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Varner JA, Rezaie R, Noorizadeh N, Boop FA, Fulton SP, Klimo P, Shimony N, Wheless JW, Narayana S. Transcranial magnetic stimulation and magnetoencephalography are feasible alternatives to invasive methods in optimizing responsive neurostimulation device placement. Epilepsy Res 2024; 206:107426. [PMID: 39128278 DOI: 10.1016/j.eplepsyres.2024.107426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/24/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024]
Abstract
Responsive neurostimulation (RNS) is a treatment option for patients with refractory epilepsy when surgical resection is not possible due to overlap of the irritative zone and eloquent cortex. Presurgical evaluations for RNS placement typically rely on invasive methods. This study investigated the potential of transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG) to provide key presurgical information non-invasively. We hypothesized that these non-invasive methods may assist in optimizing RNS placement by providing useful information for seizure localization by MEG and eloquent cortex mapping by TMS. A retrospective chart review identified nine patients who underwent RNS placement (mean age = 20.4 years [SD = 5.6], two-thirds were female). Characterization of the irritative zone using MEG was successful in eight of nine patients. Non-invasive mapping of relevant eloquent cortex was attempted in all patients. TMS was successful in eight of nine patients, and MEG was successful in two of six patients. Importantly, patients mapped with non-invasive modalities experienced an average seizure reduction of 77 % at their most recent clinic visit, compared to 75 % seizure reduction in those with invasive evaluations, indicating appropriate RNS placement. These data demonstrate that TMS and MEG can provide key information for RNS and may be feasible alternatives to invasive methods for assisting in decision making regarding RNS placement. Non-invasive methods for determining RNS placement have a high rate of success when data from multiple non-invasive modalities converge and can inform more accurate placement of intracranial electrodes prior to RNS placement or mitigate their need.
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Affiliation(s)
- J Austin Varner
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Roozbeh Rezaie
- 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
| | - Negar Noorizadeh
- 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
| | - Frederick A Boop
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Stephen P Fulton
- 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
| | - Paul Klimo
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Neurosurgery, Semmes Murphey Clinic, Memphis, TN, USA
| | - Nir Shimony
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Neurosurgery, Semmes Murphey Clinic, Memphis, TN, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James W Wheless
- 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
| | - Shalini Narayana
- 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; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA.
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Ailion A, Duong P, Maiman M, Tsuboyama M, Smith ML. Clinical recommendations for conducting pediatric functional language and memory mapping during the phase I epilepsy presurgical workup. Clin Neuropsychol 2024; 38:1060-1084. [PMID: 37985747 DOI: 10.1080/13854046.2023.2281708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Objective: Pediatric epilepsy surgery effectively controls seizures but may risk cognitive, language, or memory decline. Historically, the intra-carotid anesthetic procedure (IAP or Wada Test) was pivotal for language and memory function. However, advancements in noninvasive mapping, notably functional magnetic resonance imaging (fMRI), have transformed clinical practice, reducing IAP's role in presurgical evaluations. Method: We conducted a critical narrative review on mapping technologies, including factors to consider for discordance. Results: Neuropsychological findings suggest that if pre-surgery function remains intact and the surgery targets the eloquent cortex, there is a high chance for decline. Memory and language decline are particularly pronounced post-left anterior temporal lobe resection (ATL), making presurgical cognitive assessment crucial for predicting postoperative outcomes. However, the risk of functional decline is not always clear - particularly with higher rates of atypical organization in pediatric epilepsy patients and discordant findings from cognitive mapping. We found little research to date on the use of IAP and other newer technologies for lateralization/localization in pediatric epilepsy. Based on this review, we introduce an IAP decision tree to systematically navigate discordance in IAP decisions for epilepsy presurgical workup. Conclusions: Future research should be aimed at pediatric populations to improve the precision of functional mapping, determine which methods predict post-surgical deficits and then create evidence-based practice guidelines to standardize mapping procedures. Explicit directives are needed for resolving conflicts between developing mapping procedures and established clinical measures. The proposed decision tree is the first step to standardize when to consider IAP or invasive mapping, in coordination with the multidisciplinary epilepsy surgical team.
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Affiliation(s)
- Alyssa Ailion
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School
- Department of Neurology, Boston Children's Hospital, Harvard Medical School
| | - Priscilla Duong
- Department of Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University School of Medicine
| | - Moshe Maiman
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School
| | - Melissa Tsuboyama
- Department of Neurology, Boston Children's Hospital, Harvard Medical School
| | - Mary Lou Smith
- Department of Psychology, The Hospital for Sick Children, University of Toronto Mississauga
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Dmytriw AA, Hadjinicolaou A, Ntolkeras G, Tamilia E, Pesce M, Berto LF, Grant PE, Pang E, Ahtam B. Magnetoencephalography for the pediatric population, indications, acquisition and interpretation for the clinician. Neuroradiol J 2024:19714009241260801. [PMID: 38864180 DOI: 10.1177/19714009241260801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Magnetoencephalography (MEG) is an imaging technique that enables the assessment of cortical activity via direct measures of neurophysiology. It is a non-invasive and passive technique that is completely painless. MEG has gained increasing prominence in the field of pediatric neuroimaging. This dedicated review article for the pediatric population summarizes the fundamental technical and clinical aspects of MEG for the clinician. We discuss methods tailored for children to improve data quality, including child-friendly MEG facility environments and strategies to mitigate motion artifacts. We provide an in-depth overview on accurate localization of neural sources and different analysis methods, as well as data interpretation. The contemporary platforms and approaches of two quaternary pediatric referral centers are illustrated, shedding light on practical implementations in clinical settings. Finally, we describe the expanding clinical applications of MEG, including its pivotal role in presurgical evaluation of epilepsy patients, presurgical mapping of eloquent cortices (somatosensory and motor cortices, visual and auditory cortices, lateralization of language), its emerging relevance in autism spectrum disorder research and potential future clinical applications, and its utility in assessing mild traumatic brain injury. In conclusion, this review serves as a comprehensive resource of clinicians as well as researchers, offering insights into the evolving landscape of pediatric MEG. It discusses the importance of technical advancements, data acquisition strategies, and expanding clinical applications in harnessing the full potential of MEG to study neurological conditions in the pediatric population.
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Affiliation(s)
- Adam A Dmytriw
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Division of Neuroradiology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Aristides Hadjinicolaou
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA
| | - Georgios Ntolkeras
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Eleonora Tamilia
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Matthew Pesce
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Laura F Berto
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - P Ellen Grant
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth Pang
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Banu Ahtam
- Department of Pediatrics, Division of Newborn Medicine, Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
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Noorizadeh N, Rezaie R, Varner JA, Wheless JW, Fulton SP, Mudigoudar BD, Nevill L, Holder CM, Narayana S. Concordance between Wada, Transcranial Magnetic Stimulation, and Magnetoencephalography for Determining Hemispheric Dominance for Language: A Retrospective Study. Brain Sci 2024; 14:336. [PMID: 38671988 PMCID: PMC11047819 DOI: 10.3390/brainsci14040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/15/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Determination of language hemispheric dominance (HD) in patients undergoing evaluation for epilepsy surgery has traditionally relied on the sodium amobarbital (Wada) test. The emergence of non-invasive methods for determining language laterality has increasingly shown to be a viable alternative. In this study, we assessed the efficacy of transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG), compared to the Wada test, in determining language HD in a sample of 12 patients. TMS-induced speech errors were classified as speech arrest, semantic, or performance errors, and the HD was based on the total number of errors in each hemisphere with equal weighting of all errors (classic) and with a higher weighting of speech arrests and semantic errors (weighted). Using MEG, HD for language was based on the spatial extent of long-latency activity sources localized to receptive language regions. Based on the classic and weighted language laterality index (LI) in 12 patients, TMS was concordant with the Wada in 58.33% and 66.67% of patients, respectively. In eight patients, MEG language mapping was deemed conclusive, with a concordance rate of 75% with the Wada test. Our results indicate that TMS and MEG have moderate and strong agreement, respectively, with the Wada test, suggesting they could be used as non-invasive substitutes.
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Affiliation(s)
- Negar Noorizadeh
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Roozbeh Rezaie
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Jackie A. Varner
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - James W. Wheless
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Stephen P. Fulton
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Basanagoud D. Mudigoudar
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Leigh Nevill
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Christen M. Holder
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
| | - Shalini Narayana
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (N.N.); (R.R.); (J.W.W.); (S.P.F.); (B.D.M.); (C.M.H.)
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA; (J.A.V.); (L.N.)
