@article {3407, title = {Real-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.}, journal = {J Neurosurg Pediatr}, volume = {14}, year = {2014}, month = {09/2014}, pages = {287-95}, abstract = {

Accurate language localization expands surgical treatment options for epilepsy patients and reduces the risk of postsurgery language deficits. Electrical cortical stimulation mapping (ESM) is considered to be the clinical gold standard for language localization. While ESM affords clinically valuable results, it can be poorly tolerated by children, requires active participation and compliance, carries a risk of inducing seizures, is highly time consuming, and is labor intensive. Given these limitations, alternative and/or complementary functional localization methods such as analysis of electrocorticographic (ECoG) activity in high gamma frequency band in real time are needed to precisely identify eloquent cortex in children. In this case report, the authors examined 1) the use of real-time functional mapping (RTFM) for language localization in a high gamma frequency band derived from ECoG to guide surgery in an epileptic pediatric patient and 2) the relationship of RTFM mapping results to postsurgical language outcomes. The authors found that RTFM demonstrated relatively high sensitivity (75\%) and high specificity (90\%) when compared with ESM in a "next-neighbor" analysis. While overlapping with ESM in the superior temporal region, RTFM showed a few other areas of activation related to expressive language function, areas that were eventually resected during the surgery. The authors speculate that this resection may be associated with observed postsurgical expressive language deficits. With additional validation in more subjects, this finding would suggest that surgical planning and associated assessment of the risk/benefit ratio would benefit from information provided by RTFM mapping.

}, keywords = {Adolescent, Anticonvulsants, Brain Mapping, Cerebral Cortex, Electric Stimulation, Electroencephalography, Epilepsies, Partial, Female, Humans, Language, Neuropsychological Tests, Sensitivity and Specificity, Speech}, issn = {1933-0715}, doi = {10.3171/2014.6.PEDS13477}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24995815}, author = {Korostenskaja, Milena and Chen, Po-Ching and Salinas, Christine M and Westerveld, Michael and Peter Brunner and Gerwin Schalk and Cook, Jane C and Baumgartner, James and Lee, Ki H} } @article {2150, title = {Spatiotemporal dynamics of electrocorticographic high gamma activity during overt and covert word repetition.}, journal = {Neuroimage}, volume = {54}, year = {2011}, month = {02/2011}, pages = {2960-72}, abstract = {

Language is one of the defining abilities of humans. Many studies have characterized the neural correlates of different aspects of language processing. However, the imaging techniques typically used in these studies were limited in either their temporal or spatial resolution. Electrocorticographic (ECoG) recordings from the surface of the\ brain\ combine high spatial with high temporal resolution and thus could be a valuable tool for the study of neural correlates of language function. In this study, we defined the spatiotemporal dynamics of ECoG activity during a word repetition task in nine human subjects. ECoG was recorded while each subject overtly or covertly repeated words that were presented either visually or auditorily. ECoG amplitudes in the high gamma (HG) band confidently tracked neural changes associated with stimulus presentation and with the subject{\textquoteright}s verbal response. Overt word production was primarily associated with HG changes in the superior and middle parts of temporal lobe, Wernicke{\textquoteright}s area, the supramarginal gyrus, Broca{\textquoteright}s area, premotor cortex (PMC), primary motor cortex. Covert word production was primarily associated with HG changes in superior temporal lobe and the supramarginal gyrus. Acoustic processing from both auditory stimuli as well as the subject{\textquoteright}s own voice resulted in HG power changes in superior temporal lobe and Wernicke{\textquoteright}s area. In summary, this study represents a comprehensive characterization of overt and covert speech using electrophysiological imaging with high spatial and temporal resolution. It thereby complements the findings of previous neuroimaging studies of language and thus further adds to\ current\ understanding of word processing in humans.

}, keywords = {Adolescent, Adult, Brain, Brain Mapping, Electroencephalography, Female, Humans, Male, Middle Aged, Signal Processing, Computer-Assisted, Verbal Behavior}, issn = {1095-9572}, doi = {10.1016/j.neuroimage.2010.10.029}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21029784}, author = {Pei, Xiao-Mei and Leuthardt, E C and Charles M Gaona and Peter Brunner and Jonathan Wolpaw and Gerwin Schalk} }