The combination of recently developed methods for electroencephalographic (EEG) space-time-frequency analysis can provide noninvasive functional neuroimages necessary for obtaining an accurate localization of the epileptogenic zone. The aim of this study was to determine if time-frequency (TF) analysis, followed by EEG source localization, would improve the detection and identification of epileptogenic and related activity. Seventeen patients with refractory frontal lobe epilepsy (FLE) were studied using video EEG recording. TF analysis identified the first epileptogenic EEG changes. Using the Bayesian model averaging (BMA) approach, we compared brain electromagnetic tomographic (BET) images, constructed from the TF domain, with BET images constructed from the time domain only. We determined if the localization identified by BET images was concordant with the localization from medical history and video EEG recording. TF analysis provided a clear display of subtle EEG features, including EEG lateralization, and more concordant and delimited epileptogenic zones, compared with time-domain source analysis. In conclusion, EEG TF analysis improves source localization. After a thorough validation, this methodology could become a useful noninvasive tool for localizing the epileptogenic zone in clinical practice.
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