脑磁图在神经科学中的前沿临床应用

Frontiers in the clinical application of magnetoencephalography in neuroscience

摘要:

脑磁图（MEG）是一种无创脑功能成像技术，通过记录神经元产生的微弱磁场实现毫秒级的时间分辨率。与脑电图（EEG）相比，MEG对脑沟切向电流更敏感，能更精确稳定地进行源定位。传统超导量子干涉仪（SQUID）系统需液氦冷却且较为笨重，而新型光泵磁力计（OPM）系统可在室温下工作，具有可穿戴性且信号增强数倍，为临床应用提供了更广阔的前景。在临床应用方面，MEG在癫痫术前评估中能定位EEG未能发现的致痫灶，并通过高频振荡等标志物提高切除的精准度。在脑肿瘤术前，MEG可准确定位运动和语言功能区，避免肿瘤引起的神经血管解偶联（NVU）问题，结合影像导航帮助实现更大范围的安全切除。MEG还能检测早期阿尔茨海默病患者的脑电频谱变化，作为新疗法疗效评估的生物标志物。在帕金森病中，MEG揭示的病理性β振荡与运动症状严重度相关，并可通过MEG-DBS（脑磁图-深部脑刺激）同步分析优化刺激靶点和参数。在孤独症谱系障碍（ASD）中，MEG（尤其是OPM）能够有效克服低龄及感觉敏感患者的配合难题，精准捕捉兴奋／抑制（E/I）失衡及γ振荡异常，推动ASD向基于客观神经生理标志物的精准诊疗转变。随着OPM技术的发展，MEG在定位、手术指导、早期诊断和治疗优化中正发挥着日益关键的作用，持续推动神经疾病的精准诊疗。

Abstract:

Magnetoencephalography （MEG） is a noninvasive functional neuroimaging modality that achieves millisecond temporal resolution by recording the faint magnetic fields generated by neurons. Compared with electroencephalography （EEG）， MEG is more sensitive to the tangential currents in the cerebral sulci and can perform source localization with better accuracy and stability. Traditional superconducting quantum interference device systems are bulky and reliant on cryogenic liquid helium， while the novel optically pumped magnetometer （OPM） systems are wearable and can operate at room temperature and enhance signal-to-noise ratios， thereby holding promise for wide clinical application. In terms of clinical application， MEG can localize epileptogenic foci that are not detected by EEG during preoperative epilepsy evaluation and improve the precision of resection through markers such as high frequency oscillations. For preoperative brain tumor management， MEG accurately delineates motor and language functional areas， avoids the issue of neurovascular uncoupling （NVU） caused by tumors， and helps to achieve safe resection with a larger extent in combination with image navigation. MEG can also detect early EEG spectral changes in the brain of patients with Alzheimer’s disease and is thus used as a biomarker for evaluating the efficacy of new therapies. In Parkinson’s disease， pathological beta oscillations revealed by MEG are correlated with the severity of motor symptoms， and the synchronized MEG-deep brain stimulation analysis can optimize stimulation targets and parameters. In autism spectrum disorder （ASD）， MEG （especially OPM-based MEG） can effectively overcome compliance challenges in sensory-sensitive and pediatric populations， accurately capture excitation / inhibition imbalance and γ oscillation abnormalities， and promote the paradigm shift to the precise diagnosis and treatment of ASD based on objective neurophysiological biomarkers. With the development of OPM technology， MEG is playing an increasingly critical role in localization， surgical guidance， early diagnosis， and treatment optimization， thereby continuously promoting the precise diagnosis and treatment of neurological disorders.