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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5
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Ji Z, Song RR, Swan AR, Angeles Quinto A, Lee RR, Huang M. Magnetoencephalography Language Mapping Using Auditory Memory Retrieval and Silent Repeating Task. J Clin Neurophysiol 2024; 41:148-154. [PMID: 35512180 PMCID: PMC9633581 DOI: 10.1097/wnp.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The study aims to (1) examine the spatiotemporal map of magnetoencephalography-evoked responses during an Auditory Memory Retrieval and Silent Repeating (AMRSR) task, and determine the hemispheric dominance for language, and (2) evaluate the accuracy of the AMRSR task in Wernicke and Broca area localization. METHODS In 30 patients with brain tumors and/or epilepsies, the AMRSR task was used to evoke magnetoencephalography responses. We applied Fast VEctor-based Spatial-Temporal Analyses with minimum L1-norm source imaging method to the magnetoencephalography responses for localizing the brain areas evoked by the AMRSR task. RESULTS The Fast-VEctor-based Spatial-Temporal Analysis found consistent activation in the posterior superior temporal gyrus around 300 to 500 ms, and another activation in the frontal cortex (pars opercularis and/or pars triangularis) around 600 to 900 ms, which were localized to the Wernicke area (BA 22) and Broca area (BA 44 and BA 45), respectively. The language-dominant hemispheric laterization elicited by the AMRSR task was comparable with the result from an Auditory Dichotic task result given to the same patient, with the exception that AMRSR is more sensitive on bilateral language laterization cases on finding the Wernicke and Broca areas. CONCLUSIONS For all patients who successfully finished the AMRSR task, Fast-VEctor-based Spatial-Temporal Analysis could establish accurate and robust localizations of Broca and Wernicke area and determine hemispheric dominance. For subjects with normal auditory functionality, the AMRSR paradigm evaluation showed significant promise in providing reliable assessments of cerebral language dominance and language network localization.
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Affiliation(s)
- Zhengwei Ji
- Radiology Department, University of California, San Diego, California, U.S.A
| | - Ryan R. Song
- Department of Molecular and Cell Biology, University of California, Berkeley, California, U.S.A.; and
| | - Ashley Robb Swan
- Radiology Department, University of California, San Diego, California, U.S.A
| | | | - Roland R. Lee
- Radiology Department, University of California, San Diego, California, U.S.A
- Radiology Service, San Diego VA Healthcare System, San Diego, California, U.S.A
| | - Mingxiong Huang
- Radiology Department, University of California, San Diego, California, U.S.A
- Radiology Service, San Diego VA Healthcare System, San Diego, California, U.S.A
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Kochi R, Osawa SI, Jin K, Ishida M, Kanno A, Iwasaki M, Suzuki K, Kawashima R, Tominaga T, Nakasato N. Language MEG predicts postoperative verbal memory change in left mesial temporal lobe epilepsy. Clin Neurophysiol 2023; 156:69-75. [PMID: 37890232 DOI: 10.1016/j.clinph.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To clarify whether preoperative language magnetoencephalography (MEG) predicts postoperative verbal memory (VM) changes in left mesial temporal lobe epilepsy (LMTLE). METHODS We reviewed 18 right-handed patients with LMTLE who underwent anterior temporal lobectomy or selective amygdala hippocampectomy, 12 with (HS+) and 6 without hippocampal sclerosis (HS-). Patients underwent neuropsychological assessment before and after surgery. MEG was measured with an auditory verbal learning task in patients preoperatively and in 15 right-handed controls. Dynamic statistical parametric mapping (dSPM) was used for source imaging of task-related activity. Language laterality index (LI) was calculated by z-score of dSPM in language-related regions. LI in the region of HS+ and HS- was compared to controls. The correlation between LI and postoperative VM change was assessed in HS+ and HS-. RESULTS Preoperative LI in supramarginal gyrus showed greater right-shifted lateralization in both HS+ and HS- than in controls. Right-shifted LI in supramarginal gyrus was correlated with postoperative VM increase in HS+ (p = 0.019), but not in HS-. CONCLUSIONS Right-shifted language lateralization in dSPM of MEG signals may predict favorable VM outcome in HS+ of LMTLE. SIGNIFICANCE Findings warrant further investigation of the relation between regional language laterality index and postoperative verbal memory changes.
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Affiliation(s)
- Ryuzaburo Kochi
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shin-Ichiro Osawa
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Makoto Ishida
- Department of Advanced Spintronics Medical Engineering, Tohoku University Graduate School of Engineering, Sendai, Miyagi, Japan
| | - Akitake Kanno
- Department of Advanced Spintronics Medical Engineering, Tohoku University Graduate School of Engineering, Sendai, Miyagi, Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Advanced Spintronics Medical Engineering, Tohoku University Graduate School of Engineering, Sendai, Miyagi, Japan
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Papanicolaou AC. Non-Invasive Mapping of the Neuronal Networks of Language. Brain Sci 2023; 13:1457. [PMID: 37891824 PMCID: PMC10605023 DOI: 10.3390/brainsci13101457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
This review consists of three main sections. In the first, the Introduction, the main theories of the neuronal mediation of linguistic operations, derived mostly from studies of the effects of focal lesions on linguistic performance, are summarized. These models furnish the conceptual framework on which the design of subsequent functional neuroimaging investigations is based. In the second section, the methods of functional neuroimaging, especially those of functional Magnetic Resonance Imaging (fMRI) and of Magnetoencephalography (MEG), are detailed along with the specific activation tasks employed in presurgical functional mapping. The reliability of these non-invasive methods and their validity, judged against the results of the invasive methods, namely, the "Wada" procedure and Cortical Stimulation Mapping (CSM), is assessed and their use in presurgical mapping is justified. In the third and final section, the applications of fMRI and MEG in basic research are surveyed in the following six sub-sections, each dealing with the assessment of the neuronal networks for (1) the acoustic and phonological, (2) for semantic, (3) for syntactic, (4) for prosodic operations, (5) for sign language and (6) for the operations of reading and the mechanisms of dyslexia.
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Affiliation(s)
- Andrew C Papanicolaou
- Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38013, USA
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Babajani-Feremi A, Pourmotabbed H, Schraegle WA, Calley CS, Clarke DF, Papanicolaou AC. MEG language mapping using a novel automatic ECD algorithm in comparison with MNE, dSPM, and DICS beamformer. Front Neurosci 2023; 17:1151885. [PMID: 37332870 PMCID: PMC10272516 DOI: 10.3389/fnins.2023.1151885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/24/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction The single equivalent current dipole (sECD) is the standard clinical procedure for presurgical language mapping in epilepsy using magnetoencephalography (MEG). However, the sECD approach has not been widely used in clinical assessments, mainly because it requires subjective judgements in selecting several critical parameters. To address this limitation, we developed an automatic sECD algorithm (AsECDa) for language mapping. Methods The localization accuracy of the AsECDa was evaluated using synthetic MEG data. Subsequently, the reliability and efficiency of AsECDa were compared to three other common source localization methods using MEG data recorded during two sessions of a receptive language task in 21 epilepsy patients. These methods include minimum norm estimation (MNE), dynamic statistical parametric mapping (dSPM), and dynamic imaging of coherent sources (DICS) beamformer. Results For the synthetic single dipole MEG data with a typical signal-to-noise ratio, the average localization error of AsECDa was less than 2 mm for simulated superficial and deep dipoles. For the patient data, AsECDa showed better test-retest reliability (TRR) of the language laterality index (LI) than MNE, dSPM, and DICS beamformer. Specifically, the LI calculated with AsECDa revealed excellent TRR between the two MEG sessions across all patients (Cor = 0.80), while the LI for MNE, dSPM, DICS-event-related desynchronization (ERD) in the alpha band, and DICS-ERD in the low beta band ranged lower (Cor = 0.71, 0.64, 0.54, and 0.48, respectively). Furthermore, AsECDa identified 38% of patients with atypical language lateralization (i.e., right lateralization or bilateral), compared to 73%, 68%, 55%, and 50% identified by DICS-ERD in the low beta band, DICS-ERD in the alpha band, MNE, and dSPM, respectively. Compared to other methods, AsECDa's results were more consistent with previous studies that reported atypical language lateralization in 20-30% of epilepsy patients. Discussion Our study suggests that AsECDa is a promising approach for presurgical language mapping, and its fully automated nature makes it easy to implement and reliable for clinical evaluations.
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Affiliation(s)
- Abbas Babajani-Feremi
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Magnetoencephalography (MEG) Lab, The Norman Fixel Institute of Neurological Diseases, University of Florida Health, Gainesville, FL, United States
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Haatef Pourmotabbed
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - William A. Schraegle
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Comprehensive Pediatric Epilepsy Center, Dell Children’s Medical Center, Austin, TX, United States
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Clifford S. Calley
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Comprehensive Pediatric Epilepsy Center, Dell Children’s Medical Center, Austin, TX, United States
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Neurosurgery, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Dave F. Clarke
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Comprehensive Pediatric Epilepsy Center, Dell Children’s Medical Center, Austin, TX, United States
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Neurosurgery, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Andrew C. Papanicolaou
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
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Kakinuma K, Osawa SI, Hosokawa H, Oyafuso M, Ota S, Kobayashi E, Kawakami N, Ukishiro K, Jin K, Ishida M, Sato T, Sakamoto M, Niizuma K, Tominaga T, Nakasato N, Suzuki K. Determination of language areas in patients with epilepsy using the super-selective Wada test. IBRO Neurosci Rep 2022; 13:156-163. [PMID: 36039070 PMCID: PMC9418183 DOI: 10.1016/j.ibneur.2022.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
The Wada test is the gold standard for determining language-dominant hemisphere. However, the precise determination of language areas in each patient requires more invasive methods, such as electrocortical stimulation. Some studies have reported the use of anesthetic injection into selective cerebral arteries to predict postoperative function. To assess the function of the anterior and posterior language areas separately, we developed an advanced test named the "super-selective Wada test" (ssWada). The ssWada procedure is as follows: an endovascular neurosurgeon identifies the arterial branches of the middle cerebral artery (MCA) perfusing the anterior language area of the inferior frontal gyrus and the posterior language area of the posterior part of the superior temporal gyrus using angiography. Behavioral neurologists assess language symptoms before and after propofol administration using a microcatheter tip in the selected arterial branch. From 30 serial patients with epilepsy who underwent ssWada test at Tohoku University Hospital, we retrospectively reviewed patients in whom multiple areas in the bilateral MCA region was examined. Eight cases were identified in this study. All eight cases had been considered for resection of the area overlapping the classical language area. Three of the eight cases were left-dominant, and the within-hemisphere distribution was also considered typical. One case was determined to be left-dominant but atypical in the intra-hemispheric functional distribution. Two cases were right-dominant, and the intra-hemispheric functional distribution was considered a mirror image of the typical pattern. The remaining two cases were considered atypical, not only in terms of bilateral language function, but also in terms of anterior-posterior functional distribution. This case series demonstrates the potential utility of ssWada in revealing separate function of the anterior and posterior language areas. The ssWada allows simulation of local surgical brain resection and detailed investigation of language function, which potentially contributes to planning the resection area. Although indications for ssWada are quite limited, it could play a complementary role to noninvasive testing because it provides information related to resection using a different approach.
