Ravindra Arya1, Celie Roth2, James L Leach3, Denise Middeler2, J Adam Wilson4, Jennifer Vannest4, Leonid Rozhkov2, Hansel M Greiner5, Jason Buroker6, Craig Scholle6, Hisako Fujiwara4, Paul S Horn2, Douglas F Rose2, Nathan E Crone7, Francesco T Mangano8, Anna W Byars2, Katherine D Holland5. 1. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: Ravindra.Arya@cchmc.org. 2. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 3. Division of Pediatric Neuroradiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Pediatric Neuroimaging Research Consortium, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 6. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Engineering, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 7. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 8. Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract
BACKGROUND: Language mapping with high-gamma modulation (HGM) has compared well with electrical cortical stimulation mapping (ESM). However, there is limited prospective data about its functional validity. We compared changes in neuropsychological evaluation (NPE) performed before and 1-year after epilepsy surgery, between patients with/without resection of cortical sites showing HGM during a visual naming task. METHODS: Pediatric drug-resistant epilepsy (DRE) patients underwent pre-surgical language localization with ESM and HGM using a visual naming task. Surgical decisions were based solely on ESM results. NPE difference scores were compared between patients with/without resection of HGM naming sites using principal component (PC) analysis. Follow-up NPE scores were modeled with resection group as main effect and respective pre-surgical score as a covariate, using analysis of covariance. RESULTS: Seventeen native English speakers (12 females), aged 6.5-20.2 years, were included. One year after epilepsy surgery, first PC score increased by (mean ± standard deviation) 14.4 ± 16.5 points in patients without resection, whereas it decreased by 7.6 ± 24.6 points in those with resection of HGM naming sites (p = 0.040). This PC score represented verbal comprehension, working memory, perceptual reasoning (Wechsler subscales); Woodcock-Johnson Tests of Achievement; and Peabody Picture Vocabulary Test. Subsequent analysis showed significant difference in working memory score between patients with/without resection of HGM naming sites (-15.2 points, 95% confidence limits -29.7 to -0.7, p = 0.041). CONCLUSION: We highlight the functional consequences of resecting HGM language sites, and suggest that NPE of DRE patients should include comprehensive assessment of multiple linguistic and cognitive domains besides naming ability.
BACKGROUND: Language mapping with high-gamma modulation (HGM) has compared well with electrical cortical stimulation mapping (ESM). However, there is limited prospective data about its functional validity. We compared changes in neuropsychological evaluation (NPE) performed before and 1-year after epilepsy surgery, between patients with/without resection of cortical sites showing HGM during a visual naming task. METHODS: Pediatric drug-resistant epilepsy (DRE) patients underwent pre-surgical language localization with ESM and HGM using a visual naming task. Surgical decisions were based solely on ESM results. NPE difference scores were compared between patients with/without resection of HGM naming sites using principal component (PC) analysis. Follow-up NPE scores were modeled with resection group as main effect and respective pre-surgical score as a covariate, using analysis of covariance. RESULTS: Seventeen native English speakers (12 females), aged 6.5-20.2 years, were included. One year after epilepsy surgery, first PC score increased by (mean ± standard deviation) 14.4 ± 16.5 points in patients without resection, whereas it decreased by 7.6 ± 24.6 points in those with resection of HGM naming sites (p = 0.040). This PC score represented verbal comprehension, working memory, perceptual reasoning (Wechsler subscales); Woodcock-Johnson Tests of Achievement; and Peabody Picture Vocabulary Test. Subsequent analysis showed significant difference in working memory score between patients with/without resection of HGM naming sites (-15.2 points, 95% confidence limits -29.7 to -0.7, p = 0.041). CONCLUSION: We highlight the functional consequences of resecting HGM language sites, and suggest that NPE of DRE patients should include comprehensive assessment of multiple linguistic and cognitive domains besides naming ability.
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: 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