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Presurgical language localization with visual naming associated ECoG high- gamma modulation in pediatric drug-resistant epilepsy.
- Source :
- Epilepsia (Series 4); Apr2017, Vol. 58 Issue 4, p663-673, 11p
- Publication Year :
- 2017
-
Abstract
- Objective This prospective study compared presurgical language localization with visual naming-associated high-γ modulation ( HGM) and conventional electrical cortical stimulation ( ECS) in children with intracranial electrodes. Methods Patients with drug-resistant epilepsy who were undergoing intracranial monitoring were included if able to name pictures. Electrocorticography ( ECoG) signals were recorded during picture naming (overt and covert) and quiet baseline. For each electrode the likelihood of high-γ (70-116 Hz) power modulation during naming task relative to the baseline was estimated. Electrodes with significant HGM were plotted on a three-dimensional (3D) cortical surface model. Sensitivity, specificity, and accuracy were calculated compared to clinical ECS. Results Seventeen patients with mean age of 11.3 years (range 4-19) were included. In patients with left hemisphere electrodes (n = 10), HGM during overt naming showed high specificity (0.81, 95% confidence interval [ CI] 0.78-0.85), and accuracy (0.71, 95% CI 0.66-0.75, p < 0.001), but modest sensitivity (0.47) when ECS interference with naming (aphasia or paraphasic errors) and/or oral motor function was regarded as the gold standard. Similar results were reproduced by comparing covert naming-associated HGM with ECS naming sites. With right hemisphere electrodes (n = 7), no ECS-naming deficits were seen without interference with oral-motor function. HGM mapping showed a high specificity (0.81, 95% CI 0.78-0.84), and accuracy (0.76, 95% CI 0.71-0.81, p = 0.006), but modest sensitivity (0.44) compared to ECS interference with oral-motor function. Naming-associated ECoG HGM was consistently observed over Broca's area (left posterior inferior-frontal gyrus), bilateral oral/facial motor cortex, and sometimes over the temporal pole. Significance This study supports the use of ECoG HGM mapping in children in whom adverse events preclude ECS, or as a screening method to prioritize electrodes for ECS testing. [ABSTRACT FROM AUTHOR]
- Subjects :
- BROCA'S area
FRONTAL lobe
LONGITUDINAL method
SELF-perception
ECHOLALIA
Subjects
Details
- Language :
- English
- ISSN :
- 00139580
- Volume :
- 58
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Epilepsia (Series 4)
- Publication Type :
- Academic Journal
- Accession number :
- 122407728
- Full Text :
- https://doi.org/10.1111/epi.13708