneurography could be a novel tool for elucidating nerve physiology and pathophysiology.

Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going?

Degenerative cervical myelopathy (DCM), a recently coined term, encompasses a group of age-related and genetically associated pathologies that affect the cervical spine, including cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL). Given the significant contribution of DCM to global disease and disability, there are worldwide efforts to promote research and innovation in this area. An AO Spine effort termed 'RECODE-DCM' was initiated to create an international multistakeholder consensus group, involving patients, caregivers, physicians and researchers, to focus on launching actionable discourse on DCM. In order to improve the management, treatment and results for DCM, the RECODE-DCM consensus group recently identified ten priority areas for translational research. The current article summarizes recent advancements in the field of DCM. We first discuss the comprehensive definition recently refined by the RECODE-DCM group, including steps taken to arrive at this definition and the supporting rationale. We then provide an overview of the recent advancements in our understanding of the pathophysiology of DCM and modalities to clinically assess and diagnose DCM. A focus will be set on advanced imaging techniques that may offer the opportunity to improve characterization and diagnosis of DCM. A summary of treatment modalities, including surgical and nonoperative options, is then provided along with future neuroprotective and neuroregenerative strategies. This review concludes with final remarks pertaining to the genetics involved in DCM and the opportunity to leverage this knowledge toward a personalized medicine approach.

Magnetoneurography to investigate the mechanisms underlying the P9 far-field potential

OBJECTIVE

The mechanism underlying the generation of P9 far-field somatosensory evoked potentials (SEPs) is unresolved. Accordingly, we used magnetoneurography to visualize the current distribution in the body at the P9 peak latency and elucidate the origin of P9 generation.

METHODS

We studied five healthy male volunteers without neurological abnormalities. We recorded far-field SEPs after median nerve stimulation at the wrist to identify the P9 peak latency. Using magnetoneurography, we recorded the evoked magnetic fields in the whole body under the same stimulus conditions as the SEP recording. We analyzed the reconstructed current distribution at the P9 peak latency.

RESULTS

At the P9 peak latency, we observed the reconstructed current distribution dividing the thorax into two parts, upper and lower. Anatomically, the depolarization site at the P9 peak latency was distal to the interclavicular space and at the level of the second intercostal space.

CONCLUSIONS

By visualizing the current distribution, we proved that P9 peak latency originates in the change in volume conductor size between the upper and lower thorax.

SIGNIFICANCE

We clarified that magnetoneurography analysis is affected by the current distribution due to the junction potential.

High-Performance Implantable Sensors based on Anisotropic Magnetoresistive La0.67Sr0.33MnO3 for Biomedical Applications

We present the design, fabrication, and characterization of an implantable neural interface based on anisotropic magnetoresistive (AMR) magnetic-field sensors that combine reduced size and high performance at body temperature. The sensors are based on La_0.67Sr_0.33MnO₃ (LSMO) as a ferromagnetic material, whose epitaxial growth has been suitably engineered to get uniaxial anisotropy and large AMR output together with low noise even at low frequencies. The performance of LSMO sensors of different film thickness and at different temperatures close to 37 °C has to be explored to find an optimum sensitivity of ∼400%/T (with typical detectivity values of 2 nT·Hz^-1/2 at a frequency of 1 Hz and 0.3 nT·Hz^-1/2 at 1 kHz), fitted for the detection of low magnetic signals coming from neural activity. Biocompatibility tests of devices consisting of submillimeter-size LSMO sensors coated by a thin poly(dimethyl siloxane) polymeric layer, both in vitro and in vivo, support their high suitability as implantable detectors of low-frequency biological magnetic signals emerging from heterogeneous electrically active tissues.

Detailed magnetoelectric analysis of a nerve impulse propagation along the brachial plexus

OBJECTIVE

To visualize impulse conduction along the brachial plexus through simultaneous electromagnetic measurements.

METHODS

Neuromagnetic fields following median nerve stimulation were recorded above the clavicle with a superconducting quantum interference device biomagnetometer system in 7 healthy volunteers. Compound nerve action potentials (CNAPs) were obtained from 12 locations. Pseudocolor maps of equivalent currents reconstructed from magnetic fields and isopotential contour maps were superimposed onto X-ray images. Surface potentials and current waveforms at virtual electrodes along the brachial plexus were compared.

