TY - JOUR
T1 - Electrocorticographic high-gamma modulation with passive listening paradigm for pediatric extraoperative language mapping
AU - Arya, Ravindra
AU - Wilson, J. Adam
AU - Fujiwara, Hisako
AU - Vannest, Jennifer
AU - Byars, Anna W.
AU - Rozhkov, Leonid
AU - Leach, James L.
AU - Greiner, Hansel M.
AU - Buroker, Jason
AU - Scholle, Craig
AU - Horn, Paul S.
AU - Crone, Nathan E.
AU - Rose, Douglas F.
AU - Mangano, Francesco T.
AU - Holland, Katherine D.
N1 - Funding Information:
Funding information The study was supported by the Research Innovation Project Grant from Cincinnati Children's Research Foundation, awarded to J.A.W. and R.A., and the Division of Neurology at Cincinnati Children's Hospital Medical Center. Funding sources had no role in the study design; collection, analysis and interpretation of data; writing of the report; or in the decision to submit the manuscript for publication. R.A. wishes to acknowledge support from Susan T. Herman, MD through the American Epilepsy Society's EpiPORT program.
Funding Information:
The study was supported by the Research Innovation Project Grant from Cincinnati Children’s Research Foundation, awarded to J.A.W. and R.A., and the Division of Neurology at Cincinnati Children’s Hospital Medical Center. Funding sources had no role in the study design; collection, analysis and interpretation of data; writing of the report; or in the decision to submit the manuscript for publication.
Funding Information:
R.A. receives research support from Pediatric Epilepsy Research Foundation (coinvestigator); K.D.H. received funding from the following National Institutes of Health grants: R01 NS062756 (principal investigator), R01NS062806 (coinvestigator), and R01NS065020 (coinvestigator). None of the other authors has any conflict of interest to disclose. Findings from this work were presented partially at the 2017 annual meeting of the American Clinical Neurophysiology Society. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Funding Information:
R.A. wishes to acknowledge support from Susan T. Herman, MD through the American Epilepsy Society’s Epi-PORT program.
Publisher Copyright:
Wiley Periodicals, Inc. © 2018 International League Against Epilepsy
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - Objective: This prospective study compared the topography of high-gamma modulation (HGM) during a story-listening task requiring negligible patient cooperation, with the conventional electrical stimulation mapping (ESM) using a picture-naming task, for presurgical language localization in pediatric drug-resistant epilepsy. Methods: Patients undergoing extraoperative monitoring with subdural electrodes were included. Electrocorticographic signals were recorded during quiet baseline and a story-listening task. The likelihood of 70- to 150-Hz power modulation during the listening task relative to the baseline was estimated for each electrode and plotted on a cortical surface model. Sensitivity, specificity, accuracy, and diagnostic odds ratio (DOR) were estimated compared to ESM, using a meta-analytic framework. Results: Nineteen patients (10 with left hemisphere electrodes) aged 4-19 years were analyzed. HGM during story listening was observed in bilateral posterior superior temporal, angular, supramarginal, and inferior frontal gyri, along with anatomically defined language association areas. Compared to either cognitive or both cognitive and orofacial sensorimotor interference with naming during ESM, left hemisphere HGM showed high specificity (0.82-0.84), good accuracy (0.66-0.70), and DOR of 2.23 and 3.24, respectively. HGM was a better classifier of ESM language sites in the left temporoparietal cortex compared to the frontal lobe. Incorporating visual naming with the story-listening task substantially improved the accuracy (0.80) and DOR (13.61) of HGM mapping, while the high specificity (0.85) was retained. In the right hemisphere, no ESM sites for aphasia were seen, and the results of HGM and ESM comparisons were not significant. Significance: HGM associated with story listening is a specific determinant of left hemisphere ESM language sites. It can be used for presurgical language mapping in children who cannot cooperate with conventional language tasks requiring active engagement. Incorporation of additional language tasks, if feasible, can further improve the diagnostic accuracy of language localization with HGM.
AB - Objective: This prospective study compared the topography of high-gamma modulation (HGM) during a story-listening task requiring negligible patient cooperation, with the conventional electrical stimulation mapping (ESM) using a picture-naming task, for presurgical language localization in pediatric drug-resistant epilepsy. Methods: Patients undergoing extraoperative monitoring with subdural electrodes were included. Electrocorticographic signals were recorded during quiet baseline and a story-listening task. The likelihood of 70- to 150-Hz power modulation during the listening task relative to the baseline was estimated for each electrode and plotted on a cortical surface model. Sensitivity, specificity, accuracy, and diagnostic odds ratio (DOR) were estimated compared to ESM, using a meta-analytic framework. Results: Nineteen patients (10 with left hemisphere electrodes) aged 4-19 years were analyzed. HGM during story listening was observed in bilateral posterior superior temporal, angular, supramarginal, and inferior frontal gyri, along with anatomically defined language association areas. Compared to either cognitive or both cognitive and orofacial sensorimotor interference with naming during ESM, left hemisphere HGM showed high specificity (0.82-0.84), good accuracy (0.66-0.70), and DOR of 2.23 and 3.24, respectively. HGM was a better classifier of ESM language sites in the left temporoparietal cortex compared to the frontal lobe. Incorporating visual naming with the story-listening task substantially improved the accuracy (0.80) and DOR (13.61) of HGM mapping, while the high specificity (0.85) was retained. In the right hemisphere, no ESM sites for aphasia were seen, and the results of HGM and ESM comparisons were not significant. Significance: HGM associated with story listening is a specific determinant of left hemisphere ESM language sites. It can be used for presurgical language mapping in children who cannot cooperate with conventional language tasks requiring active engagement. Incorporation of additional language tasks, if feasible, can further improve the diagnostic accuracy of language localization with HGM.
KW - cognition
KW - drug-resistant epilepsy
KW - epilepsy surgery
KW - language localization
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U2 - 10.1111/epi.14029
DO - 10.1111/epi.14029
M3 - Article
C2 - 29460482
AN - SCOPUS:85042168167
VL - 59
SP - 792
EP - 801
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 4
ER -