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Key Words
- CTA, computed tomography angiography
- ECD, equivalent current dipole
- ECS, electrocortical stimulation
- EEG, electroencephalography
- Epilepsy
- Epilepsy surgery
- Functional mapping
- Lateralization
- M2 inf, M2 inferior division of middle cerebral artery
- M2 sup, M2 superior division of middle cerebral artery
- MCA, middle cerebral artery
- MEG, magnetoencephalography
- Preoperative planning
- Wada test
- fMRI, functional magnetic resonance imaging
- ssWada, super-selective Wada test
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Affiliation(s)
- Kazuo Kakinuma
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Shin-ichiro Osawa
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Hiroaki Hosokawa
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
- Department of Rehabilitation, National Hospital Organization Sendai-Nishitaga Hospital, 2-11-11 Kagitorihoncho, Taihaku, Sendai, Miyagi 982-8555, Japan
| | - Marie Oyafuso
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Shoko Ota
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Erena Kobayashi
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
- Department of Neurology and Stroke Medicine, Yokohama City University School of Medicine, Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan
| | - Nobuko Kawakami
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Kazushi Ukishiro
- Department of Epileptology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Makoto Ishida
- Department of Epileptology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Takafumi Sato
- Clinical Physiological Laboratory, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi 980-8574, Japan
| | - Mika Sakamoto
- Clinical Physiological Laboratory, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi 980-8574, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan
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10
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Herfurth K, Harpaz Y, Roesch J, Mueller N, Walther K, Kaltenhaeuser M, Pauli E, Goldstein A, Hamer H, Buchfelder M, Doerfler A, Prell J, Rampp S. Localization of beta power decrease as measure for lateralization in pre-surgical language mapping with magnetoencephalography, compared with functional magnetic resonance imaging and validated by Wada test. Front Hum Neurosci 2022; 16:996989. [PMID: 36393988 PMCID: PMC9644652 DOI: 10.3389/fnhum.2022.996989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2023] Open
Abstract
Objective: Atypical patterns of language lateralization due to early reorganizational processes constitute a challenge in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy. There is no consensus on an optimal analysis method used for the identification of language dominance in MEG. This study examines the concordance between MEG source localization of beta power desynchronization and fMRI with regard to lateralization and localization of expressive and receptive language areas using a visual verb generation task. Methods: Twenty-five patients with pharmaco-resistant epilepsy, including six patients with atypical language lateralization, and ten right-handed controls obtained MEG and fMRI language assessment. Fourteen patients additionally underwent the Wada test. We analyzed MEG beta power desynchronization in sensor (controls) and source space (patients and controls). Beta power decrease between 13 and 35 Hz was localized applying Dynamic Imaging of Coherent Sources Beamformer technique. Statistical inferences were grounded on cluster-based permutation testing for single subjects. Results: Event-related desynchronization of beta power in MEG was seen within the language-dominant frontal and temporal lobe and within the premotor cortex. Our analysis pipeline consistently yielded left language dominance with high laterality indices in controls. Language lateralization in MEG and Wada test agreed in all 14 patients for inferior frontal, temporal and parietal language areas (Cohen's Kappa = 1, p < 0.001). fMRI agreed with Wada test in 12 out of 14 cases (85.7%) for Broca's area (Cohen's Kappa = 0.71, p = 0.024), while the agreement for temporal and temporo-parietal language areas were non-significant. Concordance between MEG and fMRI laterality indices was highest within the inferior frontal gyrus, with an agreement in 19/24 cases (79.2%), and non-significant for Wernicke's area. Spatial agreement between fMRI and MEG varied considerably between subjects and brain regions with the lowest Euclidean distances within the inferior frontal region of interest. Conclusion: Localizing the desynchronization of MEG beta power using a verb generation task is a promising tool for the identification of language dominance in the pre-surgical evaluation of epilepsy patients. The overall agreement between MEG and fMRI was lower than expected and might be attributed to differences within the baseline condition. A larger sample size and an adjustment of the experimental designs are needed to draw further conclusions.
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Affiliation(s)
- Kirsten Herfurth
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Yuval Harpaz
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Julie Roesch
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Nadine Mueller
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Katrin Walther
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | | | - Elisabeth Pauli
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Abraham Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Hajo Hamer
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Julian Prell
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
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11
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YAMASHITA S, SAITO R, OSAWA SI, NIIZUMA K, UKISHIRO K, KANAMORI M, KAKINUMA K, SUZUKI K, TOMINAGA T. A Super-selective Wada Test Successfully Detected an Artery That Supplied Broca's Area in a Case of Left Frontal Lobe Glioblastoma: Technical Case Report. Neurol Med Chir (Tokyo) 2021; 61:661-666. [PMID: 34433753 PMCID: PMC8592815 DOI: 10.2176/nmc.tn.2021-0054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
In cases of malignant gliomas located at language eloquent area, it is often difficult to preoperatively detect those area with functional MRI. Awake surgery is often used to spare the language eloquent area during surgery for such tumors; it is not available for a patient whose intracranial pressure is elevated due to the malignant tumor. The Wada test involves infusing anesthetic agents into the internal carotid artery to determine language dominancy before surgery for epilepsy or brain tumor. The super-selective Wada test is a technique to detect more detailed functional localization by infusing anesthetics into far distal middle cerebral artery branches. We present a 37-year-old man suffering from a left frontal lobe glioblastoma, in whom detection of an artery supplying Broca's area was attempted by a super-selective Wada test. The super-selective Wada test successfully detected the branch of middle cerebral artery supplying Broca's area. Total resection of the contrast-enhancing area was achieved without damaging the artery supplying Broca's area without any neurological sequelae. This is the first report describing the usefulness of the super-selective Wada test in glioblastoma treatment. Our findings suggest that the super-selective Wada test is a powerful and useful means to distinguish the artery that supplies the language area from the tumor feeding artery in cases of tumors in the language eloquent area.
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Affiliation(s)
- Shota YAMASHITA
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Ryuta SAITO
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shin-ichiro OSAWA
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kuniyasu NIIZUMA
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan
| | - Kazushi UKISHIRO
- Department of Epileptology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masayuki KANAMORI
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kazuo KAKINUMA
- Department of Behavioral Neurology and Cognitive Neuroscience, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kyoko SUZUKI
- Department of Behavioral Neurology and Cognitive Neuroscience, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Teiji TOMINAGA
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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12
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Beatty CW, Lockrow JP, Gedela S, Gehred A, Ostendorf AP. The Missed Value of Underutilizing Pediatric Epilepsy Surgery: A Systematic Review. Semin Pediatr Neurol 2021; 39:100917. [PMID: 34620465 DOI: 10.1016/j.spen.2021.100917] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Pediatric epilepsy surgery is underutilized. Only 1%-11% of children with drug resistant epilepsy (DRE) undergo surgical treatment, or less than half of those estimated to benefit. We conducted a systematic review of articles published in PubMed, EMBASE, and Web of Science in order to study the factors related to surgery underutilization as well as the impact on both the individual and the healthcare system. Our review demonstrates multiple factors leading to underutilization, including family misconceptions about epilepsy surgery, lack of provider knowledge, as well as systemic health disparities. While the upfront cost of epilepsy surgery is significant, the long-term financial benefits and reduced health resource utilization tilt the economic advantage in favor of surgery in children with DRE. Additionally, timely interventions improve seizure and cognitive outcomes with low risk of complications. Further interventions are needed at the levels of family, provider, and the healthcare system to increase access to pediatric epilepsy surgery.
