Literature DB >> 25489639

Localization of specific language pathways using diffusion-weighted imaging tractography for presurgical planning of children with intractable epilepsy.

Jeong-Won Jeong1, Eishi Asano, Csaba Juhász, Harry T Chugani.   

Abstract

OBJECTIVE: To examine whether diffusion-weighted imaging (DWI) tractography can detect multiple white matter pathways connected to language cortices, we employed a maximum a posteriori probability (MAP) classification method, which has been recently validated for the corticospinal tract.
METHODS: DWI was performed in 12 normally developing children and 17 children with intractable focal epilepsy who underwent subsequent two-stage epilepsy surgery with intracranial functional mapping. First, whole-brain DWI tractography was performed to identify unique pathways originating from Broca's area, premotor area, and Wernicke's area on functional magnetic resonance imaging (fMRI) of normal children and intracranial electrical stimulation mapping (ESM) of children with epilepsy. Group averaging of these pathways based on fMRI was performed to construct the probability maps of language areas in standard MRI space. These maps were finally used to design a DWI-MAP classifier, which can automatically sort individual fibers originating from fMRI language areas as well as ESM language areas.
RESULTS: In normally developing children, the DWI-MAP classifier predicted language-activation areas on fMRI with up to 77% accuracy. In children with focal epilepsy, the DWI-MAP classifier also showed high accuracy (up to 82%) for the fibers terminating in proximity to essential language areas determined by ESM. Decreased volumes in DWI-MAP-defined pathways after epilepsy surgery were associated with postoperative language deficits. SIGNIFICANCE: This study encourages further investigations to determine if DWI-MAP analysis can serve as a noninvasive diagnostic tool during pediatric presurgical planning by estimating not only the location of essential language cortices, but also the underlying fibers connecting these cortical areas. Wiley Periodicals, Inc.
© 2014 International League Against Epilepsy.

Entities:  

Keywords:  Children; Classification; Diffusion MRI tractography; Epilepsy surgery; Functional MRI; Language pathways

Mesh:

Year:  2014        PMID: 25489639      PMCID: PMC4354866          DOI: 10.1111/epi.12863

Source DB:  PubMed          Journal:  Epilepsia        ISSN: 0013-9580            Impact factor:   5.864


  24 in total

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Review 5.  Neuropsychological outcomes after epilepsy surgery: systematic review and pooled estimates.

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9.  Prediction of postoperative deficits using an improved diffusion-weighted imaging maximum a posteriori probability analysis in pediatric epilepsy surgery.

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10.  Novel diffusion tractography methodology using Kalman filter prediction to improve preoperative benefit-risk analysis in pediatric epilepsy surgery.

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Journal:  J Neurosurg Pediatr       Date:  2019-07-05       Impact factor: 2.713

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