EMHapp: a pipeline for the automatic detection, localization and visualization of epileptic magnetoencephalographic high-frequency oscillations.

High-frequency oscillations (HFOs) are promising biomarkers for localizing epileptogenic brain tissue. Previous studies have revealed that HFOs that present concurrence with interictal epileptic discharges (IEDs) better delineate epileptogenic brain tissue, particularly for epilepsy patients with multitype interictal discharges. However, the analysis of noninvasively recorded epileptic HFOs involves many complex procedures, such as data preprocessing, detection and source localization, impeding the translation of this approach to clinical practice.To address these problems, we developed a graphical user interface (GUI)-based pipeline called EMHapp, which can be used for the automatic detection, source localization and visualization of HFO events concurring with IEDs in magnetoencephalography (MEG) signals by using a beamformer-based virtual sensor (VS) technique. An improved VS reconstruction method was developed to enhance the amplitudes of both HFO and IED VS signals. To test the capability of our pipeline, we collected MEG data from 11 complex focal epilepsy patients with surgical resections or seizure onset zones (SOZs) that were identified by intracranial electroencephalography.Our results showed that the HFO sources of eight patients were concordant with their resection margins or SOZs. Our proposed VS signal reconstruction approach achieved an 83.2% improvement regarding the number of detected HFO events and a 17.3% improvement in terms of the spatial overlaps between the HFO sources and the resection margins or SOZs in comparison with conventional VS reconstruction approaches.EMHapp is the first GUI-based pipeline for the analysis of epileptic magnetoencephalographic HFOs, which conveniently obtains HFO source locations using clinical data and enables direct translation to clinical applications.