TY - JOUR
T1 - Electrocorticographic language mapping in children by high-gamma synchronization during spontaneous conversation
T2 - Comparison with conventional electrical cortical stimulation
AU - Arya, Ravindra
AU - Wilson, J. Adam
AU - Vannest, Jennifer
AU - Byars, Anna W.
AU - Greiner, Hansel M.
AU - Buroker, Jason
AU - Fujiwara, Hisako
AU - Mangano, Francesco T.
AU - Holland, Katherine D.
AU - Horn, Paul S.
AU - Crone, Nathan E.
AU - Rose, Douglas F.
N1 - Funding Information:
The study was supported by the Division of Neurology at Cincinnati Children's Hospital Medical Center . No external funding agency was involved. None of the authors has any conflicts of interest to declare.
Funding Information:
RA wishes to acknowledge support from Susan T. Herman, M.D. through American Epilepsy Society's EpiPORT program which facilitated collaboration between RA and NEC.
Publisher Copyright:
© 2014 Elsevier B.V.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Introduction: This study describes development of a novel language mapping approach using high-γ modulation in electrocorticograph (ECoG) during spontaneous conversation, and its comparison with electrical cortical stimulation (ECS) in childhood-onset drug-resistant epilepsy. Methods: Patients undergoing invasive pre-surgical monitoring and able to converse with the investigator were eligible. ECoG signals and synchronized audio were acquired during quiet baseline and during natural conversation between investigator and the patient. Using Signal Modeling for Real-time Identification and Event Detection (SIGFRIED) procedure, a statistical model for baseline high-γ (70-116. Hz) power, and a single score for each channel representing the probability that the power features in the experimental signal window belonged to the baseline model, were calculated. Electrodes with significant high-γ responses (HGS) were plotted on the 3D cortical model. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), and classification accuracy were calculated compared to ECS. Results: Seven patients were included (4 males, mean age 10.28. ±. 4.07 years). Significant high-γ responses were observed in classic language areas in the left hemisphere plus in some homologous right hemispheric areas. Compared with clinical standard ECS mapping, the sensitivity and specificity of HGS mapping was 88.89% and 63.64%, respectively, and PPV and NPV were 35.29% and 96.25%, with an overall accuracy of 68.24%. HGS mapping was able to correctly determine all ECS+ sites in 6 of 7 patients and all false-sites (ECS+, HGS- for visual naming, n=. 3) were attributable to only 1 patient. Conclusions: This study supports the feasibility of language mapping with ECoG HGS during spontaneous conversation, and its accuracy compared to traditional ECS. Given long-standing concerns about ecological validity of ECS mapping of cued language tasks, and difficulties encountered with its use in children, ECoG mapping of spontaneous language may provide a valid alternative for clinical use.
AB - Introduction: This study describes development of a novel language mapping approach using high-γ modulation in electrocorticograph (ECoG) during spontaneous conversation, and its comparison with electrical cortical stimulation (ECS) in childhood-onset drug-resistant epilepsy. Methods: Patients undergoing invasive pre-surgical monitoring and able to converse with the investigator were eligible. ECoG signals and synchronized audio were acquired during quiet baseline and during natural conversation between investigator and the patient. Using Signal Modeling for Real-time Identification and Event Detection (SIGFRIED) procedure, a statistical model for baseline high-γ (70-116. Hz) power, and a single score for each channel representing the probability that the power features in the experimental signal window belonged to the baseline model, were calculated. Electrodes with significant high-γ responses (HGS) were plotted on the 3D cortical model. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), and classification accuracy were calculated compared to ECS. Results: Seven patients were included (4 males, mean age 10.28. ±. 4.07 years). Significant high-γ responses were observed in classic language areas in the left hemisphere plus in some homologous right hemispheric areas. Compared with clinical standard ECS mapping, the sensitivity and specificity of HGS mapping was 88.89% and 63.64%, respectively, and PPV and NPV were 35.29% and 96.25%, with an overall accuracy of 68.24%. HGS mapping was able to correctly determine all ECS+ sites in 6 of 7 patients and all false-sites (ECS+, HGS- for visual naming, n=. 3) were attributable to only 1 patient. Conclusions: This study supports the feasibility of language mapping with ECoG HGS during spontaneous conversation, and its accuracy compared to traditional ECS. Given long-standing concerns about ecological validity of ECS mapping of cued language tasks, and difficulties encountered with its use in children, ECoG mapping of spontaneous language may provide a valid alternative for clinical use.
KW - Drug resistant epilepsy
KW - Electrical cortical stimulation
KW - Electrocorticograph
KW - High-γ synchronization
KW - Language mapping
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U2 - 10.1016/j.eplepsyres.2014.11.013
DO - 10.1016/j.eplepsyres.2014.11.013
M3 - Article
C2 - 25616459
AN - SCOPUS:84921320805
SN - 0920-1211
VL - 110
SP - 78
EP - 87
JO - Journal of Epilepsy
JF - Journal of Epilepsy
ER -