Clinical Impact and Implication of Real-Time Oscillation Analysis for Language Mapping
详细信息 查看全文
- 作者：Hiroshi Ogawa<sup>1sup> ; Kyousuke Kamada<sup>1sup><sup> ; sup><sup>kamady-k@umin.ac.jpsup> ; Christoph Kapeller<sup>3sup> ; Robert Prueckl<sup>3sup> ; Fumiya Takeuchi<sup>2sup> ; Satoru Hiroshima<sup>1sup> ; Ryogo Anei<sup>1sup> ; Christoph Guger<sup>3sup>
- 关键词：Awake craniotomy ; Electrocorticogram ; Functional dynamics ; High gamma activity ; Real-time mapping
- 刊名：World Neurosurgery
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：97
- 期：Complete
- 页码：123-131
- 全文大小：3324 K
- 卷排序：97
文摘
We developed a functional brain analysis system that enabled us to perform real-time task-related electrocorticography (ECoG) and evaluated its potential in clinical practice. We hypothesized that high gamma activity (HGA) mapping would provide better spatial and temporal resolution with high signal-to-noise ratios.MethodsSeven awake craniotomy patients were evaluated. ECoG was recorded during language tasks using subdural grids, and HGA (60–170 Hz) maps were obtained in real time. The patients also underwent electrocortical stimulation (ECS) mapping to validate the suspected functional locations on HGA mapping. The results were compared and calculated to assess the sensitivity and specificity of HGA mapping. For reference, bedside HGA–ECS mapping was performed in 5 epilepsy patients.ResultsHGA mapping demonstrated functional brain areas in real time and was comparable with ECS mapping. Sensitivity and specificity for the language area were 90.1% ± 11.2% and 90.0% ± 4.2%, respectively. Most HGA-positive areas were consistent with ECS-positive regions in both groups, and there were no statistical between-group differences.ConclusionsAlthough this study included a small number of subjects, it showed real-time HGA mapping with the same setting and tasks under different conditions. This study demonstrates the clinical feasibility of real-time HGA mapping. Real-time HGA mapping enabled simple and rapid detection of language functional areas in awake craniotomy. The mapping results were highly accurate, although the mapping environment was noisy. Further studies of HGA mapping may provide the potential to elaborate complex brain functions and networks.