Clin EEG Neurosci. 2014 Jul;45(3):205-11. doi: 10.1177/1550059413492960.
SIGFRIED (SIGnal modeling For Real-time Identification and Event Detection) software provides real-time functional mapping (RTFM) of eloquent cortex for epilepsy patients preparing to undergo resective surgery. This study presents the first application of paradigms used in functional magnetic resonance (fMRI) and electrical cortical stimulation mapping (ESM) studies for shared functional cortical mapping in the context of RTFM. Results from the 3 modalities are compared. A left-handed 13-year-old male with intractable epilepsy participated in functional mapping for localization of eloquent language cortex with fMRI, ESM, and RTFM. For RTFM, data were acquired over the frontal and temporal cortex. Several paradigms were sequentially presented: passive (listening to stories) and active (picture naming and verb generation). For verb generation and story processing, fMRI showed atypical right lateralizing language activation within temporal lobe regions of interest and bilateral frontal activation with slight right lateralization. Left hemisphere ESM demonstrated no eloquent language areas. RTFM procedures using story processing and picture naming elicited activity in the right lateral and basal temporal regions. Verb generation elicited strong right lateral temporal lobe activation, as well as left frontal lobe activation. RTFM results confirmed atypical language lateralization evident from fMRI and ESM. We demonstrated the feasibility and usefulness of a new RTFM stimulation paradigm during presurgical evaluation. Block design paradigms used in fMRI may be optimal for this purpose. Further development is needed to create age-appropriate RTFM test batteries.
SIGFRIED（实时识别和事件检测信号建模）软件为准备接受切除术的癫痫患者提供了语言功能区的实时功能映射（RTFM）。本研究首次将功能磁共振成像（fMRI）和皮质电刺激映射（ESM）研究中使用的范式应用于 RTFM 中的共享功能皮质映射。比较了这 3 种模式的结果。一名左撇子 13 岁男性患有难治性癫痫，他接受了 fMRI、ESM 和 RTFM 定位语言功能区的功能映射。对于 RTFM，数据是在前额和颞叶皮层上采集的。依次呈现了几种范式：被动（听故事）和主动（图片命名和动词生成）。对于动词生成和故事处理，fMRI 显示颞叶感兴趣区的右偏侧语言激活以及双侧额叶激活，右偏侧化稍显。左侧 ESM 未显示出语言功能区。使用故事处理和图片命名的 RTFM 程序可在右侧颞叶和基底颞叶区域引起活动。动词生成可引起强烈的右侧颞叶激活以及左侧额叶激活。RTFM 结果证实了 fMRI 和 ESM 显示的异常语言侧化。我们证明了在术前评估中使用新的 RTFM 刺激范式的可行性和实用性。在 fMRI 中使用的块设计范式可能最适合该目的。需要进一步开发来创建适合年龄的 RTFM 测试套件。
