Electrocorticographic language mapping in children by high-gamma synchronization during spontaneous conversation: Comparison with conventional electrical cortical stimulation
Electrocorticographic language mapping in children by high-gamma synchronization during spontaneous conversation: Comparison with conventional electrical cortical stimulation
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DOI：
10.1016/j.eplepsyres.2014.11.013
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发表时间：
2015-02-01
影响因子：
2.2
通讯作者：
Rose, Douglas F.
中科院分区：
文献类型：
--
作者：
Arya, Ravindra;Wilson, J. Adam;Rose, Douglas F.
简介：本研究描述了一种新型语言映射方法的开发，该方法在自发对话期间使用皮层电图描记器 (ECoG) 的高伽玛调制，并将其与儿童期发作的耐药性癫痫中的皮层电刺激 (ECS) 进行比较。方法：接受侵入性术前监测并能够与研究者交谈的患者符合资格。 ECoG 信号和同步音频是在安静的基线以及研究者和患者之间的自然对话期间获取的。使用实时识别和事件检测信号建模 (SIGFRIED) 程序，计算基线高伽玛 (70-116 Hz) 功率的统计模型，以及表示实验信号窗口中的功率特征属于基线模型的概率的每个通道的单个分数。具有显着高伽马响应 (HGS) 的电极绘制在 3D 皮质模型上。与 ECS 相比，计算了敏感性、特异性、阳性和阴性预测值（PPV、NPV）以及分类准确性。结果：纳入 7 名患者（4 名男性，平均年龄 10.28 +/- 4.07 岁）。在左半球的经典语言区域以及一些同源的右半球区域中观察到显着的高伽马反应。与临床标准ECS映射相比，HGS映射的敏感性和特异性分别为88.89%和63.64%，PPV和NPV分别为35.29%和96.25%，总体准确率为68.24%。 HGS 映射能够正确确定 7 名患者中 6 名的所有 ECS+ 位点，所有错误位点（ECS+、HGS- 用于视觉命名，n=3）仅可归因于 1 名患者。 结论：本研究支持在自发对话期间使用 ECoG HGS 进行语言映射的可行性，及其与传统 ECS 相比的准确性。鉴于人们长期以来对提示语言任务的 ECS 映射的生态有效性的担忧，以及其在儿童中使用时遇到的困难，自发语言的 ECoG 映射可能为临床使用提供有效的替代方案。 (C) 2014 Elsevier B.V. 保留所有权利。
Introduction: This study describes development of a novel language mapping approach using high-gamma 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-gamma (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-gamma 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-gamma 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. (C) 2014 Elsevier B.V. All rights reserved.