National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
Clin Neurophysiol. 2023 Mar;147:31-44. doi: 10.1016/j.clinph.2022.11.021. Epub 2022 Dec 22.
To investigate the feasibility of passive functional mapping in the receptive language cortex during general anesthesia using electrocorticographic (ECoG) signals.
We used subdurally placed ECoG grids to record cortical responses to speech stimuli during awake and anesthesia conditions. We identified the cortical areas with significant responses to the stimuli using the spectro-temporal consistency of the brain signal in the broadband gamma (BBG) frequency band (70-170 Hz).
We found that ECoG BBG responses during general anesthesia effectively identify cortical regions associated with receptive language function. Our analyses demonstrated that the ability to identify receptive language cortex varies across different states and depths of anesthesia. We confirmed these results by comparing them to receptive language areas identified during the awake condition. Quantification of these results demonstrated an average sensitivity and specificity of passive language mapping during general anesthesia to be 49±7.7% and 100%, respectively.
Our results demonstrate that mapping receptive language cortex in patients during general anesthesia is feasible.
Our proposed protocol could greatly expand the population of patients that can benefit from passive language mapping techniques, and could eliminate the risks associated with electrocortical stimulation during an awake craniotomy.
利用脑电描记术（ECoG）信号研究全麻状态下被动语言功能定位的可行性。
我们使用硬脑膜下放置的 ECoG 网格在清醒和麻醉状态下记录对言语刺激的皮质反应。我们使用宽带伽马（BBG）频段（70-170 Hz）中脑信号的时频谱一致性来识别对刺激有显著反应的皮质区域。
我们发现，全麻期间的 ECoG BBG 反应能够有效地识别与接受性语言功能相关的皮质区域。我们的分析表明，识别接受性语言皮质的能力因麻醉状态和深度的不同而有所差异。我们通过将其与清醒状态下识别的接受性语言区域进行比较，证实了这些结果。这些结果的量化表明，全麻期间被动语言定位的平均灵敏度和特异性分别为 49±7.7%和 100%。
我们的结果表明，全麻状态下对患者的接受性语言皮质进行定位是可行的。
我们提出的方案可以大大扩大受益于被动语言定位技术的患者群体，并消除在清醒开颅术中电刺激相关的风险。
