The impact of CSF-filled cavities on scalp EEG and its implications

Abstract Previous studies have found EEG amplitude and scalp topography differences between neurotypical and neurological/neurosurgical groups, being interpreted at the cognitive level. However, these comparisons are invariably accompanied by anatomical changes. Critical to EEG are the so-called volume currents, which are affected by the spatial distribution of the different tissues in the head. We investigated the effect of CSF-filled cavities on simulated EEG scalp data. We simulated EEG scalp potentials for known sources using different volume conduction models: a reference model (i.e., unlesioned brain) and models with realistic CSF-filled cavities gradually increasing in size. We used this approach for a single source close or far from the CSF-lesion cavity, and for a scenario with a distributed configuration of sources (i.e., a “cognitive ERP effect”). Magnitude and topography error between the reference and lesion models were quantified. For the single-source simulation close to the lesion, the CSF-filled lesion modulated signal amplitude with more than 17% magnitude error, and topography with more than 9% topographical error. Negligible modulation was found for the single source far from the lesion. For the multi-source simulations of the cognitive effect, the CSF-filled lesion modulated signal amplitude with more than 6% magnitude error, and topography with more than 16% topography error in a non-monotonic fashion. In conclusion, the impact of a CSF-filled cavity cannot be neglected for scalp-level EEG data. Especially when group-level comparisons are made, any scalp-level attenuated, aberrant, or absent effects are difficult to interpret without considering the confounding effect of CSF. Impact statement Previous studies have found EEG amplitude and scalp topography differences between neurotypical and neurological/neurosurgical groups (whose brain damage leads to the presence of a CSF-filled cavity), being interpreted at the cognitive level. Via simulations of scalp-level EEG patterns, we show that attenuated, aberrant, or absent effects in these comparisons are difficult to interpret without considering the confounding effect of CSF. Funding This study was partly supported by grants from the Netherlands Organization for Scientific Research (Nederlandse Organisatie voor Wetenschappelijk Onderzoek [NWO]) to V. P. (451-17-003 and VI.Vidi.201.081) and to the Language in Interaction Consortium (024-001-006). CRediT VP: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Visualization, Writing – original draft, Writing – review & editing RO: Conceptualization, Methodology, Software, Writing – review & editing JMS: Conceptualization, Methodology, Software, Writing – review & editing MCP: Conceptualization, Investigation, Methodology, Visualization, Writing – review & editing