02881nas a2200397   4500008004100000022001400041245011100055210006900166260001200235300001100247490000700258520172500265653001501990653002002005653001802025653002002043653002502063653002702088653002402115653001102139653001102150653001302161653002902174653003202203653001102235100002602246700001902272700002602291700002402317700001902341700001902360700001802379700002302397700001502420856004802435       2014                        eng d  a1933-071500aReal-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.0 aRealtime functional mapping potential tool for improving languag  c09/2014  a287-950 v143 a<p>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.</p>10aAdolescent10aAnticonvulsants10aBrain Mapping10aCerebral Cortex10aElectric Stimulation10aElectroencephalography10aEpilepsies, Partial10aFemale10aHumans10aLanguage10aNeuropsychological Tests10aSensitivity and Specificity10aSpeech1 aKorostenskaja, Milena1 aChen, Po-Ching1 aSalinas, Christine, M1 aWesterveld, Michael1 aBrunner, Peter1 aSchalk, Gerwin1 aCook, Jane, C1 aBaumgartner, James1 aLee, Ki, H  uhttp://www.ncbi.nlm.nih.gov/pubmed/2499581502800nas a2200349   4500008004100000245012100041210006900162260001200231520168800243653003501931653002501966653003201991653002102023653004902044653002302093653001502116653001302131100002602144700002002170700002102190700001902211700001902230700001702249700002602266700002102292700002002313700001802333700001902351700001702370700001502387856004802402       2014                        eng d00aReal-Time Functional Mapping with Electrocorticography in Pediatric Epilepsy: Comparison with fMRI and ESM Findings.0 aRealTime Functional Mapping with Electrocorticography in Pediatr  c07/20143 aSIGFRIED (SIGnal modeling For Real-time Identification and Event Detection) software provides real-time functional mapping (RTFM) of eloquent cortex for epilepsy patients preparing to undergo resective surgery. This study presents the first application of paradigms used in functional magnetic resonance (fMRI) and electrical cortical stimulation mapping (ESM) studies for shared functional cortical mapping in the context of RTFM. Results from the 3 modalities are compared. A left-handed 13-year-old male with intractable epilepsy participated in functional mapping for localization of eloquent language cortex with fMRI, ESM, and RTFM. For RTFM, data were acquired over the frontal and temporal cortex. Several paradigms were sequentially presented: passive (listening to stories) and active (picture naming and verb generation). For verb generation and story processing, fMRI showed atypical right lateralizing language activation within temporal lobe regions of interest and bilateral frontal activation with slight right lateralization. Left hemisphere ESM demonstrated no eloquent language areas. RTFM procedures using story processing and picture naming elicited activity in the right lateral and basal temporal regions. Verb generation elicited strong right lateral temporal lobe activation, as well as left frontal lobe activation. RTFM results confirmed atypical language lateralization evident from fMRI and ESM. We demonstrated the feasibility and usefulness of a new RTFM stimulation paradigm during presurgical evaluation. Block design paradigms used in fMRI may be optimal for this purpose. Further development is needed to create age-appropriate RTFM test batteries.10aBrain-computer interface (BCI)10acortical stimulation10aelectrocorticography (ECoG)10aepilepsy surgery10afunctional magnetic resonance imaging (fMRI)10afunctional mapping10apediatrics10aSIGFRIED1 aKorostenskaja, Milena1 aWilson, Adam, J1 aRose, Douglas, F1 aBrunner, Peter1 aSchalk, Gerwin1 aLeach, James1 aMangano, Francesco, T1 aFujiwara, Hisako1 aRozhkov, Leonid1 aHarris, Elana1 aChen, Po-Ching1 aSeo, Joo-Hee1 aLee, Ki, H  uhttp://www.ncbi.nlm.nih.gov/pubmed/2429316101883nas a2200217   4500008004100000022001400041245011000055210006900165260001200234300001100246490000900257520120500266100002001471700002401491700002101515700002601536700001901562700001501581700002101596856004801617       2013                        eng d  a1557-170X00aCortiQ - clinical software for electrocorticographic real-time functional mapping of the eloquent cortex.0 aCortiQ clinical software for electrocorticographic realtime func  c07/2013  a6365-80 v20133 aPlanning for epilepsy surgery depends substantially on the localization of brain cortical areas responsible for sensory, motor, or cognitive functions, clinically also known as eloquent cortex. In this paper, we present the novel software package 'cortiQ' that allows clinicians to localize eloquent cortex, thus providing a safe margin for surgical resection with a low incidence of neurological deficits. This software can be easily used in addition to traditional mapping procedures such as the electrical cortical stimulation (ECS) mapping. The software analyses task-related changes in gamma activity recorded from implanted subdural electrocorticography electrodes using extensions to previously published methods. In this manuscript, we describe the system's architecture and workflow required to obtain a map of the eloquent cortex. We validate the system by comparing our mapping results with those acquired using ECS mapping in two subjects. Our results indicate that cortiQ reliably identifies eloquent cortex much faster (several minutes compared to an hour or more) than ECS mapping. Next-neighbour analyses show that there are no false positives and an average of 1.24% false negatives.1 aPrueckl, Robert1 aKapeller, Christoph1 aPotes, Cristhian1 aKorostenskaja, Milena1 aSchalk, Gerwin1 aLee, Ki, H1 aGuger, Christoph  uhttp://www.ncbi.nlm.nih.gov/pubmed/24111197