Predicting postoperative language outcome using presurgical fMRI, MEG, TMS, and high gamma ECoG

Babajani‐Feremi, Abbas; Holder, Christen M; Narayana, Shalini; Fulton, Stephen; Choudhri, Asim F.; Boop, Frederick A.; Wheless, James W.

doi:10.1016/j.clinph.2017.12.031

Cited by 29 publications

(18 citation statements)

References 79 publications

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“…In addition, several studies have reported that surgical decision making based on cortical stimulation mapping can lead to postoperative language deficits in patients undergoing epilepsy surgery. 4,6 –17 We, along with others, 11,17 found postoperative language deficits after cortical resections that spared cortical stimulation mapping–positive language sites but included electrocorticography-positive language sites. 4 Furthermore, high-gamma electrocorticography has advantages over noninvasive methods, including insensitivity to patients’ head movement and potentially higher accuracy.…”

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confidence: 55%

“…To address a strong concern about postoperative language deficit after resection of the tuber within the left inferior frontal gyrus (and possible Broca area), we performed presurgical language mapping using functional MRI, magnetoencephalography, and transcranial magnetic stimulation, as part of routine clinical procedures in our center. 4 Patient underwent magnetoencephalography scan under sedation for language mapping using a passive word listening task. Magnetoencephalography was not successful in localizing language-specific cortex.…”

Section: Presurgical Language Mapping Using Noninvasive Modalitiesmentioning

confidence: 99%

“…Previous studies have shown the utility of language mapping using functional magnetic resonance imaging (MRI), magnetoencephalography, and transcranial magnetic stimulation. 3,4 However, language mapping using these noninvasive methods is challenging in very young patients because these patients often struggle to cooperate and follow instructions required for data collection. Augmentation of power in the high-gamma frequency band in electrocorticographic recordings has been used to localize language-specific cortex.…”

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confidence: 99%

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Localization of Expressive Language Cortex in a 2-Year-Old Child Using High-Gamma Electrocorticography

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Cortical stimulation mapping is the gold standard for presurgical language mapping; however, it cannot be reliably performed in very young patients. Language mapping using noninvasive modalities is also challenging in very young patients. Although utility of language mapping using power of high-gamma in electrocorticographic recordings was demonstrated in adults and older children, there is a gap of knowledge in the ability of this procedure for localizing language-specific cortex in very young patients. We describe a case of a 2-year-old patient who, to our knowledge, is the youngest person to undergo successful high-gamma electrocorticographic presurgical language mapping for localization of the expressive language cortex (Broca area). The surgical plan was to resect a cortical tuber within the left inferior frontal gyrus and there was a strong concern about postoperative language deficit after resection. Presurgical language mapping using noninvasive modalities were attempted without success. Cortical stimulation mapping was not feasible in this patient. Therefore, high-gamma electrocorticography was the only viable option for language mapping, and it successfully localized the expressive language cortex. The patient underwent surgery for resection of the IFG tuber based on results of high-gamma electrocorticography and had no postoperative language deficit. High-gamma electrocorticography can be used for localizing language-specific cortex, especially Broca’s area, in very young patients.

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Section: Presurgical Language Mapping Using Noninvasive Modalitiesmentioning

confidence: 99%

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Localization of Expressive Language Cortex in a 2-Year-Old Child Using High-Gamma Electrocorticography

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“…Hirata et al (42) reported distances between MEG activation maxima and DCS positive sites of 6.0 ± 7.1 mm, Simos et al (34) described concordant results in a case report. Babajani-Feremi et al (55) showed that the combination of fMRI, high-gamma electrocorticography (ECoG) and MEG predicted postoperative language decline best, while integrating fMRI and MEG provided the best trade-off between model complexity and prediction accuracy. Tarapore et al (56) compared TMS, DCS, and MEG for language mapping in the same patients and found high sensitivity and specificity (90 and 98%) of TMS for DCS results in a population of 12 patients with lesions around cortical language areas, while MEG results correlated with TMS sites only in 5 subjects and DCS sites in 2 subjects.…”

Section: Eeg/meg Functional Cortical Mapping Compared To Other Methodsmentioning

confidence: 99%

Presurgical Functional Cortical Mapping Using Electromagnetic Source Imaging

2019

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Preoperative localization of functionally eloquent cortex (functional cortical mapping) is common clinical practice in order to avoid or reduce postoperative morbidity. This review aims at providing a general overview of magnetoencephalography (MEG) and high-density electroencephalography (hdEEG) based methods and their clinical role as compared to common alternatives for functional cortical mapping of (1) verbal language function, (2) sensorimotor cortex, (3) memory, (4) visual, and (5) auditory cortex. We highlight strengths, weaknesses and limitations of these functional cortical mapping modalities based on findings in the recent literature. We also compare their performance relative to other non-invasive functional cortical mapping methods, such as functional Magnetic Resonance Imaging (fMRI), Transcranial Magnetic Stimulation (TMS), and to invasive methods like the intracarotid Amobarbital Test (WADA-Test) or intracranial investigations.