RESULTS

In magnetic field analysis, the leading axonal current followed by a trailing backward current traveled rostrally along the brachial plexus. The spatial extent of the longitudinal intra-axonal currents corresponded to the extent of the positive-negative-positive potential field reflecting transmembrane volume currents. The peaks and troughs of the intra-axonal biphasic current waveforms coincided with the zero-crossings of triphasic CNAP waveforms. The amplitudes of CNAPs and current moments were linearly correlated.

CONCLUSIONS

Reconstructed neural activity in magnetic field analysis visualizes not only intra-axonal currents, but also transmembrane volume currents, which are in good agreement with the surface potential field.

SIGNIFICANCE

Magnetoneurography is a novel non-invasive functional imaging modality for the brachial plexus whose performance can surpass that of electric potential measurement.

Cross-Axis Dynamic Field Compensation of Optically Pumped Magnetometer Arrays for MEG

We present dynamic field compensation (DFC), whereby three-axis field measurements from reference magnetometers are used to dynamically maintain null at the alkali vapor cells of an array of primary sensors that are proximal to a subject's scalp. Precision measurement of the magnetoencephalogram (MEG) by zero-field optically pumped magnetometer (OPM) sensors requires that sensor response is linear and sensor gain is constant over time. OPMs can be operated in open-loop mode, where the measured field is proportional to the output at the demodulated photodiode output, or in closed-loop, where on-board coils are dynamically driven to maintain the internal cell at zero field in the measurement direction. While OPMs can be operated in closed-loop mode along all three axes, this can increase sensor noise and poses engineering challenges. Uncompensated fluctuations in the ambient field along any statically nulled axes perturb the measured field by tipping the measurement axis and altering effective sensor gain - a phenomenon recently referred to as cross-axis projection error (CAPE). These errors are particularly problematic when OPMs are allowed to move in the remnant background field. Sensor gain-errors, if not mitigated, preclude precision measurements with OPMs operating in the presence of ambient field fluctuations within a typical MEG laboratory. In this manuscript, we present the cross-axis dynamic field compensation (DFC) method for maintaining zero field dynamically on all three axes of each sensor in an array of OPMs. Together, DFC and closed-loop operation strongly attenuate errors introduced by CAPE. This method was implemented by using three orthogonal reference sensors together with OPM electronics that permit driving each sensor's transverse field coils dynamically to maintain null field across its OPM measurement cell. These reference sensors can also be used for synthesizing 1st-gradient response to further reduce the effects of fluctuating ambient fields on measured brain activity and compensate for movement within a uniform field. We demonstrate that, using the DFC method, magnetic field measurement errors of less than 0.7% are easily achieved for an array of OPM sensors in the presence of ambient field perturbations of several nT.

Imaging and Electrophysiology for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 9]

STUDY DESIGN

Narrative review.

OBJECTIVE

The current review aimed to describe the role of existing techniques and emerging methods of imaging and electrophysiology for the management of degenerative cervical myelopathy (DCM), a common and often progressive condition that causes spinal cord dysfunction and significant morbidity globally.

METHODS

A narrative review was conducted to summarize the existing literature and highlight future directions.

RESULTS

Anatomical magnetic resonance imaging (MRI) is well established in the literature as the key imaging tool to identify spinal cord compression, disc herniation/bulging, and inbuckling of the ligamentum flavum, thus facilitating surgical planning, while radiographs and computed tomography (CT) provide complimentary information. Electrophysiology techniques are primarily used to rule out competing diagnoses. However, signal change and measures of cord compression on conventional MRI have limited utility to characterize the degree of tissue injury, which may be helpful for diagnosis, prognostication, and repeated assessments to identify deterioration. Early translational studies of quantitative imaging and electrophysiology techniques show potential of these methods to more accurately reflect changes in spinal cord microstructure and function.

CONCLUSION

Currently, clinical management of DCM relies heavily on anatomical MRI, with additional contributions from radiographs, CT, and electrophysiology. Novel quantitative assessments of microstructure, perfusion, and function have the potential to transform clinical practice, but require robust validation, automation, and standardization prior to uptake.

Assessment of thoracic spinal cord electrophysiological activity through magnetoneurography

OBJECTIVE

Noninvasive and detailed visualization of electrophysiological activity in the thoracic spinal cord through magnetoneurography.

METHODS

In five healthy volunteers, magnetic fields around current flowing in the thoracic spinal cord after alternating unilateral and synchronized bilateral sciatic nerve stimulation were measured using a magnetoneurograph system with superconductive quantum interference device biomagnetometers. The current distribution was obtained from the magnetic data by spatial filtering and visualized by superimposing it on the X-ray image. Conduction velocity was calculated using the peak latency of the current waveforms.

