Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA.
Epilepsy Behav. 2020 Nov;112:107407. doi: 10.1016/j.yebeh.2020.107407. Epub 2020 Sep 30.
A crucial element of the surgical treatment of medically refractory epilepsy is to delineate cortical areas that must be spared in order to avoid clinically relevant neurological and neuropsychological deficits postoperatively. For each patient, this typically necessitates determining the language lateralization between hemispheres and language localization within hemisphere. Understanding cortical language systems is complicated by two primary challenges: the extent of the neural tissue involved and the substantial variability across individuals, especially in pathological populations. We review the contributions made through the study of electrophysiological activity to address these challenges. These contributions are based on the techniques of magnetoencephalography (MEG), intracerebral recordings, electrical-cortical stimulation (ECS), and the electrovideo analyses of seizures and their semiology. We highlight why no single modality alone is adequate to identify cortical language systems and suggest avenues for improving current practice.
手术治疗药物难治性癫痫的一个关键要素是描绘出必须保留的皮质区域，以避免术后出现临床相关的神经和神经心理学缺陷。对于每个患者，这通常需要确定半球间的语言侧化和半球内的语言定位。理解皮质语言系统受到两个主要挑战的影响：涉及的神经组织的范围和个体之间的显著变异性，特别是在病理性人群中。我们回顾了通过研究电生理活动来解决这些挑战的贡献。这些贡献基于脑磁图（MEG）、脑内记录、皮层电刺激（ECS）以及癫痫发作及其症候学的电视频分析技术。我们强调了为什么没有单一的模态足以识别皮质语言系统，并提出了改善当前实践的途径。
