TY - JOUR
T1 - ECoG high-gamma modulation versus electrical stimulation for presurgical language mapping
AU - Arya, Ravindra
AU - Horn, Paul S.
AU - Crone, Nathan E.
N1 - Funding Information:
Research reported in this paper was supported by NINDS of the National Institutes of Health (NIH) under award number R01NS091139 (PI: NEC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. There are no other conflicts to disclose.
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/2
Y1 - 2018/2
N2 - Objective This meta-analysis compared diagnostic validity of electrocorticographic (ECoG) high-γ modulation (HGM) with electrical stimulation mapping (ESM) for presurgical language localization. Methods From a structured literature search, studies with electrode level data comparing ECoG HGM and ESM for language localization were included in the meta-analysis. Outcomes included global measures of diagnostic validity: area under the summary receiver operating characteristic (SROC) curve (AUC), and diagnostic odds ratio (DOR); as well as pooled estimates of sensitivity and specificity. Clinical and technical determinants of sensitivity/specificity were explored. Results Fifteen studies were included in qualitative synthesis, and 10 studies included in the meta-analysis (number of patients 1–17, mean age 10.3–53.6 years). Overt picture naming was the most commonly used task for language mapping with either method. Electrocorticographic high-γ modulation was analyzed at 50–400 Hz with different bandwidths in individual studies. For ESM, pulse duration, train duration, and maximum current varied greatly among studies. Sensitivity (0.23–0.99), specificity (0.48–0.96), and DOR (1.45–376.28) varied widely across studies. The pooled estimates are: sensitivity 0.61 (95% CI 0.44, 0.76), specificity 0.79 (95% CI 0.68, 0.88), and DOR 6.44 (95% CI 3.47, 11.94). Area under the SROC curve was 0.77. Results of bivariate meta-regression were limited by small samples for individual variables. Conclusion Electrocorticographic high-γ modulation is a specific but not sensitive method for language localization compared with gold-standard ESM. Given the pooled DOR of 6.44 and AUC of 0.77, ECoG HGM can fairly reliably ascertain electrodes overlying ESM cortical language sites.
AB - Objective This meta-analysis compared diagnostic validity of electrocorticographic (ECoG) high-γ modulation (HGM) with electrical stimulation mapping (ESM) for presurgical language localization. Methods From a structured literature search, studies with electrode level data comparing ECoG HGM and ESM for language localization were included in the meta-analysis. Outcomes included global measures of diagnostic validity: area under the summary receiver operating characteristic (SROC) curve (AUC), and diagnostic odds ratio (DOR); as well as pooled estimates of sensitivity and specificity. Clinical and technical determinants of sensitivity/specificity were explored. Results Fifteen studies were included in qualitative synthesis, and 10 studies included in the meta-analysis (number of patients 1–17, mean age 10.3–53.6 years). Overt picture naming was the most commonly used task for language mapping with either method. Electrocorticographic high-γ modulation was analyzed at 50–400 Hz with different bandwidths in individual studies. For ESM, pulse duration, train duration, and maximum current varied greatly among studies. Sensitivity (0.23–0.99), specificity (0.48–0.96), and DOR (1.45–376.28) varied widely across studies. The pooled estimates are: sensitivity 0.61 (95% CI 0.44, 0.76), specificity 0.79 (95% CI 0.68, 0.88), and DOR 6.44 (95% CI 3.47, 11.94). Area under the SROC curve was 0.77. Results of bivariate meta-regression were limited by small samples for individual variables. Conclusion Electrocorticographic high-γ modulation is a specific but not sensitive method for language localization compared with gold-standard ESM. Given the pooled DOR of 6.44 and AUC of 0.77, ECoG HGM can fairly reliably ascertain electrodes overlying ESM cortical language sites.
KW - Epilepsy surgery
KW - Functional brain mapping
KW - Language localization
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U2 - 10.1016/j.yebeh.2017.10.044
DO - 10.1016/j.yebeh.2017.10.044
M3 - Article
C2 - 29247963
AN - SCOPUS:85037998627
SN - 1525-5050
VL - 79
SP - 26
EP - 33
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
ER -