Ravindra Arya1, J Adam Wilson1,2, Hisako Fujiwara1, Leonid Rozhkov1, James L Leach3, Anna W Byars1, Hansel M Greiner1, Jennifer Vannest2, Jason Buroker1,4, Griffin Milsap5,6, Brian Ervin7, Ali Minai7, Paul S Horn1,8, Katherine D Holland1, Francesco T Mangano9, Nathan E Crone6, Douglas F Rose1. 1. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. 2. Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. 3. Division of Pediatric Neuroradiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. 4. Division of Clinical Engineering, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. 5. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, U.S.A. 6. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A. 7. Complex Adaptive Systems Lab, Department of Electrical Engineering and Computing Systems, University of Cincinnati, Cincinnati, Ohio, U.S.A. 8. Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A. 9. Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Abstract
OBJECTIVE: This prospective study compared presurgical language localization with visual naming-associated high-γ modulation (HGM) and conventional electrical cortical stimulation (ECS) in children with intracranial electrodes. METHODS: Patients with drug-resistant epilepsy who were undergoing intracranial monitoring were included if able to name pictures. Electrocorticography (ECoG) signals were recorded during picture naming (overt and covert) and quiet baseline. For each electrode the likelihood of high-γ (70-116 Hz) power modulation during naming task relative to the baseline was estimated. Electrodes with significant HGM were plotted on a three-dimensional (3D) cortical surface model. Sensitivity, specificity, and accuracy were calculated compared to clinical ECS. RESULTS: Seventeen patients with mean age of 11.3 years (range 4-19) were included. In patients with left hemisphere electrodes (n = 10), HGM during overt naming showed high specificity (0.81, 95% confidence interval [CI] 0.78-0.85), and accuracy (0.71, 95% CI 0.66-0.75, p < 0.001), but modest sensitivity (0.47) when ECS interference with naming (aphasia or paraphasic errors) and/or oral motor function was regarded as the gold standard. Similar results were reproduced by comparing covert naming-associated HGM with ECS naming sites. With right hemisphere electrodes (n = 7), no ECS-naming deficits were seen without interference with oral-motor function. HGM mapping showed a high specificity (0.81, 95% CI 0.78-0.84), and accuracy (0.76, 95% CI 0.71-0.81, p = 0.006), but modest sensitivity (0.44) compared to ECS interference with oral-motor function. Naming-associated ECoG HGM was consistently observed over Broca's area (left posterior inferior-frontal gyrus), bilateral oral/facial motor cortex, and sometimes over the temporal pole. SIGNIFICANCE: This study supports the use of ECoG HGM mapping in children in whom adverse events preclude ECS, or as a screening method to prioritize electrodes for ECS testing. Wiley Periodicals, Inc.
OBJECTIVE: This prospective study compared presurgical language localization with visual naming-associated high-γ modulation (HGM) and conventional electrical cortical stimulation (ECS) in children with intracranial electrodes. METHODS:Patients with drug-resistant epilepsy who were undergoing intracranial monitoring were included if able to name pictures. Electrocorticography (ECoG) signals were recorded during picture naming (overt and covert) and quiet baseline. For each electrode the likelihood of high-γ (70-116 Hz) power modulation during naming task relative to the baseline was estimated. Electrodes with significant HGM were plotted on a three-dimensional (3D) cortical surface model. Sensitivity, specificity, and accuracy were calculated compared to clinical ECS. RESULTS: Seventeen patients with mean age of 11.3 years (range 4-19) were included. In patients with left hemisphere electrodes (n = 10), HGM during overt naming showed high specificity (0.81, 95% confidence interval [CI] 0.78-0.85), and accuracy (0.71, 95% CI 0.66-0.75, p < 0.001), but modest sensitivity (0.47) when ECS interference with naming (aphasia or paraphasic errors) and/or oral motor function was regarded as the gold standard. Similar results were reproduced by comparing covert naming-associated HGM with ECS naming sites. With right hemisphere electrodes (n = 7), no ECS-naming deficits were seen without interference with oral-motor function. HGM mapping showed a high specificity (0.81, 95% CI 0.78-0.84), and accuracy (0.76, 95% CI 0.71-0.81, p = 0.006), but modest sensitivity (0.44) compared to ECS interference with oral-motor function. Naming-associated ECoG HGM was consistently observed over Broca's area (left posterior inferior-frontal gyrus), bilateral oral/facial motor cortex, and sometimes over the temporal pole. SIGNIFICANCE: This study supports the use of ECoG HGM mapping in children in whom adverse events preclude ECS, or as a screening method to prioritize electrodes for ECS testing. Wiley Periodicals, Inc.
Authors: Abbas Babajani-Feremi; Shalini Narayana; Roozbeh Rezaie; Asim F Choudhri; Stephen P Fulton; Frederick A Boop; James W Wheless; Andrew C Papanicolaou Journal: Clin Neurophysiol Date: 2015-11-26 Impact factor: 3.708
Authors: Alon Sinai; Christopher W Bowers; Ciprian M Crainiceanu; Dana Boatman; Barry Gordon; Ronald P Lesser; Frederick A Lenz; Nathan E Crone Journal: Brain Date: 2005-04-07 Impact factor: 13.501
Authors: Yujing Wang; Matthew S Fifer; Adeen Flinker; Anna Korzeniewska; Mackenzie C Cervenka; William S Anderson; Dana F Boatman-Reich; Nathan E Crone Journal: Neurology Date: 2016-03-02 Impact factor: 9.910
Authors: V Menon; W J Freeman; B A Cutillo; J E Desmond; M F Ward; S L Bressler; K D Laxer; N Barbaro; A S Gevins Journal: Electroencephalogr Clin Neurophysiol Date: 1996-02
Authors: Brian Ervin; Jason Buroker; Anna W Byars; Leonid Rozhkov; James L Leach; Paul S Horn; Craig Scholle; Francesco T Mangano; Hansel M Greiner; Katherine D Holland; Tracy A Glauser; Ravindra Arya Journal: Clin Neurophysiol Date: 2021-09-30 Impact factor: 3.708
Authors: Ravindra Arya; Brian Ervin; Jason Buroker; Hansel M Greiner; Anna W Byars; Leonid Rozhkov; Jesse Skoch; Paul S Horn; Clayton Frink; Craig Scholle; James L Leach; Francesco T Mangano; Tracy A Glauser; Katherine D Holland Journal: Front Neurosci Date: 2022-05-19 Impact factor: 5.152
Authors: Daniel L Drane; Nigel P Pedersen; David S Sabsevitz; Cady Block; Adam S Dickey; Abdulrahman Alwaki; Ammar Kheder Journal: Front Neurol Date: 2021-04-12 Impact factor: 4.003
Authors: Yujing Wang; Mark A Hays; Christopher Coogan; Joon Y Kang; Adeen Flinker; Ravindra Arya; Anna Korzeniewska; Nathan E Crone Journal: Front Hum Neurosci Date: 2021-04-14 Impact factor: 3.169