J R Swift1, W G Coon2, C Guger3, P Brunner4, M Bunch5, T Lynch6, B Frawley7, A L Ritaccio8, G Schalk9. 1. g.tec neurotechnology USA, Rensselaer, NY, USA; Dept. of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; National Ctr. for Adaptive Neurotechnologies, Wadsworth Center, NY State Dept. of Health, Albany, NY, USA. Electronic address: jswift@albany.edu. 2. g.tec neurotechnology USA, Rensselaer, NY, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Dept. of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; National Ctr. for Adaptive Neurotechnologies, Wadsworth Center, NY State Dept. of Health, Albany, NY, USA. Electronic address: wcoon@mgh.harvard.edu. 3. g.tec neurotechnology USA, Rensselaer, NY, USA. Electronic address: guger@gtec.at. 4. Dept. of Neurology, Albany Medical College, Albany, NY, USA; National Ctr. for Adaptive Neurotechnologies, Wadsworth Center, NY State Dept. of Health, Albany, NY, USA. Electronic address: brunner@neurotechcenter.org. 5. Dept. of Neurology, Albany Medical College, Albany, NY, USA. Electronic address: BunchM@mail.amc.edu. 6. Dept. of Neurology, Albany Medical College, Albany, NY, USA. Electronic address: lyncht@mail.amc.edu. 7. Dept. of Neurology, Albany Medical College, Albany, NY, USA. Electronic address: FrawleBK@mail.amc.edu. 8. Dept. of Neurology, Mayo Clinic, Jacksonville, FL, USA; National Ctr. for Adaptive Neurotechnologies, Wadsworth Center, NY State Dept. of Health, Albany, NY, USA. Electronic address: ritaccio.anthony@mayo.edu. 9. Dept. of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; Dept. of Neurology, Albany Medical College, Albany, NY, USA; National Ctr. for Adaptive Neurotechnologies, Wadsworth Center, NY State Dept. of Health, Albany, NY, USA. Electronic address: gschalk@neurotechcenter.org.
Abstract
OBJECTIVE: To validate the use of passive functional mapping using electrocorticographic (ECoG) broadband gamma signals for identifying receptive language cortex. METHODS: We mapped language function in 23 patients using ECoG and using electrical cortical stimulation (ECS) in a subset of 15 subjects. RESULTS: The qualitative comparison between cortical sites identified by ECoG and ECS show a high concordance. A quantitative comparison indicates a high level of sensitivity (95%) and a lower level of specificity (59%). Detailed analysis reveals that 82% of all cortical sites identified by ECoG were within one contact of a site identified by ECS. CONCLUSIONS: These results show that passive functional mapping reliably localizes receptive language areas, and that there is a substantial concordance between the ECoG- and ECS-based methods. They also point to a more refined understanding of the differences between ECoG- and ECS-based mappings. This refined understanding helps to clarify the instances in which the two methods disagree and can explain why neurosurgical practice has established the concept of a "safety margin." SIGNIFICANCE: Passive functional mapping using ECoG signals provides a fast, robust, and reliable method for identifying receptive language areas without many of the risks and limitations associated with ECS.
OBJECTIVE: To validate the use of passive functional mapping using electrocorticographic (ECoG) broadband gamma signals for identifying receptive language cortex. METHODS: We mapped language function in 23 patients using ECoG and using electrical cortical stimulation (ECS) in a subset of 15 subjects. RESULTS: The qualitative comparison between cortical sites identified by ECoG and ECS show a high concordance. A quantitative comparison indicates a high level of sensitivity (95%) and a lower level of specificity (59%). Detailed analysis reveals that 82% of all cortical sites identified by ECoG were within one contact of a site identified by ECS. CONCLUSIONS: These results show that passive functional mapping reliably localizes receptive language areas, and that there is a substantial concordance between the ECoG- and ECS-based methods. They also point to a more refined understanding of the differences between ECoG- and ECS-based mappings. This refined understanding helps to clarify the instances in which the two methods disagree and can explain why neurosurgical practice has established the concept of a "safety margin." SIGNIFICANCE: Passive functional mapping using ECoG signals provides a fast, robust, and reliable method for identifying receptive language areas without many of the risks and limitations associated with ECS.
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