Intraoperative Mapping of Language Using High Gamma

使用高伽玛进行术中语言映射

• 批准号: 7298399
• 负责人: Robert Thomas Knight
• 金额: $ 7.6万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7298399
• 关键词: Acute; Address; Adverse effects; Animals; Anomia; Anterior; Area; Arteriovenous malformation; Auditory; Binding; Brain; Brain Neoplasms; California; Cerebral cortex; Collaborations; Congenital arteriovenous malformation; Count; Data; Depth; Electric Stimulation; Electrocorticogram; Electrodes; Epilepsy; Excision; Fractionation; Frequencies; Generations; Goals; Gray unit of radiation dose; Human; Implant; Invasive; Laboratories; Language; Lead; Lesion; Maps; Measures; Memory; Methods; Monitor; Morbidity - disease rate; Motor; Motor Cortex; Movement; Names; Neurosurgeon; Neurosurgical Procedures; Numbers; Operating Rooms; Operative Surgical Procedures; Outcome; Patients; Physiologic pulse; Postoperative Period; Procedures; Production; Pulse taking; Range; Research; Risk; San Francisco; Seizures; Series; Short-Term Memory; Site; Speech; Standards of Weights and Measures; Stimulus; Superior temporal gyrus; Surgeon; Techniques; Theta Rhythm; Time; Tissues; Universities; awake; base; cognitive function; deviant; improved; indexing; language processing; neurosurgery; novel; response; tool; tumor

DESCRIPTION (provided by applicant): Neurosurgical patients who need a brain tumor, epileptic region or other structural lesion removed that might be near language cortex require an invasive 45 min procedure (intra-operative electrical stimulation mapping; ESM) to map language and motor function and guide the neurosurgeon's operative approach. The information gained from ESM is critical to spare language areas and has been shown to improve post-operative morbidity. The methods used in this mapping procedure have remained unchanged for 60 years. The procedure requires passing current into the patient's brain to temporarily disrupt function and is associated with problems such as seizure induction during surgery. Further, the procedure typically takes 45 minutes, is not well tolerated in many patients and must be aborted in up to 25% of cases. Hence, a new method to map language is needed. The goal of this proposal is to assess whether high gamma activity (70-250 Hz) in the human electrocorticogram (ECoG) can be used to accurately and rapidly track critical language cortex in the operating room. It is hypothesized that high gamma activity, a likely index of cortical activation, can aid surgeons identify critical language areas and potentially replace classic intra-operative ESM eliminating the risks associated with this procedure and shortening the surgical time. In order to investigate this issue, two studies will be conducted. First, we will record ECoG in the awake neurosurgical patient in the operating room during the picture naming/number counting study traditionally employed by neurosurgeons. Second, we will perform a brief verb generation study in the OR in these same patients. It is predicted that during picture naming and number counting regions showing arrest during ESM will elicit high gamma activity. We further predict that the high gamma map of language obtained in the verb generation task will also correlate with the stimulation mapping results obtained during study one. If obtained the results would provide evidence that language mapping using ECoG and high gamma recording might provide a safer and faster alternative method to the traditional intra-operative ESM method resulting in reduced intra-operative morbidity and improved post-surgical outcome. Neurosurgeons need to identify critical language areas in the human brain to avoid causing a language problem when removing tumors and other brain abnormalities. The current method to accomplish this requires a 60 year old approach that has serious side-effects such as causing a seizure in the operating room. We propose to apply a novel method of brain electrical analysis to replace the traditional method employed. If successful the results would lead to safer and more effective neurosurgical procedures.

描述（由申请人提供）：需要切除可能靠近语言皮层的脑肿瘤、癫痫区域或其他结构性病变的神经外科患者需要进行 45 分钟的侵入性手术（术中电刺激标测；ESM）来标测语言和运动功能并指导神经外科医生的手术方法。从 ESM 获得的信息对于保留语言区域至关重要，并且已被证明可以改善术后发病率。该绘图过程中使用的方法 60 年来一直保持不变。该手术需要将电流传递到患者的大脑中以暂时扰乱功能，并与手术期间诱发癫痫发作等问题相关。此外，该手术通常需要 45 分钟，许多患者的耐受性不佳，并且高达 25% 的病例必须中止。因此，需要一种新的语言映射方法。该提案的目标是评估人类皮层电图（ECoG）中的高伽马活动（70-250 Hz）是否可用于准确、快速地跟踪手术室中的关键语言皮层。据推测，高伽马活性（可能是皮质激活的指标）可以帮助外科医生识别关键语言区域，并有可能取代传统的术中 ESM，消除与该手术相关的风险并缩短手术时间。为了调查这个问题，将进行两项研究。首先，我们将在神经外科医生传统上采用的图片命名/计数研究过程中记录手术室中清醒的神经外科患者的 ECoG。其次，我们将在这些相同患者的 OR 中进行简短的动词生成研究。据预测，在图片命名和计数过程中，ESM 期间显示停滞的区域将引发高伽马活性。我们进一步预测，在动词生成任务中获得的语​​言的高伽玛图也将与研究一期间获得的刺激映射结果相关。如果获得结果，将提供证据表明，使用 ECoG 和高伽玛记录进行语言映射可能会为传统术中 ESM 方法提供更安全、更快速的替代方法，从而降低术中发病率并改善术后结果。神经外科医生需要识别人脑中的关键语言区域，以避免在切除肿瘤和其他大脑异常时引起语言问题。目前实现这一目标的方法需要采用 60 年前的方法，该方法具有严重的副作用，例如导致手术室癫痫发作。我们建议应用一种新的脑电分析方法来代替传统的方法。如果成功，结果将带来更安全、更有效的神经外科手术。