Assessment of hemispheric dominance for receptive language in pediatric patients under sedation using magnetoencephalography

Abstract

Non-invasive assessment of hemispheric dominance for receptive language using magnetoencephalography (MEG) is now a well-established procedure used across several epilepsy centers in the context of pre-surgical evaluation of children and adults while awake, alert and attentive. However, the utility of MEG for the same purpose, in cases of sedated patients, is contested. Establishment of the efficiency of MEG is especially important in the case of children who, for a number of reasons, must be assessed under sedation. Here we explored the efficacy of MEG language mapping under sedation through retrospective review of 95 consecutive pediatric patients, who underwent our receptive language test as part of routine clinical evaluation. Localization of receptive language cortex and subsequent determination of laterality was successfully completed in 78% (n = 36) and 55% (n = 27) of non-sedated and sedated patients, respectively. Moreover, the proportion of patients deemed left hemisphere dominant for receptive language did not differ between non-sedated and sedated patients, exceeding 90% in both groups. Considering the challenges associated with assessing brain function in pediatric patients, the success of passive MEG in the context of the cases reviewed in this study support the utility of this method in pre-surgical receptive language mapping.

MEG Assessment of Expressive Language in Children Evaluated for Epilepsy Surgery

“…Yet despite the overall positive contribution of MEG in the assessment of language localization in typically developing individuals, data on its clinical use in clinical pediatric populations is still relatively modest. Recent studies have reported the feasibility of passive paradigms in children and adolescents under sedation (Rezaie et al 2014 ) and during sleep (Van Poppel et al 2012 ), but MEG studies using more traditional expressive language tasks in pre-surgical assessment of children are still limited.…”

Spectral and Spatial Characteristics of the Activity of Brain Structures, Participating in the Perception and Production of Speech

“…Использование МЭГ для неинвазивной оценки доминирующего полушария в восприятии речи является хорошо отработанной процедурой при лечении эпилепсии у детей и взрослых хирургическим способом. Авторы работы говорят о важности оценки функционирования мозга, определении доминирующего полушария у детей, которых необходимо поддерживать седативной терапией в дооперационном периоде [21]. Для определения доминирующего полушария восприятия речи необходимо понять, достаточно ли активируются корковые механизмы лингвистической обработки речевых стимулов при седатации.…”

Presurgical electromagnetic functional brain mapping in refractory focal epilepsy

“…In young children and cognitively impaired patients, this may not be feasible for the patients. Interestingly, successful passive MEG language mapping in small groups of sleeping or sedated children have been reported [70,88]. For example, one Meg study used a word listening paradigm in 3 children in natural or propofol-induced sleep and successfully lateralized the receptive language areas [88].…”