Language mapping using high gamma electrocorticography, fMRI, and TMS versus electrocortical stimulation

Abbas Babajani-Feremi; Shalini Narayana; Roozbeh Rezaie; Asim F Choudhri; Stephen P Fulton; Frederick A Boop; James W Wheless; Andrew C Papanicolaou

doi:10.1016/j.clinph.2015.11.017

Language mapping using high gamma electrocorticography, fMRI, and TMS versus electrocortical stimulation

Clin Neurophysiol. 2016 Mar;127(3):1822-36. doi: 10.1016/j.clinph.2015.11.017. Epub 2015 Nov 26.

Authors

Abbas Babajani-Feremi¹, Shalini Narayana², Roozbeh Rezaie³, Asim F Choudhri⁴, Stephen P Fulton⁵, Frederick A Boop⁶, James W Wheless⁵, Andrew C Papanicolaou²

Affiliations

¹ Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, TN, USA; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address: ababajan@uthsc.edu.
² Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, TN, USA; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA.
³ Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, TN, USA; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA.
⁴ Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA.
⁵ Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
⁶ Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA.

PMID: 26679420
DOI: 10.1016/j.clinph.2015.11.017

Abstract

Objective: The aim of the present study was to compare localization of the language cortex using cortical stimulation mapping (CSM), high gamma electrocorticography (hgECoG), functional magnetic resonance imaging (fMRI), and transcranial magnetic stimulation (TMS).

Methods: Language mapping using CSM, hgECoG, fMRI, and TMS were compared in nine patients with epilepsy. Considering CSM as reference, we compared language mapping approaches based on hgECoG, fMRI, and TMS using their sensitivity, specificity, and the results of receiver operating characteristic (ROC) analyses.

Results: Our results show that areas involved in language processing can be identified by hgECoG, fMRI, and TMS. The average sensitivity/specificity of hgECoG, fMRI, and TMS across all patients was 100%/85%, 50%/80%, and 67%/66%, respectively. The average area under the ROC curve of hgECoG, fMRI, and TMS across CSM-positive patients was 0.98, 0.76, and 0.68, respectively.

Conclusions: There is considerable concordance between CSM, hgECoG, fMRI, and TMS language mapping. Our results reveal that hgECoG, fMRI, and TMS are valuable tools for presurgical language mapping.

Significance: Language mapping on the basis of hgECoG, fMRI, and TMS can provide important additional information, therefore, these methods can be used in conjunction with CSM or as an alternative, when the latter is deemed impractical.

Keywords: Cortical stimulation mapping (CSM); Epilepsy; Functional MRI (fMRI); High gamma electrocorticography (hgECoG); Presurgical language mapping; Transcranial magnetic stimulation (TMS).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Brain Mapping / methods*
Cerebral Cortex / physiology*
Electric Stimulation / methods
Electrocorticography / methods*
Female
Gamma Rhythm / physiology*
Humans
Language*
Magnetic Resonance Imaging / methods*
Male
Retrospective Studies
Transcranial Magnetic Stimulation / methods*
Young Adult