RESULTS

A sufficiently high magnetic signal intensity and signal-to-noise ratio were obtained in all participants after synchronized bilateral sciatic nerve stimulation. Leading and trailing components along the spinal canal and inward components flowing into the depolarization site ascended to the upper thoracic spine. Conduction velocity of the inward current in the whole thoracic spine was 42.4 m/s.

CONCLUSIONS

Visualization of electrophysiological activity in the thoracic spinal cord was achieved through magnetoneurography and a new method for synchronized bilateral sciatic nerve stimulation. Magnetoneurography is expected to be a useful modality in functional assessment of thoracic myelopathy.

SIGNIFICANCE

This is the first report to use magnetoneurography to noninvasively visualize electrophysiological activity in the thoracic spinal cord in detail.

Noninvasive measurement of sensory action currents in the cervical cord by magnetospinography

OBJECTIVE

To obtain magnetic recordings of electrical activities in the cervical cord and visualize sensory action currents of the dorsal column, intervertebral foramen, and dorsal horn.

METHODS

Neuromagnetic fields were measured at the neck surface upon median nerve stimulation at the wrist using a magnetospinography system with high-sensitivity superconducting quantum interference device sensors. Somatosensory evoked potentials (SEPs) were also recorded. Evoked electrical currents were reconstructed by recursive null-steering beamformer and superimposed on cervical X-ray images.

RESULTS

Estimated electrical currents perpendicular to the cervical cord ascended sequentially. Their peak latency at C5 and N11 peak latency of SEP were well-correlated in all 16 participants (r = 0.94, p < 0.0001). Trailing axonal currents in the intervertebral foramens were estimated in 10 participants. Estimated dorsal-ventral electrical currents were obtained within the spinal canal at C5. Current density peak latency significantly correlated with cervical N13-P13 peak latency of SEPs in 13 participants (r = 0.97, p < 0.0001).

CONCLUSIONS

Magnetospinography shows excellent spatial and temporal resolution after median nerve stimulation and can identify the spinal root entry level, calculate the dorsal column conduction velocity, and analyze segmental dorsal horn activity.

SIGNIFICANCE

This approach is useful for functional electrophysiological diagnosis of somatosensory pathways.

Visualization of electrical activity in the cervical spinal cord and nerve roots after ulnar nerve stimulation using magnetospinography

OBJECTIVE

To establish a method for magnetospinography (MSG) measurement after ulnar nerve stimulation and to clarify its characteristics.

METHODS

Using a 132-channel magnetoneurography system with a superconducting quantum interference device, cervical MSG measurements were obtained for 10 healthy volunteers after stimulation of the ulnar nerve at the elbow and the wrist, and neural current distribution was calculated and superimposed on the cervical X-ray images.

RESULTS

Neuromagnetic signals were obtained in all participants after applying the stimulus artifact removal algorithm. The measured magnetic field intensity after elbow stimulation was about twice that after wrist stimulation. Calculated neural currents flowed into the intervertebral foramina at C6/7 to T1/2 and propagated cranially along the spinal canal. The conduction velocity from the peak latency of inward currents at C5-C7 was 73.4 ± 19.6 m/s.

CONCLUSIONS

We successfully obtained MSG measurements after ulnar nerve stimulation. The neural currents flowed into the spinal canal from more caudal segments after ulnar nerve stimulation compared with median nerve stimulation, and these MSG measurements were effective in examining the spinal tracts at C5/6/7.

SIGNIFICANCE

This is the first report on the use of MSG to visualize electrical activity in the cervical spinal cord and nerve root after ulnar nerve stimulation.

Evaluation of neural activity by magnetospinography with 3D sensors

OBJECTIVE

Magnetospinography (MSG) has been developed for clinical application and is expected to be a novel neurophysiological examination. Here, we used an MSG system with sensors positioned in three orthogonal directions to record lumbar canal evoked magnetic fields (LCEFs) in response to peripheral nerve stimulation and to evaluate methods for localizing spinal cord lesions.

METHODS

LCEFs from the lumbar area of seven rabbits were recorded by the MSG system in response to electrical stimulation of a sciatic nerve. LCEFs and lumbar canal evoked potentials (LCEPs) were measured before and after spinal cord compression induced by a balloon catheter. The lesion positions were estimated using LCEPs and computationally reconstructed currents corresponding to the depolarization site.

RESULTS

LCEFs were recorded in all rabbits and neural activity in the lumbar spinal cord could be visualized in the form of a magnetic contour map and reconstructed current map. The position of the spinal cord lesion could be estimated by the LCEPs and reconstructed currents at the depolarization site.

