床边使用皮质脑电图进行语言的时空功能映射。
Spatial-temporal functional mapping of language at the bedside with electrocorticography.
作者信息
Wang Yujing, Fifer Matthew S, Flinker Adeen, Korzeniewska Anna, Cervenka Mackenzie C, Anderson William S, Boatman-Reich Dana F, Crone Nathan E
机构信息
From the Departments of Neurology (Y.W., A.K., M.C.C., D.F.B.-R., N.E.C.), Biomedical Engineering (M.S.F.), and Neurosurgery (W.S.A.), Johns Hopkins University, Baltimore, MD; Fischell Department of Bioengineering (Y.W.), University of Maryland College Park; and Department of Psychology (A.F.), New York University, New York.
出版信息
Neurology. 2016 Mar 29;86(13):1181-9. doi: 10.1212/WNL.0000000000002525. Epub 2016 Mar 2.
OBJECTIVE
To investigate the feasibility and clinical utility of using passive electrocorticography (ECoG) for online spatial-temporal functional mapping (STFM) of language cortex in patients being monitored for epilepsy surgery.
METHODS
We developed and tested an online system that exploits ECoG's temporal resolution to display the evolution of statistically significant high gamma (70-110 Hz) responses across all recording sites activated by a discrete cognitive task. We illustrate how this spatial-temporal evolution can be used to study the function of individual recording sites engaged during different language tasks, and how this approach can be particularly useful for mapping eloquent cortex.
RESULTS
Using electrocortical stimulation mapping (ESM) as the clinical gold standard for localizing language cortex, the average sensitivity and specificity of online STFM across 7 patients were 69.9% and 83.5%, respectively. Moreover, relative to regions of interest where discrete cortical lesions have most reliably caused language impairments in the literature, the sensitivity of STFM was significantly greater than that of ESM, while its specificity was also greater than that of ESM, though not significantly so.
CONCLUSIONS
This study supports the feasibility and clinical utility of online STFM for mapping human language function, particularly under clinical circumstances in which time is limited and comprehensive ESM is impractical.
目的
研究在接受癫痫手术监测的患者中，使用被动皮质脑电图（ECoG）进行语言皮质的在线时空功能映射（STFM）的可行性和临床实用性。
方法
我们开发并测试了一个在线系统，该系统利用ECoG的时间分辨率来显示由离散认知任务激活的所有记录部位上具有统计学意义的高伽马（70 - 110赫兹）反应的演变。我们举例说明了这种时空演变如何用于研究不同语言任务期间参与的各个记录部位的功能，以及这种方法如何对绘制明确的皮质特别有用。
结果
以皮质电刺激映射（ESM）作为定位语言皮质的临床金标准，7例患者在线STFM的平均敏感性和特异性分别为69.9%和83.5%。此外，相对于文献中离散皮质病变最可靠地导致语言障碍的感兴趣区域，STFM的敏感性显著高于ESM，其特异性也高于ESM，尽管差异不显著。
结论
本研究支持在线STFM用于绘制人类语言功能的可行性和临床实用性，特别是在时间有限且全面的ESM不切实际的临床情况下。
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