Abstract
Objective: To examine current thresholds and their determinants for language and motor mapping with extra-operative electrical cortical stimulation (ECS). Methods: ECS electrocorticograph recordings were reviewed to determine functional thresholds. Predictors of functional thresholds were found with multivariable analyses. Results: In 122 patients (age 11.9. ±. 5.4. years), average minimum, frontal, and temporal language thresholds were 7.4 (± 3.0), 7.8 (± 3.0), and 7.4 (± 3.1) mA respectively. Average minimum, face, upper and lower extremity motor thresholds were 5.4 (± 2.8), 6.1 (± 2.8), 4.9 (± 2.3), and 5.3 (± 3.3) mA respectively.Functional and after-discharge (AD)/seizure thresholds were significantly related. Minimum, frontal, and temporal language thresholds were higher than AD thresholds at all ages. Minimum motor threshold was higher than minimum AD threshold up to 8.0. years of age, face motor threshold was higher than frontal AD threshold up to 11.8. years age, and lower subsequently. UE motor thresholds remained below frontal AD thresholds throughout the age range. Conclusions: Functional thresholds are frequently above AD thresholds in younger children. Significance: These findings raise concerns about safety and neurophysiologic validity of ECS mapping. Functional and AD/seizure thresholds relationships suggest individual differences in cortical excitability which cannot be explained by clinical variables.
| Original language | English (US) |
|---|---|
| Journal | Clinical Neurophysiology |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- After-discharges
- Direct cortical stimulation
- Epilepsy surgery
- Functional brain mapping
ASJC Scopus subject areas
- Sensory Systems
- Neurology
- Clinical Neurology
- Physiology (medical)
Cite this
Language and motor function thresholds during pediatric extra-operative electrical cortical stimulation brain mapping. / Zea Vera, Alonso; Aungaroon, Gewalin; Horn, Paul S.; Byars, Anna W.; Greiner, Hansel M.; Tenney, Jeffrey R.; Arthur, Todd M.; Crone, Nathan E; Holland, Katherine D.; Mangano, Francesco T.; Arya, Ravindra.
In: Clinical Neurophysiology, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Language and motor function thresholds during pediatric extra-operative electrical cortical stimulation brain mapping
AU - Zea Vera, Alonso
AU - Aungaroon, Gewalin
AU - Horn, Paul S.
AU - Byars, Anna W.
AU - Greiner, Hansel M.
AU - Tenney, Jeffrey R.
AU - Arthur, Todd M.
AU - Crone, Nathan E
AU - Holland, Katherine D.
AU - Mangano, Francesco T.
AU - Arya, Ravindra
PY - 2017
Y1 - 2017
N2 - Objective: To examine current thresholds and their determinants for language and motor mapping with extra-operative electrical cortical stimulation (ECS). Methods: ECS electrocorticograph recordings were reviewed to determine functional thresholds. Predictors of functional thresholds were found with multivariable analyses. Results: In 122 patients (age 11.9. ±. 5.4. years), average minimum, frontal, and temporal language thresholds were 7.4 (± 3.0), 7.8 (± 3.0), and 7.4 (± 3.1) mA respectively. Average minimum, face, upper and lower extremity motor thresholds were 5.4 (± 2.8), 6.1 (± 2.8), 4.9 (± 2.3), and 5.3 (± 3.3) mA respectively.Functional and after-discharge (AD)/seizure thresholds were significantly related. Minimum, frontal, and temporal language thresholds were higher than AD thresholds at all ages. Minimum motor threshold was higher than minimum AD threshold up to 8.0. years of age, face motor threshold was higher than frontal AD threshold up to 11.8. years age, and lower subsequently. UE motor thresholds remained below frontal AD thresholds throughout the age range. Conclusions: Functional thresholds are frequently above AD thresholds in younger children. Significance: These findings raise concerns about safety and neurophysiologic validity of ECS mapping. Functional and AD/seizure thresholds relationships suggest individual differences in cortical excitability which cannot be explained by clinical variables.
AB - Objective: To examine current thresholds and their determinants for language and motor mapping with extra-operative electrical cortical stimulation (ECS). Methods: ECS electrocorticograph recordings were reviewed to determine functional thresholds. Predictors of functional thresholds were found with multivariable analyses. Results: In 122 patients (age 11.9. ±. 5.4. years), average minimum, frontal, and temporal language thresholds were 7.4 (± 3.0), 7.8 (± 3.0), and 7.4 (± 3.1) mA respectively. Average minimum, face, upper and lower extremity motor thresholds were 5.4 (± 2.8), 6.1 (± 2.8), 4.9 (± 2.3), and 5.3 (± 3.3) mA respectively.Functional and after-discharge (AD)/seizure thresholds were significantly related. Minimum, frontal, and temporal language thresholds were higher than AD thresholds at all ages. Minimum motor threshold was higher than minimum AD threshold up to 8.0. years of age, face motor threshold was higher than frontal AD threshold up to 11.8. years age, and lower subsequently. UE motor thresholds remained below frontal AD thresholds throughout the age range. Conclusions: Functional thresholds are frequently above AD thresholds in younger children. Significance: These findings raise concerns about safety and neurophysiologic validity of ECS mapping. Functional and AD/seizure thresholds relationships suggest individual differences in cortical excitability which cannot be explained by clinical variables.
KW - After-discharges
KW - Direct cortical stimulation
KW - Epilepsy surgery
KW - Functional brain mapping
UR - http://www.scopus.com/inward/record.url?scp=85026402035&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026402035&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2017.07.006
DO - 10.1016/j.clinph.2017.07.006
M3 - Article
C2 - 28774583
AN - SCOPUS:85026402035
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
ER -