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Affiliation(s)
- Christopher W Beatty
- The Ohio State University and Nationwide Children's Hospital, Division of Neurology, Department of Pediatrics, Columbus, OH
| | - Jason P Lockrow
- Department of Neurology, Section of Pediatric Neurology, University of Washington, Seattle, WA
| | - Satyanarayana Gedela
- Emory University and Children's Healthcare of Atlanta, Division of Neurology, Department of Pediatrics, Atlanta, GA
| | - Alison Gehred
- Medical Library Division, Nationwide Children's Hospital, Columbus, OH
| | - Adam P Ostendorf
- The Ohio State University and Nationwide Children's Hospital, Division of Neurology, Department of Pediatrics, Columbus, OH.
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13
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Watkins MW, Shah EG, Funke ME, Garcia-Tarodo S, Shah MN, Tandon N, Maestu F, Laohathai C, Sandberg DI, Lankford J, Thompson S, Mosher J, Von Allmen G. Indications for Inpatient Magnetoencephalography in Children - An Institution's Experience. Front Hum Neurosci 2021; 15:667777. [PMID: 34149382 PMCID: PMC8213217 DOI: 10.3389/fnhum.2021.667777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Magnetoencephalography (MEG) is recognized as a valuable non-invasive clinical method for localization of the epileptogenic zone and critical functional areas, as part of a pre-surgical evaluation for patients with pharmaco-resistant epilepsy. MEG is also useful in localizing functional areas as part of pre-surgical planning for tumor resection. MEG is usually performed in an outpatient setting, as one part of an evaluation that can include a variety of other testing modalities including 3-Tesla MRI and inpatient video-electroencephalography monitoring. In some clinical circumstances, however, completion of the MEG as an inpatient can provide crucial ictal or interictal localization data during an ongoing inpatient evaluation, in order to expedite medical or surgical planning. Despite well-established clinical indications for performing MEG in general, there are no current reports that discuss indications or considerations for completion of MEG on an inpatient basis. We conducted a retrospective institutional review of all pediatric MEGs performed between January 2012 and December 2020, and identified 34 cases where MEG was completed as an inpatient. We then reviewed all relevant medical records to determine clinical history, all associated diagnostic procedures, and subsequent treatment plans including epilepsy surgery and post-surgical outcomes. In doing so, we were able to identify five indications for completing the MEG on an inpatient basis: (1) super-refractory status epilepticus (SRSE), (2) intractable epilepsy with frequent electroclinical seizures, and/or frequent or repeated episodes of status epilepticus, (3) intractable epilepsy with infrequent epileptiform discharges on EEG or outpatient MEG, or other special circumstances necessitating inpatient monitoring for successful and safe MEG data acquisition, (4) MEG mapping of eloquent cortex or interictal spike localization in the setting of tumor resection or other urgent neurosurgical intervention, and (5) international or long-distance patients, where outpatient MEG is not possible or practical. MEG contributed to surgical decision-making in the majority of our cases (32 of 34). Our clinical experience suggests that MEG should be considered on an inpatient basis in certain clinical circumstances, where MEG data can provide essential information regarding the localization of epileptogenic activity or eloquent cortex, and be used to develop a treatment plan for surgical management of children with complicated or intractable epilepsy.
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Affiliation(s)
- Michael W Watkins
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Ekta G Shah
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Michael E Funke
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - Stephanie Garcia-Tarodo
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Pediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Manish N Shah
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States.,Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School, Houston, TX, United States
| | - Nitin Tandon
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States
| | - Fernando Maestu
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politecnica de Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Christopher Laohathai
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - David I Sandberg
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States.,Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School, Houston, TX, United States
| | - Jeremy Lankford
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Stephen Thompson
- Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - John Mosher
- Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - Gretchen Von Allmen
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Department of Neurology, McGovern Medical School, Houston, TX, United States
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14
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Narayana S, Gibbs SK, Fulton SP, McGregor AL, Mudigoudar B, Weatherspoon SE, Boop FA, Wheless JW. Clinical Utility of Transcranial Magnetic Stimulation (TMS) in the Presurgical Evaluation of Motor, Speech, and Language Functions in Young Children With Refractory Epilepsy or Brain Tumor: Preliminary Evidence. Front Neurol 2021; 12:650830. [PMID: 34093397 PMCID: PMC8170483 DOI: 10.3389/fneur.2021.650830] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
Accurate presurgical mapping of motor, speech, and language cortices, while crucial for neurosurgical planning and minimizing post-operative functional deficits, is challenging in young children with neurological disease. In such children, both invasive (cortical stimulation mapping) and non-invasive functional mapping imaging methods (MEG, fMRI) have limited success, often leading to delayed surgery or adverse post-surgical outcomes. We therefore examined the clinical utility of transcranial magnetic stimulation (TMS) in young children who require functional mapping. In a retrospective chart review of TMS studies performed on children with refractory epilepsy or a brain tumor, at our institution, we identified 47 mapping sessions in 36 children 3 years of age or younger, in whom upper and lower extremity motor mapping was attempted; and 13 children 5–6 years old in whom language mapping, using a naming paradigm, was attempted. The primary hand motor cortex was identified in at least one hemisphere in 33 of 36 patients, and in both hemispheres in 27 children. In 17 children, primary leg motor cortex was also successfully identified. The language cortices in temporal regions were successfully mapped in 11 of 13 patients, and in six of them language cortices in frontal regions were also mapped, with most children (n = 5) showing right hemisphere dominance for expressive language. Ten children had a seizure that was consistent with their clinical semiology during or immediately following TMS, none of which required intervention or impeded completion of mapping. Using TMS, both normal motor, speech, and language developmental patterns and apparent disease induced reorganization were demonstrated in this young cohort. The successful localization of motor, speech, and language cortices in young children improved the understanding of the risk-benefit ratio prior to surgery and facilitated surgical planning aimed at preserving motor, speech, and language functions. Post-operatively, motor function was preserved or improved in nine out of 11 children who underwent surgery, as was language function in all seven children who had surgery for lesions near eloquent cortices. We provide feasibility data that TMS is a safe, reliable, and effective tool to map eloquent cortices in young children.
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Affiliation(s)
- Shalini Narayana
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Savannah K Gibbs
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Stephen P Fulton
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Amy Lee McGregor
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Basanagoud Mudigoudar
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Sarah E Weatherspoon
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Frederick A Boop
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Semmes Murphey Neurologic and Spine Institute, Memphis, TN, United States.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States
| | - James W Wheless
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
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15
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Beyond the Wada: An updated approach to pre-surgical language and memory testing: An updated review of available evaluation techniques and recommended workflow to limit Wada test use to essential clinical cases. Epilepsy Res 2021; 174:106673. [PMID: 34082393 DOI: 10.1016/j.eplepsyres.2021.106673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/27/2021] [Accepted: 05/13/2021] [Indexed: 11/21/2022]
Abstract
The Intracarotid amobarbital test (IAT), also called Wada test, is considered the "gold standard" for lateralizing language dominance in the pre-surgical evaluation of patients with epilepsy. In addition, it has been further modified to assess the postoperative risk of amnesia in patients undergoing temporal lobectomy. Since then it has been utilized to lateralize language and assess pre-surgical memory function. Over the years, its popularity has declined due to several limitations and availability of alternative procedures like fMRI and MEG. A survey of its use in the pre-surgical evaluation for epilepsy surgery has not been performed since the 2008 international survey by Baxendale et al. and it was heavily skewed due to data from European and North American countries. Only approximately 12% of the epilepsy centers indicated that they used the Wada test in every patient to assess preoperative memory function and language lateralization before temporal lobectomy. Nowadays, we have many functional mapping tools at our disposal. It has become somewhat unsuitable to have epilepsy patients undergo an invasive test such as the Wada test for the risks associated with it outweigh the benefits. Our objective is to review the Wada Test and alternative methods of assessing language and memory dominance, as it is past its prime and should only be used in specific circumstances.
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16
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Brahimaj BC, Kochanski RB, Pearce JJ, Guryildirim M, Gerard CS, Kocak M, Sani S, Byrne RW. Structural and Functional Imaging in Glioma Management. Neurosurgery 2021; 88:211-221. [PMID: 33313852 DOI: 10.1093/neuros/nyaa360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/26/2020] [Indexed: 01/08/2023] Open
Abstract
The goal of glioma surgery is maximal safe resection in order to provide optimal tumor control and survival benefit to the patient. There are multiple imaging modalities beyond traditional contrast-enhanced magnetic resonance imaging (MRI) that have been incorporated into the preoperative workup of patients presenting with gliomas. The aim of these imaging modalities is to identify cortical and subcortical areas of eloquence, and their relationship to the lesion. In this article, multiple modalities are described with an emphasis on the underlying technology, clinical utilization, advantages, and disadvantages of each. functional MRI and its role in identifying hemispheric dominance and areas of language and motor are discussed. The nuances of magnetoencephalography and transcranial magnetic stimulation in localization of eloquent cortex are examined, as well as the role of diffusion tensor imaging in defining normal white matter tracts in glioma surgery. Lastly, we highlight the role of stimulated Raman spectroscopy in intraoperative histopathological diagnosis of tissue to guide tumor resection. Tumors may shift the normal arrangement of functional anatomy in the brain; thus, utilization of multiple modalities may be helpful in operative planning and patient counseling for successful surgery.