CONCLUSIONS

MSG can visualize neural activity in the spinal cord and localize the lesion site.

SIGNIFICANCE

MSG enables noninvasive assessment of neural activity in the spinal canal using currents at depolarization sites reconstructed from LCEFs.

Ultrasensitive Magnetic Field Sensors for Biomedical Applications

The development of magnetic field sensors for biomedical applications primarily focuses on equivalent magnetic noise reduction or overall design improvement in order to make them smaller and cheaper while keeping the required values of a limit of detection. One of the cutting-edge topics today is the use of magnetic field sensors for applications such as magnetocardiography, magnetotomography, magnetomyography, magnetoneurography, or their application in point-of-care devices. This introductory review focuses on modern magnetic field sensors suitable for biomedicine applications from a physical point of view and provides an overview of recent studies in this field. Types of magnetic field sensors include direct current superconducting quantum interference devices, search coil, fluxgate, magnetoelectric, giant magneto-impedance, anisotropic/giant/tunneling magnetoresistance, optically pumped, cavity optomechanical, Hall effect, magnetoelastic, spin wave interferometry, and those based on the behavior of nitrogen-vacancy centers in the atomic lattice of diamond.

Magnetic Measurement of Electrically Evoked Muscle Responses With Optically Pumped Magnetometers

OBJECTIVE

Electroneurography has been an essential method for assessing peripheral nerve disorders for decades. During this procedure, a nerve is briefly electrically excited, and nerve conduction properties are identified by indirect means from the behavior of the innervated muscle. The magnetic field of the resulting muscle response can also be recorded by novel, uncooled magnetometers, which have become very attractive for different medical applications over recent years. These highly sensitive magnetometers are called optically pumped magnetometers.

METHODS

We performed unaveraged and averaged magnetic signal detection of electrically evoked muscle responses using optically pumped magnetometers. We then discussed the suitability of this procedure for clinical applications in the context of diagnostic value and in direct comparison with the current electrical gold standard.

RESULTS

The magnetic detection of muscle responses is possible using optically pumped magnetometers. Our magnetic results (averaged and unaveraged) closely match those from electrical measurements.

CONCLUSION

Optically pumped magnetometers provide an alternative, contactless technology for electrode-based motor studies, but they are currently not ready for routine clinical use. This costly technology requires additional earth magnetic shielding because this is a prerequisite for proper operation. Currently, there are no diagnostic advantages over electrical measurements. Additionally, the required measurement setup and procedure are much more complicated.

SIGNIFICANCE

In contrast to already published proof-of-principle studies for magnetomyography, we report in detail the results of the magnetic measurements of electrically evoked muscle responses in a shielded environment by applying supramaximal stimulation and finally validate our findings with electroneurography data as a reference.

Visualization of electrophysiological activity at the carpal tunnel area using magnetoneurography

OBJECTIVE

To establish a noninvasive method to measure the neuromagnetic fields of the median nerve at the carpal tunnel after electrical digital nerve stimulation and evaluate peripheral nerve function.

METHODS

Using a vector-type biomagnetometer system with a superconducting quantum interference device, neuromagnetic fields at the carpal tunnel were recorded after electrical stimulation of the index or middle digital nerve in five healthy volunteers. A novel technique for removing stimulus-induced artifacts was applied, and current distributions were calculated using a spatial filter algorithm and superimposed on X-ray.

RESULTS

A neuromagnetic field propagating from the palm to the carpal tunnel was observed in all participants. Current distributions estimated from the magnetic fields had five components: leading and trailing components parallel to the conduction pathway, outward current preceding the leading component, inward currents between the leading and trailing components, and outward current following the trailing component. The conduction velocity and peak latency of the inward current agreed well with those of sensory nerve action potentials.

CONCLUSION

Removing stimulus-induced artifacts enabled magnetoneurography to noninvasively visualize with high spatial resolution the electrophysiological neural activity from the palm to the carpal tunnel.

SIGNIFICANCE

This is the first report of using magnetoneurography to visualize electrophysiological nerve activity at the palm and carpal tunnel.

