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Holes in the skull may have a large influence on the EEG and ERP. Inverse source modeling techniques such as dipole fitting require an accurate volume conductor model. This model should incorporate holes if present, especially when either a neuronal generator or the electrodes are close to the hole, e.g., in case of a trephine hole in the upper part of the skull. The boundary element method (BEM) is at present the preferred method for inverse computations using a realistic head model, because of its efficiency and availability. Using a simulation approach, we have studied the accuracy of the BEM by comparing it to the analytical solution for a volume conductor without a hole, and to the finite difference method (FDM) for one with a hole. Furthermore, we have evaluated the influence of holes on the results of forward and inverse computations using the BEM. Without a hole and compared to the analytical model, a three-sphere BEM model was accurate up to 5-10%, while the corresponding FDM model had an error <0.5%. In the presence of a hole, the difference between the BEM and the FDM was, on average, 4% (1.3-11.4%). The FDM turned out to be very accurate if no hole is present. We believe that the difference between the BEM and the FDM represents the inaccuracy of the BEM. This inaccuracy in the BEM is very small compared to the effect that holes can have on the scalp potential (up to 450%). In regard to the large influence of holes on forward and inverse computations, we conclude that holes in the skull can be treated reliably by means of the BEM and should be incorporated in forward and inverse modeling.
Oostenveld et al. (Wed,) studied this question.