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Affiliation(s)
- Bledi C Brahimaj
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois
| | - Ryan B Kochanski
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois
| | - John J Pearce
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois
| | - Melike Guryildirim
- Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland
| | - Carter S Gerard
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington
| | - Mehmet Kocak
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois
| | - Richard W Byrne
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois
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17
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Otsubo H, Ogawa H, Pang E, Wong SM, Ibrahim GM, Widjaja E. A review of magnetoencephalography use in pediatric epilepsy: an update on best practice. Expert Rev Neurother 2021; 21:1225-1240. [PMID: 33780318 DOI: 10.1080/14737175.2021.1910024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Magnetoencephalography (MEG) is a noninvasive technique that is used for presurgical evaluation of children with drug-resistant epilepsy (DRE).Areas covered: The contributions of MEG for localizing the epileptogenic zone are discussed, in particular in extra-temporal lobe epilepsy and focal cortical dysplasia, which are common in children, as well as in difficult to localize epilepsy such as operculo-insular epilepsy. Further, the authors review current evidence on MEG for mapping eloquent cortex, its performance, application in clinical practice, and potential challenges.Expert opinion: MEG could change the clinical management of children with DRE by directing placement of intracranial electrodes thereby enhancing their yield. With improved identification of a circumscribed epileptogenic zone, MEG could render more patients as suitable candidates for epilepsy surgery and increase utilization of surgery.
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Affiliation(s)
- Hiroshi Otsubo
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
| | - Hiroshi Ogawa
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
| | - Elizabeth Pang
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada.,Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Canada
| | - Simeon M Wong
- Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Canada
| | - George M Ibrahim
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Canada.,Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
| | - Elysa Widjaja
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada.,Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Canada.,Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
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18
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Kim JA, Davis KD. Magnetoencephalography: physics, techniques, and applications in the basic and clinical neurosciences. J Neurophysiol 2021; 125:938-956. [PMID: 33567968 DOI: 10.1152/jn.00530.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Magnetoencephalography (MEG) is a technique used to measure the magnetic fields generated from neuronal activity in the brain. MEG has a high temporal resolution on the order of milliseconds and provides a more direct measure of brain activity when compared with hemodynamic-based neuroimaging methods such as magnetic resonance imaging and positron emission tomography. The current review focuses on basic features of MEG such as the instrumentation and the physics that are integral to the signals that can be measured, and the principles of source localization techniques, particularly the physics of beamforming and the techniques that are used to localize the signal of interest. In addition, we review several metrics that can be used to assess functional coupling in MEG and describe the advantages and disadvantages of each approach. Lastly, we discuss the current and future applications of MEG.
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Affiliation(s)
- Junseok A Kim
- Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen D Davis
- Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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19
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Auditory Mapping With MEG: An Update on the Current State of Clinical Research and Practice With Considerations for Clinical Practice Guidelines. J Clin Neurophysiol 2020; 37:574-584. [DOI: 10.1097/wnp.0000000000000518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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20
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Trébuchon A, Liégeois-Chauvel C, Gonzalez-Martinez JA, Alario FX. Contributions of electrophysiology for identifying cortical language systems in patients with epilepsy. Epilepsy Behav 2020; 112:107407. [PMID: 33181892 DOI: 10.1016/j.yebeh.2020.107407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
A crucial element of the surgical treatment of medically refractory epilepsy is to delineate cortical areas that must be spared in order to avoid clinically relevant neurological and neuropsychological deficits postoperatively. For each patient, this typically necessitates determining the language lateralization between hemispheres and language localization within hemisphere. Understanding cortical language systems is complicated by two primary challenges: the extent of the neural tissue involved and the substantial variability across individuals, especially in pathological populations. We review the contributions made through the study of electrophysiological activity to address these challenges. These contributions are based on the techniques of magnetoencephalography (MEG), intracerebral recordings, electrical-cortical stimulation (ECS), and the electrovideo analyses of seizures and their semiology. We highlight why no single modality alone is adequate to identify cortical language systems and suggest avenues for improving current practice.
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Affiliation(s)
- Agnès Trébuchon
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Catherine Liégeois-Chauvel
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA
| | | | - F-Xavier Alario
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA; Aix-Marseille Univ, CNRS, LPC, Marseille, France.
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21
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Bowyer SM, Zillgitt A, Greenwald M, Lajiness-O'Neill R. Language Mapping With Magnetoencephalography: An Update on the Current State of Clinical Research and Practice With Considerations for Clinical Practice Guidelines. J Clin Neurophysiol 2020; 37:554-563. [DOI: 10.1097/wnp.0000000000000489] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Youssofzadeh V, Stout J, Ustine C, Gross WL, Conant LL, Humphries CJ, Binder JR, Raghavan M. Mapping language from MEG beta power modulations during auditory and visual naming. Neuroimage 2020; 220:117090. [DOI: 10.1016/j.neuroimage.2020.117090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/06/2020] [Accepted: 06/23/2020] [Indexed: 01/22/2023] Open
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23
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The Clinical Utility of Transcranial Magnetic Stimulation in Determining Hemispheric Dominance for Language: A Magnetoencephalography Comparison Study. J Clin Neurophysiol 2020; 37:90-103. [PMID: 32142020 DOI: 10.1097/wnp.0000000000000499] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Transcranial magnetic stimulation (TMS) has recently emerged as a noninvasive alternative to the intracarotid sodium amytal (Wada) procedure for establishing hemispheric dominance (HD) for language. The accuracy of HD determined by TMS was examined by comparing against the HD derived by magnetoencephalography (MEG), a prominent clinical technique with excellent concordance with the Wada procedure. METHODS Sixty-seven patients (54 patients ≤18 years) underwent language mapping with TMS and MEG as part of clinical epilepsy and tumor presurgical assessment. Language was mapped in MEG during an auditory word recognition paradigm, and a laterality index was calculated using the number of dipoles and their spatial extent in the two hemispheres. Transcranial magnetic stimulation language mapping was performed as patients performed a naming task, and TMS-induced speech disruptions were recorded during 5-Hz TMS applied to anterior and posterior language cortices. Transcranial magnetic stimulation laterality index was estimated using the number and type of speech disruption in the language regions of each hemisphere. RESULTS Transcranial magnetic stimulation and MEG estimates of HD were concordant in 42 (63%) patients, resulting in a sensitivity of 74% and a specificity of 72%. The overall accuracy of TMS was 73%, equivalent to an odds ratio of 7.35. CONCLUSIONS In this first large-scale comparative study in a clinical population, we demonstrate that TMS is a safe and reliable noninvasive tool in determining HD for language. Improving the accuracy of TMS by optimizing TMS parameters and improving task choice will further facilitate the use of TMS to characterize language function, especially in pediatrics.
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24
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Hinkley LBN, De Witte E, Cahill-Thompson M, Mizuiri D, Garrett C, Honma S, Findlay A, Gorno-Tempini ML, Tarapore P, Kirsch HE, Mariën P, Houde JF, Berger M, Nagarajan SS. Optimizing Magnetoencephalographic Imaging Estimation of Language Lateralization for Simpler Language Tasks. Front Hum Neurosci 2020; 14:105. [PMID: 32499685 PMCID: PMC7242765 DOI: 10.3389/fnhum.2020.00105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
Magnetoencephalographic imaging (MEGI) offers a non-invasive alternative for defining preoperative language lateralization in neurosurgery patients. MEGI indeed can be used for accurate estimation of language lateralization with a complex language task - auditory verb generation. However, since language function may vary considerably in patients with focal lesions, it is important to optimize MEGI for estimation of language function with other simpler language tasks. The goal of this study was to optimize MEGI laterality analyses for two such simpler language tasks that can have compliance from those with impaired language function: a non-word repetition (NWR) task and a picture naming (PN) task. Language lateralization results for these two tasks were compared to the verb-generation (VG) task. MEGI reconstruction parameters (regions and time windows) for NWR and PN were first defined in a presurgical training cohort by benchmarking these against laterality indices for VG. Optimized time windows and regions of interest (ROIs) for NWR and PN were determined by examining oscillations in the beta band (12-30 Hz) a marker of neural activity known to be concordant with the VG laterality index (LI). For NWR, additional ROIs include areas MTG/ITG and for both NWR and PN, the postcentral gyrus was included in analyses. Optimal time windows for NWR were defined as 650-850 ms (stimulus-locked) and -350 to -150 ms (response-locked) and for PN -450 to -250 ms (response-locked). To verify the optimal parameters defined in our training cohort for NWR and PN, we examined an independent validation cohort (n = 30 for NWR, n = 28 for PN) and found high concordance between VG laterality and PN laterality (82%) and between VG laterality and NWR laterality (87%). Finally, in a test cohort (n = 8) that underwent both the intracarotid amobarbital procedure (IAP) test and MEG for VG, NWR, and PN, we identified excellent concordance (100%) with IAP for VG + NWR + PN composite LI, high concordance for PN alone (87.5%), and moderate concordance for NWR alone (66.7%). These findings provide task options for non-invasive language mapping with MEGI that can be calibrated for language abilities of individual patients. Results also demonstrate that more accurate estimates can be obtained by combining laterality estimates obtained from multiple tasks. MEGI.
