Clinical Impact and Implication of Real-Time Oscillation Analysis for Language Mapping

Ogawa, Hiroshi; Kapeller, Christoph; Prueckl, Robert; Takeuchi, Fumiya; Hiroshima, Satoru; Anei, Ryogo; Guger, Christoph

doi:10.1016/j.wneu.2016.09.071

Cited by 19 publications

(11 citation statements)

References 18 publications

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“…Electrical stimulation to the identified temporal receptive language area by linguistic-HGA mapping evoked CCEPs in the frontal language area. ECS confirmed that HGA/CCEP mapping regions were highly reliable for normal functional mapping (21,22). Compared to previous intraoperative normal functional mapping, we further concentrated on identifying pathological networks in epilepsy by applying electrical stimuli to each focus at the bedside and in the operating room.…”

Section: Discussionmentioning

confidence: 72%

Tailor-Made Surgery Based on Functional Networks for Intractable Epilepsy

et al. 2020

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Normal and pathological networks related to seizure propagation have got attention to elucide complex seizure semiology and contribute to diagnosis and surgical monitoring in epilepsy treatment. Since focal and generalized epileptogenic syndromes abnormalities might involve multiple foci and large-scale networks, we applied electrophysiolpgy (cortco-cortico evoked potential; CCEP), and tractography to make detailed diagnosis for complex syndrome. All 14 epilepsy patients with no or little abnormality on images investigations underwent subdural grid implantation for epilepsy diagnosis. To perform quick network analysis, we recorded and analyzed high gamma activity (HGA) of epileptogenic activity and CCEPs to identify pathological activity distribution and network connectivity. [Results] Pathological CCEPs showed two negative deflections consisting of early (>40 ms) and late (>150 ms) components in electrically stable circumstance at bed side and early CCEPs appeared in 57% of the patients. On the basis of the CCEP findings, tractography detected anatomical connections. Early components of pathological CCEPs diminished after complete disconnection of tractoography-based fibers between the foci in seven of eight cases. One case with residual pathological CCEPs showed poorer outcome. Thirteen (92.8%) patients with or without CCEPs who underwent network surgery had favorable prognosis except for a case with wide traumatic epilepsy. Intraoperative CCEP measurements and HGA mapping enabled visualization of pathological networks and clinical impotence as a biomarker to improve functional prognosis. HGA/CCEP recording should shed light on pathological and complex propagation for epilepsy surgery.

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Section: Discussionmentioning

confidence: 72%

Tailor-Made Surgery Based on Functional Networks for Intractable Epilepsy

et al. 2020

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“…Tamura et al described a passive mapping procedure for intraoperative guidance consisting of 2 steps: linguistic HGA mapping with sounds and CCEP with paired electrical stimuli to the temporal receptive language area. 20,25 Electric stimulation to the identified temporal receptive language area by linguistic HGA mapping evoked CCEPs in the frontal language area. ECS mapping of the areas with CCEP responses revealed deficits of language-related functions with high sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…In our previous study, we demonstrated that intraoperative CCEP recording is feasible and reliable. Ogawa et al 19 and several other groups proposed that HGA mapping reflects localized cortical processing, 20 while CCEPs can reflect bidirectional responses between widely dispersed language cortices.…”

Section: Discussionmentioning

confidence: 99%

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Disconnection of the pathological connectome for multifocal epilepsy surgery

Kamada¹,

Ogawa²,

Kapeller

et al. 2018

Journal of Neurosurgery

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OBJECTIVE Recent neuroimaging studies suggest that intractable epilepsy involves pathological functional networks as well as strong epileptogenic foci. Combining cortico-cortical evoked potential (CCEP) recording and tractography is a useful strategy for mapping functional connectivity in normal and pathological networks. In this study, the authors sought to demonstrate the efficacy of preoperative combined CCEP recording, high gamma activity (HGA) mapping, and tractography for surgical planning, and of intraoperative CCEP measures for confirmation of selective pathological network disconnection. METHODS The authors treated 4 cases of intractable epilepsy. Diffusion tensor imaging-based tractography data were acquired before the first surgery for subdural grid implantation. HGA and CCEP investigations were done after the first surgery, before the second surgery was performed to resect epileptogenic foci, with continuous CCEP monitoring during resection. RESULTS All 4 patients in this report had measurable pathological CCEPs. The mean negative peak-1 latency of normal CCEPs related to language functions was 22.2 ± 3.5 msec, whereas pathological CCEP latencies varied between 18.1 and 22.4 msec. Pathological CCEPs diminished after complete disconnection in all cases. At last follow-up, all of the patients were in long-term postoperative seizure-free status, although 1 patient still suffered from visual aura every other month. CONCLUSIONS Combined CCEP measurement, HGA mapping, and tractography greatly facilitated targeted disconnection of pathological networks in this study. Although CCEP recording requires technical expertise, it allows for assessment of pathological network involvement in intractable epilepsy and may improve seizure outcome.

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“…[8][9][10] Generally, the topography of language-related HGM has been comparable between children and adults. 1,[11][12][13][14][15] However, age of the patient is an important determinant of postoperative seizure and language outcomes after epilepsy surgery. [16][17][18] There is a paucity of data about the impact of age on network properties of language-related HGM.…”

Section: Introductionmentioning

confidence: 99%

Development of information sharing in language neocortex in childhood‐onset drug‐resistant epilepsy

et al. 2019

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Summary Objective We studied age‐related dynamics of information sharing among cortical language regions with electrocorticographic high‐gamma modulation during picture‐naming and story‐listening tasks. Methods Seventeen epilepsy patients aged 4‐19 years, undergoing extraoperative monitoring with left‐hemispheric subdural electrodes, were included. Mutual information (MI), a nondirectional measure of shared information, between 16 pairs of cortical regions of interest, was computed from trial‐averaged 70–150 Hz power modulations during language tasks. Impact of age on pairwise MI between language regions and their determinants were ascertained with regression analysis. Results During picture naming, significant increase in MI with age was seen between pairwise combinations of Broca's area, inferior precentral gyrus (iPreC), and frontal association cortex (FAC); Wernicke's area and posterior association cortex (PAC); and Broca's and Wernicke's areas. During story listening, significant age‐related increase in MI was seen between Wernicke's area and either Broca's area, FAC, or PAC; and between Broca's area and FAC. Significant impact of baseline intelligence quotient was seen on the relationship between age and MI for all pairs, except between Broca's area and iPreC. The mean MI was higher during naming compared to listening for pairs including iPreC with Broca's area, FAC, or PAC and was lower for pairs of Wernicke's area or PAC with anterior language regions. Significance Information sharing matures with age “within” frontal and temporoparietal language cortices, and “between” Broca's and Wernicke's areas. This study provides evidence for distinct patterns of developmental plasticity within perisylvian language cortex and has implications for planning epilepsy surgery.

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Clinical Impact and Implication of Real-Time Oscillation Analysis for Language Mapping

Cited by 19 publications

References 18 publications

Tailor-Made Surgery Based on Functional Networks for Intractable Epilepsy

Tailor-Made Surgery Based on Functional Networks for Intractable Epilepsy

Disconnection of the pathological connectome for multifocal epilepsy surgery

Development of information sharing in language neocortex in childhood‐onset drug‐resistant epilepsy

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