Electrocorticographic high gamma activity versus electrical cortical stimulation mapping of naming
Electrocorticographic high gamma activity versus electrical cortical stimulation mapping of naming
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DOI：
10.1093/brain/awh491
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发表时间：
2005-07-01
期刊：
影响因子：
14.5
通讯作者：
Crone, NE
中科院分区：
文献类型：
--
作者：
Sinai, A;Bowers, CW;Crone, NE
接受癫痫手术的患者的硬膜下皮质电图（ECoG）记录表明，功能激活与事件相关的宽带伽玛活动相关，其频率范围（> 70 Hz）比之前在人类头皮脑电图中研究的频率范围更高。为了研究这种高伽玛活性（HGA）在绘制语言皮层图谱方面的效用，我们将其神经解剖学分布与皮层电刺激（ECS）衍生的功能图进行了比较，后者仍然是预测癫痫、肿瘤或血管畸形手术后功能障碍的金标准。 13 名患者接受了硬膜下电极植入手术治疗顽固性癫痫。记录硬膜下 ECoG 信号，同时按顺序对每位患者进行口头命名，呈现物体的线条图，并在每个记录部位对事件相关的 HGA (80-100 Hz) 进行估计。常规临床 ECS 映射在每个皮质部位使用相同命名刺激的子集。如果 ECS 扰乱了与口腔相关的运动功能，即如果它影响了口腔、嘴唇或舌头，则无法在同一皮质部位使用 ECS 测试命名。由于 ECoG 期间的命名涉及这些发音肌肉，因此 ECoG HGA 的敏感性和特异性是相对于 ECS 引起的命名损伤和 ECS 对口腔相关运动功能的破坏来估计的。当对每位患者的 12 个电极部位（具有显着 HGA 的平均数量）分别进行这些估计时，ECoG HGA 相对于 ECS 的命名特异性为 78%，口腔相关运动功能特异性为 81%，等效敏感性分别为 38% 和 46%。当结合命名和口腔相关运动功能的 ECS 图时，ECoG HGA 对于 ECS 的特异性和敏感性分别为 84% 和 43%。本研究表明，对抗命名过程中事件相关的 ECoG HGA 可以预测 ECS 对命名和口腔相关运动功能的干扰，特异性良好，但敏感性相对较低。其有利的特异性表明 ECoG HGA 可用于构建初步功能图谱，这可能有助于识别 ECS 映射的较低优先级的皮质位点。 ECoG 伽玛活动的被动记录可以在所有电极部位同时进行，而不存在与 ECS 映射相关的后放电风险，ECS 映射必须在电极对上顺序进行。我们讨论这两种功能映射技术的相对优点。
Subdural electrocorticographic (ECoG) recordings in patients undergoing epilepsy surgery have shown that functional activation is associated with event-related broadband gamma activity in a higher frequency range (> 70 Hz) than previously studied in human scalp EEG. To investigate the utility of this high gamma activity (HGA) for mapping language cortex, we compared its neuroanatomical distribution with functional maps derived from electrical cortical stimulation (ECS), which remains the gold standard for predicting functional impairment after surgery for epilepsy, tumours or vascular malformations. Thirteen patients had undergone subdural electrode implantation for the surgical management of intractable epilepsy. Subdural ECoG signals were recorded while each patient verbally named sequentially presented line drawings of objects, and estimates of event-related HGA (80-100 Hz) were made at each recording site. Routine clinical ECS mapping used a subset of the same naming stimuli at each cortical site. If ECS disrupted mouth-related motor function, i.e. if it affected the mouth, lips or tongue, naming could not be tested with ECS at the same cortical site. Because naming during ECoG involved these muscles of articulation, the sensitivity and specificity of ECoG HGA were estimated relative to both ECS-induced impairments of naming and ECS disruption of mouth-related motor function. When these estimates were made separately for 12 electrode sites per patient (the average number with significant HGA), the specificity of ECoG HGA with respect to ECS was 78% for naming and 81% for mouth-related motor function, and equivalent sensitivities were 38% and 46%, respectively. When ECS maps of naming and mouth-related motor function were combined, the specificity and sensitivity of ECoG HGA with respect to ECS were 84% and 43%, respectively. This study indicates that event-related ECoG HGA during confrontation naming predicts ECS interference with naming and mouth-related motor function with good specificity but relatively low sensitivity. Its favourable specificity suggests that ECoG HGA can be used to construct a preliminary functional map that may help identify cortical sites of lower priority for ECS mapping. Passive recordings of ECoG gamma activity may be done simultaneously at all electrode sites without the risk of after-discharges associated with ECS mapping, which must be done sequentially at pairs of electrodes. We discuss the relative merits of these two functional mapping techniques.