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Affiliation(s)
- Leighton B. N. Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Elke De Witte
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Megan Cahill-Thompson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Danielle Mizuiri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Coleman Garrett
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Susanne Honma
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Anne Findlay
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Phiroz Tarapore
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Heidi E. Kirsch
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Peter Mariën
- Department of Neurology, Ziekenhuis Netwerk Antwerpen, Antwerp, Belguim
| | - John F. Houde
- Department of Otolaryngology; University of California, San Francisco, San Francisco, CA, United States
| | - Mitchel Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Srikantan S. Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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25
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Bowyer SM, Pang EW, Huang M, Papanicolaou AC, Lee RR. Presurgical Functional Mapping with Magnetoencephalography. Neuroimaging Clin N Am 2020; 30:159-174. [DOI: 10.1016/j.nic.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Foley E, Wood AG, Furlong PL, Walsh AR, Kearney S, Bill P, Hillebrand A, Seri S. Mapping language networks and their association with verbal abilities in paediatric epilepsy using MEG and graph analysis. Neuroimage Clin 2020; 27:102265. [PMID: 32413809 PMCID: PMC7226893 DOI: 10.1016/j.nicl.2020.102265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 10/26/2022]
Abstract
Recent theoretical models of language have emphasised the importance of integration within distributed networks during language processing. This is particularly relevant to young patients with epilepsy, as the topology of the functional network and its dynamics may be altered by the disease, resulting in reorganisation of functional language networks. Thus, understanding connectivity within the language network in patients with epilepsy could provide valuable insights into healthy and pathological brain function, particularly when combined with clinical correlates. The objective of this study was to investigate interactions within the language network in a paediatric population of epilepsy patients using measures of MEG phase synchronisation and graph-theoretical analysis, and to examine their association with language abilities. Task dependent increases in connectivity were observed in fronto-temporal networks during verb generation across a group of 22 paediatric patients (9 males and 13 females; mean age 14 years). Differences in network connectivity were observed between patients with typical and atypical language representation and between patients with good and poor language abilities. In addition, node centrality in left frontal and temporal regions was significantly associated with language abilities, where patients with good language abilities had significantly higher node centrality within inferior frontal and superior temporal regions of the left hemisphere, compared to patients with poor language abilities. Our study is one of the first to apply task-based measures of MEG network synchronisation in paediatric epilepsy, and we propose that these measures of functional connectivity and node centrality could be used as tools to identify critical regions of the language network prior to epilepsy surgery.
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Affiliation(s)
- Elaine Foley
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK.
| | - Amanda G Wood
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; School of Psychology, Faculty of Health, Melbourne Burwood Campus, Deakin University, Geelong, Victoria, Australia
| | - Paul L Furlong
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK
| | - A Richard Walsh
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Shauna Kearney
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Peter Bill
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
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27
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Patel NJ, Gavvala JR, Jimenez-Shahed J. Awake Testing to Confirm Target Engagement. Stereotact Funct Neurosurg 2020. [DOI: 10.1007/978-3-030-34906-6_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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He X, Zhou J, Teng P, Wang X, Guan Y, Zhai F, Li T, Luan G. The impact of MEG results on surgical outcomes in patients with drug-resistant epilepsy associated with focal encephalomalacia: a single-center experience. J Neurol 2019; 267:812-822. [PMID: 31773245 DOI: 10.1007/s00415-019-09638-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To analyze the impact of magnetoencephalography (MEG) results on surgical outcomes in patients with drug-resistant epilepsy secondary to encephalomalacia. METHODS We retrospectively reviewed 121 patients with drug-resistant epilepsy associated with encephalomalacia who underwent MEG followed by resection surgery. Patients were subdivided into concordant MEG group and dis-concordant MEG group for analysis based on whether the MEG results were in concordance with epileptogenic zones or not. RESULTS 121 patients were included in the present study. The MEG spike sources of 73 (60.33%) patients were in concordance with epileptogenic zones while the MEG spike sources of the other 48 (39.67%) were in dis-concordance with epileptogenic zones. Favorable seizure outcomes were achieved in 79.45% (58 of 73) of patients with concordant MEG results while only 62.50% (30 of 48) of patients with dis-concordant MEG results were seizure free with a follow-up of 2-10 years. The differences of seizure-free rate between patients with concordant MEG results and dis-concordant MEG results were statistically significant. For patients with concordant MEG results, bilateral lesions on MRI are the only independent predictor of unfavorable seizure outcomes. For patients with discordant MEG results, duration of seizures is the only independent predictor of unfavorable seizure outcomes. CONCLUSIONS Concordant MEG results are associated with favorable seizure outcomes. Bilateral lesions on MRI independently predict unfavorable seizure outcomes in patients with concordant MEG results while longer seizure durations independently predict unfavorable seizure outcomes in patients with dis-concordant MEG results.
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Affiliation(s)
- Xinghui He
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Jian Zhou
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Pengfei Teng
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Xiongfei Wang
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Yuguang Guan
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Feng Zhai
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China
| | - Tianfu Li
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.,Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Guoming Luan
- Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China. .,Department of Neurosurgery, Epilepsy Center, Beijing Sanbo Brain Hospital, Capital Medical University, Xiangshan Yikesong 50, Haidian District, Beijing, 100093, China. .,Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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29
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Sollmann N, Kelm A, Ille S, Schröder A, Zimmer C, Ringel F, Meyer B, Krieg SM. Setup presentation and clinical outcome analysis of treating highly language-eloquent gliomas via preoperative navigated transcranial magnetic stimulation and tractography. Neurosurg Focus 2019; 44:E2. [PMID: 29852769 DOI: 10.3171/2018.3.focus1838] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Awake surgery combined with intraoperative direct electrical stimulation (DES) and intraoperative neuromonitoring (IONM) is considered the gold standard for the resection of highly language-eloquent brain tumors. Different modalities, such as functional magnetic resonance imaging (fMRI) or magnetoencephalography (MEG), are commonly added as adjuncts for preoperative language mapping but have been shown to have relevant limitations. Thus, this study presents a novel multimodal setup consisting of preoperative navigated transcranial magnetic stimulation (nTMS) and nTMS-based diffusion tensor imaging fiber tracking (DTI FT) as an adjunct to awake surgery. METHODS Sixty consecutive patients (63.3% men, mean age 47.6 ± 13.3 years) suffering from highly language-eloquent left-hemispheric low- or high-grade glioma underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by awake surgery for tumor resection. Both nTMS language mapping and DTI FT data were available for resection planning and intraoperative guidance. Clinical outcome parameters, including craniotomy size, extent of resection (EOR), language deficits at different time points, Karnofsky Performance Scale (KPS) score, duration of surgery, and inpatient stay, were assessed. RESULTS According to postoperative evaluation, 28.3% of patients showed tumor residuals, whereas new surgery-related permanent language deficits occurred in 8.3% of patients. KPS scores remained unchanged (median preoperative score 90, median follow-up score 90). CONCLUSIONS This is the first study to present a clinical outcome analysis of this very modern approach, which is increasingly applied in neurooncological centers worldwide. Although human language function is a highly complex and dynamic cortico-subcortical network, the presented approach offers excellent functional and oncological outcomes in patients undergoing surgery of lesions affecting this network.
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Affiliation(s)
- Nico Sollmann
- 1Department of Diagnostic and Interventional Neuroradiology.,3TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Anna Kelm
- 2Department of Neurosurgery, and.,3TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Sebastian Ille
- 2Department of Neurosurgery, and.,3TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany
| | | | - Claus Zimmer
- 1Department of Diagnostic and Interventional Neuroradiology.,3TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany
| | | | | | - Sandro M Krieg
- 2Department of Neurosurgery, and.,3TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany
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30
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Mapping critical hubs of receptive and expressive language using MEG: A comparison against fMRI. Neuroimage 2019; 201:116029. [PMID: 31325641 DOI: 10.1016/j.neuroimage.2019.116029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 01/22/2023] Open
Abstract
The complexity of the widespread language network makes it challenging for accurate localization and lateralization. Using large-scale connectivity and graph-theoretical analyses of task-based magnetoencephalography (MEG), we aimed to provide robust representations of receptive and expressive language processes, comparable with spatial profiles of corresponding functional magnetic resonance imaging (fMRI). We examined MEG and fMRI data from 12 healthy young adults (age 20-37 years) completing covert auditory word-recognition task (WRT) and covert auditory verb-generation task (VGT). For MEG language mapping, broadband (3-30 Hz) beamformer sources were estimated, voxel-level connectivity was quantified using phase locking value, and highly connected hubs were characterized using eigenvector centrality graph measure. fMRI data were analyzed using a classic general linear model approach. A laterality index (LI) was computed for 20 language-specific frontotemporal regions for both MEG and fMRI. MEG network analysis showed bilateral and symmetrically distributed hubs within the left and right superior temporal gyrus (STG) during WRT and predominant hubs in left inferior prefrontal gyrus (IFG) during VGT. MEG and fMRI localization maps showed high correlation values within frontotemporal regions during WRT and VGT (r = 0.63, 0.74, q < 0.05, respectively). Despite good concordance in localization, notable discordances were observed in lateralization between MEG and fMRI. During WRT, MEG favored a left-hemispheric dominance of left STG (LI = 0.25 ± 0.22) whereas fMRI supported a bilateral representation of STG (LI = 0.08 ± 0.2). Laterality of MEG and fMRI during VGT consistently showed a strong asymmetry in left IFG regions (MEG-LI = 0.45 ± 0.35 and fMRI-LI = 0.46 ± 0.13). Our results demonstrate the utility of a large-scale connectivity and graph theoretical analyses for robust identification of language-specific regions. MEG hubs are in great agreement with the literature in revealing with canonical and extra-canonical language sites, thus providing additional support for the underlying topological organization of receptive and expressive language cortices. Discordances in lateralization may emphasize the need for multimodal integration of MEG and fMRI to obtain an excellent predictive value in a heterogeneous healthy population and patients with neurosurgical conditions.