The multipole approach for EEG forward modeling using the finite element method

For accurate EEG forward solutions, it is necessary to apply numerical methods that allow to take into account the realistic geometry of the subject's head. A commonly used method to solve this task is the finite element method (FEM). Different approaches have been developed to obtain EEG forward solutions for dipolar sources with the FEM. The St. Venant approach is frequently applied, since its high numerical accuracy and stability as well as its computational efficiency was demonstrated in multiple comparison studies. In this manuscript, we propose a variation of the St. Venant approach, the multipole approach, to improve the numerical accuracy of the St. Venant approach even further and to allow for the simulation of additional source scenarios, such as quadrupolar sources. Exploiting the multipole expansion of electric fields, we demonstrate that the newly proposed multipole approach achieves even higher numerical accuracies than the St. Venant approach in both multi-layer sphere and realistic head models. Additionally, we exemplarily show that the multipole approach allows to not only simulate dipolar but also quadrupolar sources.

Novel functional imaging technique for the brachial plexus based on magnetoneurography

OBJECTIVE

To visualize neural activity in the brachial plexus using magnetoneurography (MNG).

METHODS

Using a 124- or 132-channel biomagnetometer system with a superconducting quantum interference device, neuromagnetic fields above the clavicle and neck region were recorded in response to electrical stimulation of the median and ulnar nerves in five asymptomatic volunteers (four men and one woman; age, 27-45 years old). Equivalent currents were computationally reconstructed from neuromagnetic fields and visualized as pseudocolor maps. Reconstructed currents at the depolarization site and compound nerve action potentials (CNAPs) at Erb's point were compared.

RESULTS

Neuromagnetic fields were recorded in all subjects. The reconstructed equivalent currents propagated into the vertebral foramina, and the main inflow levels differed between the median nerve (C5/C6-C7/T1 vertebral foramen) and the ulnar nerve (C7/T1-T1/T2). The inward current peaks at the depolarization site and CNAPs showed high linear correlation.

CONCLUSIONS

MNG visualizes neural activity in the brachial plexus and can differentiate the conduction pathways after median and ulnar nerve stimulations. In addition, it can visualize not only the leading and trailing components of intra-axonal currents, but also inward currents at the depolarization site.

SIGNIFICANCE

MNG is a novel and promising functional imaging modality for the brachial plexus.

Visualization of the electrical activity of the cauda equina using a magnetospinography system in healthy subjects

OBJECTIVE

To establish a method to measure cauda equina action fields (CEAFs) and visualize the electrical activities of the cauda equina in a broadly aged group of healthy adults.

METHODS

Using a 124-channel magnetospinography (MSG) system with superconducting interference devices, the CEAFs of 43 healthy volunteers (22-64 years of age) were measured after stimulation of the peroneal nerve at the knee. Reconstructed currents were obtained from the CEAFs and superimposed on the X-ray image. Conduction velocities were also calculated from the waveform of the reconstructed currents.

RESULTS

The reconstructed currents were successfully visualized. They flowed into the L5/S1 foramen about 8.25-8.95 ms after the stimulation and propagated cranially along the spinal canal. In 32 subjects (74%), the conduction velocities of the reconstructed currents in the cauda equina could be calculated from the peak latency at the L2-L5 level.

CONCLUSIONS

MSG visualized the electrical activity of the cauda equina after peroneal nerve stimulation in healthy adults. In addition, the conduction velocities of the reconstructed currents in the cauda equina could be calculated, despite previously being difficult to measure.

SIGNIFICANCE

MSG has the potential to be a novel and noninvasive functional examination for lumbar spinal disease.

Integrated Giant Magnetoresistance Technology for Approachable Weak Biomagnetic Signal Detections

With the extensive applications of biomagnetic signals derived from active biological tissue in both clinical diagnoses and human-computer-interaction, there is an increasing need for approachable weak biomagnetic sensing technology. The inherent merits of giant magnetoresistance (GMR) and its high integration with multiple technologies makes it possible to detect weak biomagnetic signals with micron-sized, non-cooled and low-cost sensors, considering that the magnetic field intensity attenuates rapidly with distance. This paper focuses on the state-of-art in integrated GMR technology for approachable biomagnetic sensing from the perspective of discipline fusion between them. The progress in integrated GMR to overcome the challenges in weak biomagnetic signal detection towards high resolution portable applications is addressed. The various strategies for 1/f noise reduction and sensitivity enhancement in integrated GMR technology for sub-pT biomagnetic signal recording are discussed. In this paper, we review the developments of integrated GMR technology for in vivo/vitro biomagnetic source imaging and demonstrate how integrated GMR can be utilized for biomagnetic field detection. Since the field sensitivity of integrated GMR technology is being pushed to fT/Hz0.5 with the focused efforts, it is believed that the potential of integrated GMR technology will make it preferred choice in weak biomagnetic signal detection in the future.