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“…A recent machine learning study used a support vector regression (SVR) model and the results of multimodal presurgical language mapping, including fMRI, MEG, transcranial magnetic stimulation, and high-gamma ECoG (hgECoG), to predict postoperative language outcome. The SVR model consisting of fMRI and MEG was the optimal model that facilitated the best trade-off between model complexity and prediction accuracy 133 .…”

Section: Functional Magnetic Resonance Imagingmentioning

confidence: 99%

Presurgical epilepsy evaluation and epilepsy surgery

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F1000 Faculty Reviews are written by members of the prestigious . They are F1000 Faculty commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. The reviewers who approved the final version are listed with their names and affiliations. AbstractWith a prevalence of 0.8 to 1.2%, epilepsy represents one of the most frequent chronic neurological disorders; 30 to 40% of patients suffer from drug-resistant epilepsy (that is, seizures cannot be controlled adequately with antiepileptic drugs). Epilepsy surgery represents a valuable treatment option for 10 to 50% of these patients. Epilepsy surgery aims to control seizures by resection of the epileptogenic tissue while avoiding neuropsychological and other neurological deficits by sparing essential brain areas. The most common histopathological findings in epilepsy surgery specimens are hippocampal sclerosis in adults and focal cortical dysplasia in children. Whereas presurgical evaluations and surgeries in patients with mesial temporal sclerosis and benign tumors recently decreased in most centers, non-lesional patients, patients requiring intracranial recordings, and neocortical resections increased. Recent developments in neurophysiological techniques (high-density electroencephalography [EEG], magnetoencephalography, electrical and magnetic source imaging, EEG-functional magnetic resonance imaging [EEG-fMRI], and recording of pathological high-frequency oscillations), structural magnetic resonance imaging (MRI) (ultra-high-field imaging at 7 Tesla, novel imaging acquisition protocols, and advanced image analysis [post-processing] techniques), functional imaging (positron emission tomography and single-photon emission computed tomography co-registered to MRI), and fMRI significantly improved non-invasive presurgical evaluation and have opened the option of epilepsy surgery to patients previously not considered surgical candidates. Technical improvements of resective surgery techniques facilitate successful and safe operations in highly delicate brain areas like the perisylvian area in operculoinsular epilepsy. Novel less-invasive surgical techniques include stereotactic radiosurgery, MR-guided laser interstitial thermal therapy, and stereotactic intracerebral EEG-guided radiofrequency thermocoagulation. PubMed Abstract | Publisher Full Text 18. Cloppenborg T, May TW, Blümcke I, et al.: Trends in epilepsy surgery: stable surgical numbers despite increasing presurgical volumes. J Neurol Neurosurg Psychiatr. 2016; 87(12): 1322-9. PubMed Abstract | Publisher Full Text 19. Dugan P, Carlson C, Jetté N, et al.: Derivation and initial validation of a surgical grading scale for the preliminary evaluation of adult patients with drug-resistant focal epilepsy. Epilepsia. 2017; 58(5): 792-800. PubMed Abstract | Publisher Full Text | F1000 Recommendation 20. Butler TA, Dugan P, French J: Why is mesial temporal lobe epilepsy with Ammon's horn sclerosis becoming less common? Eur J Neurol. 2015; 22(1): e12.PubMe...

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Predicting postoperative language outcome using presurgical fMRI, MEG, TMS, and high gamma ECoG

Cited by 29 publications

References 79 publications

Localization of Expressive Language Cortex in a 2-Year-Old Child Using High-Gamma Electrocorticography

Localization of Expressive Language Cortex in a 2-Year-Old Child Using High-Gamma Electrocorticography

Presurgical Functional Cortical Mapping Using Electromagnetic Source Imaging

Presurgical epilepsy evaluation and epilepsy surgery

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