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31
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Kreidenhuber R, De Tiège X, Rampp S. Presurgical Functional Cortical Mapping Using Electromagnetic Source Imaging. Front Neurol 2019; 10:628. [PMID: 31249552 PMCID: PMC6584755 DOI: 10.3389/fneur.2019.00628] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/28/2019] [Indexed: 02/03/2023] Open
Abstract
Preoperative localization of functionally eloquent cortex (functional cortical mapping) is common clinical practice in order to avoid or reduce postoperative morbidity. This review aims at providing a general overview of magnetoencephalography (MEG) and high-density electroencephalography (hdEEG) based methods and their clinical role as compared to common alternatives for functional cortical mapping of (1) verbal language function, (2) sensorimotor cortex, (3) memory, (4) visual, and (5) auditory cortex. We highlight strengths, weaknesses and limitations of these functional cortical mapping modalities based on findings in the recent literature. We also compare their performance relative to other non-invasive functional cortical mapping methods, such as functional Magnetic Resonance Imaging (fMRI), Transcranial Magnetic Stimulation (TMS), and to invasive methods like the intracarotid Amobarbital Test (WADA-Test) or intracranial investigations.
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Affiliation(s)
- Rudolf Kreidenhuber
- Department of Neurology, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.,Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Xavier De Tiège
- Laboratoire de Cartographie Fonctionelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany.,Department of Neurosurgery, University Hospital Halle, Halle, Germany
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Balter S, Lin G, Leyden KM, Paul BM, McDonald CR. Neuroimaging correlates of language network impairment and reorganization in temporal lobe epilepsy. BRAIN AND LANGUAGE 2019; 193:31-44. [PMID: 27393391 PMCID: PMC5215985 DOI: 10.1016/j.bandl.2016.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/27/2016] [Accepted: 06/15/2016] [Indexed: 06/02/2023]
Abstract
Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.
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Affiliation(s)
- S Balter
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - G Lin
- Palo Alto University, Palo Alto, CA, United States
| | - K M Leyden
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States
| | - B M Paul
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - C R McDonald
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States; Department of Psychiatry, University of California, San Diego, CA, United States.
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MEG Assessment of Expressive Language in Children Evaluated for Epilepsy Surgery. Brain Topogr 2019; 32:492-503. [PMID: 30895423 PMCID: PMC6476853 DOI: 10.1007/s10548-019-00703-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/07/2019] [Indexed: 11/21/2022]
Abstract
Establishing language dominance is an important step in the presurgical evaluation of patients with refractory epilepsy. In the absence of a universally accepted gold-standard non-invasive method to determine language dominance in the preoperative assessment, a range of tools and methodologies have recently received attention. When applied to pediatric age, many of the proposed methods, such as functional magnetic resonance imaging (fMRI), may present some challenges due to the time-varying effects of epileptogenic lesions and of on-going seizures on maturational phenomena. Magnetoencephalography (MEG) has the advantage of being insensitive to the distortive effects of anatomical lesions on brain microvasculature and to differences in the metabolism or vascularization of the developing brain and also provides a less intimidating recording environment for younger children. In this study we investigated the reliability of lateralized synchronous cortical activation during a verb generation task in a group of 28 children (10 males and 18 females, mean age 12 years) with refractory epilepsy who were evaluated for epilepsy surgery. The verb generation task was associated with significant decreases in beta oscillatory power (13–30 Hz) in frontal and temporal lobes. The MEG data were compared with other available presurgical non-invasive data including cortical stimulation, neuropsychological and fMRI data on language lateralization where available. We found that the lateralization of MEG beta power reduction was concordant with language dominance determined by one or more different assessment methods (i.e. cortical stimulation mapping, neuropsychological, fMRI or post-operative data) in 89% of patients. Our data suggest that qualitative hemispheric differences in task-related changes of spectral power could offer a promising insight into the contribution of dominant and non-dominant hemispheres in language processing and may help to characterize the specialization and lateralization of language processes in children.
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Magnetoencephalography: Clinical and Research Practices. Brain Sci 2018; 8:brainsci8080157. [PMID: 30126121 PMCID: PMC6120049 DOI: 10.3390/brainsci8080157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/07/2018] [Accepted: 08/11/2018] [Indexed: 11/25/2022] Open
Abstract
Magnetoencephalography (MEG) is a neurophysiological technique that detects the magnetic fields associated with brain activity. Synthetic aperture magnetometry (SAM), a MEG magnetic source imaging technique, can be used to construct both detailed maps of global brain activity as well as virtual electrode signals, which provide information that is similar to invasive electrode recordings. This innovative approach has demonstrated utility in both clinical and research settings. For individuals with epilepsy, MEG provides valuable, nonredundant information. MEG accurately localizes the irritative zone associated with interictal spikes, often detecting epileptiform activity other methods cannot, and may give localizing information when other methods fail. These capabilities potentially greatly increase the population eligible for epilepsy surgery and improve planning for those undergoing surgery. MEG methods can be readily adapted to research settings, allowing noninvasive assessment of whole brain neurophysiological activity, with a theoretical spatial range down to submillimeter voxels, and in both humans and nonhuman primates. The combination of clinical and research activities with MEG offers a unique opportunity to advance translational research from bench to bedside and back.
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Hari R, Baillet S, Barnes G, Burgess R, Forss N, Gross J, Hämäläinen M, Jensen O, Kakigi R, Mauguière F, Nakasato N, Puce A, Romani GL, Schnitzler A, Taulu S. IFCN-endorsed practical guidelines for clinical magnetoencephalography (MEG). Clin Neurophysiol 2018; 129:1720-1747. [PMID: 29724661 PMCID: PMC6045462 DOI: 10.1016/j.clinph.2018.03.042] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/18/2018] [Accepted: 03/24/2018] [Indexed: 12/22/2022]
Abstract
Magnetoencephalography (MEG) records weak magnetic fields outside the human head and thereby provides millisecond-accurate information about neuronal currents supporting human brain function. MEG and electroencephalography (EEG) are closely related complementary methods and should be interpreted together whenever possible. This manuscript covers the basic physical and physiological principles of MEG and discusses the main aspects of state-of-the-art MEG data analysis. We provide guidelines for best practices of patient preparation, stimulus presentation, MEG data collection and analysis, as well as for MEG interpretation in routine clinical examinations. In 2017, about 200 whole-scalp MEG devices were in operation worldwide, many of them located in clinical environments. Yet, the established clinical indications for MEG examinations remain few, mainly restricted to the diagnostics of epilepsy and to preoperative functional evaluation of neurosurgical patients. We are confident that the extensive ongoing basic MEG research indicates potential for the evaluation of neurological and psychiatric syndromes, developmental disorders, and the integrity of cortical brain networks after stroke. Basic and clinical research is, thus, paving way for new clinical applications to be identified by an increasing number of practitioners of MEG.
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Affiliation(s)
- Riitta Hari
- Department of Art, Aalto University, Helsinki, Finland.
| | - Sylvain Baillet
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Gareth Barnes
- Wellcome Centre for Human Neuroimaging, University College of London, London, UK
| | - Richard Burgess
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nina Forss
- Clinical Neuroscience, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Joachim Gross
- Centre for Cognitive Neuroimaging, University of Glasgow, Glasgow, UK; Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Germany
| | - Matti Hämäläinen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA; NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ole Jensen
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Ryusuke Kakigi
- Department of Integrative Physiology, National Institute of Physiological Sciences, Okazaki, Japan
| | - François Mauguière
- Department of Functional Neurology and Epileptology, Neurological Hospital & University of Lyon, Lyon, France
| | | | - Aina Puce
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Gian-Luca Romani
- Department of Neuroscience, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Samu Taulu
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA; Department of Physics, University of Washington, Seattle, WA, USA
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Functional brain mapping: overview of techniques and their application to neurosurgery. Neurosurg Rev 2018; 42:639-647. [DOI: 10.1007/s10143-018-1007-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/25/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
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Wilenius J, Lehtinen H, Paetau R, Salmelin R, Kirveskari E. A simple magnetoencephalographic auditory paradigm may aid in confirming left-hemispheric language dominance in epilepsy patients. PLoS One 2018; 13:e0200073. [PMID: 29966017 PMCID: PMC6028140 DOI: 10.1371/journal.pone.0200073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/19/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The intracarotid amobarbital procedure (IAP) is the current "gold standard" in the preoperative assessment of language lateralization in epilepsy surgery candidates. It is, however, invasive and has several limitations. Here we tested a simple noninvasive language lateralization test performed with magnetoencephalography (MEG). METHODS We recorded auditory MEG responses to pairs of vowels and pure tones in 16 epilepsy surgery candidates who had undergone IAP. For each individual, we selected the pair of planar gradiometer sensors with the strongest N100m response to vowels in each hemisphere and-from the vector sum of signals of this gradiometer pair-calculated the vowel/tone amplitude ratio in the left (L) and right (R) hemisphere and, subsequently, the laterality index: LI = (L-R)/(L+R). In addition to the analysis using a single sensor pair, an alternative analysis was performed using averaged responses over 18 temporal sensor pairs in both hemispheres. RESULTS The laterality index did not correlate significantly with the lateralization data obtained from the IAP. However, an MEG pattern of stronger responses to vowels than tones in the left hemisphere and stronger responses to tones than vowels in the right hemisphere was associated with left-hemispheric language dominance in the IAP in all the six patients who showed this pattern. This results in a specificity of 100% and a sensitivity of 67% of this MEG pattern in predicting left-hemispheric language dominance (p = 0.01, Fisher's exact test). In the analysis using averaged responses over temporal channels, one additional patient who was left-dominant in IAP showed this particular MEG pattern, increasing the sensitivity to 78% (p = 0.003). SIGNIFICANCE This simple MEG paradigm shows promise in feasibly and noninvasively confirming left-hemispheric language dominance in epilepsy surgery candidates. It may aid in reducing the need for the IAP, if the results are confirmed in larger patient samples.
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Affiliation(s)
- Juha Wilenius
- Clinical Neurosciences, Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henri Lehtinen
- Epilepsy Unit, Department of Pediatric Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ritva Paetau
- Clinical Neurosciences, Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Epilepsy Unit, Department of Pediatric Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riitta Salmelin
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Erika Kirveskari
- Clinical Neurosciences, Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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On the relative merits of invasive and non-invasive pre-surgical brain mapping: New tools in ablative epilepsy surgery. Epilepsy Res 2018; 142:153-155. [DOI: 10.1016/j.eplepsyres.2017.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/01/2017] [Accepted: 07/01/2017] [Indexed: 11/23/2022]
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Presurgical electromagnetic functional brain mapping in refractory focal epilepsy. ZEITSCHRIFT FUR EPILEPTOLOGIE 2018. [DOI: 10.1007/s10309-018-0189-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dinga S, Wu D, Huang S, Wu C, Wang X, Shi J, Hu Y, Liang C, Zhang F, Lu M, Leiken K, Xiang J. Neuromagnetic correlates of audiovisual word processing in the developing brain. Int J Psychophysiol 2018; 128:7-21. [PMID: 29580903 DOI: 10.1016/j.ijpsycho.2018.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/01/2018] [Accepted: 03/21/2018] [Indexed: 11/25/2022]
Abstract
The brain undergoes enormous changes during childhood. Little is known about how the brain develops to serve word processing. The objective of the present study was to investigate the maturational changes of word processing in children and adolescents using magnetoencephalography (MEG). Responses to a word processing task were investigated in sixty healthy participants. Each participant was presented with simultaneous visual and auditory word pairs in "match" and "mismatch" conditions. The patterns of neuromagnetic activation from MEG recordings were analyzed at both sensor and source levels. Topography and source imaging revealed that word processing transitioned from bilateral connections to unilateral connections as age increased from 6 to 17 years old. Correlation analyses of language networks revealed that the path length of word processing networks negatively correlated with age (r = -0.833, p < 0.0001), while the connection strength (r = 0.541, p < 0.01) and the clustering coefficient (r = 0.705, p < 0.001) of word processing networks were positively correlated with age. In addition, males had more visual connections, whereas females had more auditory connections. The correlations between gender and path length, gender and connection strength, and gender and clustering coefficient demonstrated a developmental trend without reaching statistical significance. The results indicate that the developmental trajectory of word processing is gender specific. Since the neuromagnetic signatures of these gender-specific paths to adult word processing were determined using non-invasive, objective, and quantitative methods, the results may play a key role in understanding language impairments in pediatric patients in the future.
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Affiliation(s)
- Samantha Dinga
- Psychology Department, University of Rochester, 500 Joseph C Wilson Blvd, Rochester, NY 14627, USA; MEG Center, Department of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45220, USA
| | - Di Wu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Shuyang Huang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Caiyun Wu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Jingping Shi
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Yue Hu
- Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Chun Liang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Fawen Zhang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Meng Lu
- College of Information Science and Engineering, Northeastern University, Shenyang, China
| | - Kimberly Leiken
- MEG Center, Department of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45220, USA
| | - Jing Xiang
- MEG Center, Department of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45220, USA.
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Babajani-Feremi A, Holder CM, Narayana S, Fulton SP, Choudhri AF, Boop FA, Wheless JW. Predicting postoperative language outcome using presurgical fMRI, MEG, TMS, and high gamma ECoG. Clin Neurophysiol 2018; 129:560-571. [PMID: 29414401 DOI: 10.1016/j.clinph.2017.12.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To predict the postoperative language outcome using the support vector regression (SVR) and results of multimodal presurgical language mapping. METHODS Eleven patients with epilepsy received presurgical language mapping using functional MRI (fMRI), magnetoencephalography (MEG), transcranial magnetic stimulation (TMS), and high-gamma electrocorticography (hgECoG), as well as pre- and postoperative neuropsychological evaluation of language. We constructed 15 (24-1) SVR models by considering the extent of resected language areas identified by all subsets of four modalities as input feature vector and the postoperative language outcome as output. We trained and cross-validated SVR models, and compared the cross-validation (CV) errors of all models for prediction of language outcome. RESULTS Seven patients had some level of postoperative language decline and two of them had significant postoperative decline in naming. Some parts of language areas identified by four modalities were resected in these patients. We found that an SVR model consisting of fMRI, MEG, and hgECoG provided minimum CV error, although an SVR model consisting of fMRI and MEG was the optimal model that facilitated the best trade-off between model complexity and prediction accuracy. CONCLUSIONS A multimodal SVR can be used to predict the language outcome. SIGNIFICANCE The developed multimodal SVR models in this study can be utilized to calculate the language outcomes of different resection plans prior to surgery and select the optimal surgical plan.
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Affiliation(s)
- Abbas Babajani-Feremi
- University of Tennessee Health Science Center, Department of Pediatrics and Department of Anatomy and Neurobiology, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA.
| | - Christen M Holder
- University of Tennessee Health Science Center, Department of Pediatrics, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
| | - Shalini Narayana
- University of Tennessee Health Science Center, Department of Pediatrics and Department of Anatomy and Neurobiology, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
| | - Stephen P Fulton
- University of Tennessee Health Science Center, Department of Pediatrics, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
| | - Asim F Choudhri
- University of Tennessee Health Science Center, Department of Pediatrics, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
| | - Frederick A Boop
- University of Tennessee Health Science Center, Department of Pediatrics, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
| | - James W Wheless
- University of Tennessee Health Science Center, Department of Pediatrics, Le Bonheur Children's Hospital, Neuroscience Institute, Memphis, TN, USA
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Pre-surgical mapping of eloquent cortex for paediatric epilepsy surgery candidates: Evidence from a review of advanced functional neuroimaging. Seizure 2017; 52:136-146. [DOI: 10.1016/j.seizure.2017.09.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/16/2017] [Accepted: 09/29/2017] [Indexed: 11/19/2022] Open
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Neural basis of individual differences in the response to mental stress: a magnetoencephalography study. Brain Imaging Behav 2017; 10:1160-1171. [PMID: 26586263 DOI: 10.1007/s11682-015-9479-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Stress is a risk factor for the onset of mental disorders. Although stress response varies across individuals, the mechanism of individual differences remains unclear. Here, we investigated the neural basis of individual differences in response to mental stress using magnetoencephalography (MEG). Twenty healthy male volunteers completed the Temperament and Character Inventory (TCI). The experiment included two types of tasks: a non-stress-inducing task and a stress-inducing task. During these tasks, participants passively viewed non-stress-inducing images and stress-inducing images, respectively, and MEG was recorded. Before and after each task, MEG and electrocardiography were recorded and subjective ratings were obtained. We grouped participants according to Novelty seeking (NS) - tendency to be exploratory, and Harm avoidance (HA) - tendency to be cautious. Participants with high NS and low HA (n = 10) assessed by TCI had a different neural response to stress than those with low NS and high HA (n = 10). Event-related desynchronization (ERD) in the beta frequency band was observed only in participants with high NS and low HA in the brain region extending from Brodmann's area 31 (including the posterior cingulate cortex and precuneus) from 200 to 350 ms after the onset of picture presentation in the stress-inducing task. Individual variation in personality traits (NS and HA) was associated with the neural response to mental stress. These findings increase our understanding of the psychological and neural basis of individual differences in the stress response, and will contribute to development of the psychotherapeutic approaches to stress-related disorders.
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De Tiège X, Lundqvist D, Beniczky S, Seri S, Paetau R. Current clinical magnetoencephalography practice across Europe: Are we closer to use MEG as an established clinical tool? Seizure 2017. [PMID: 28623727 DOI: 10.1016/j.seizure.2017.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Xavier De Tiège
- Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium; Laboratoire de Cartographie fonctionnelle du Cerveau, ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - Daniel Lundqvist
- NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sándor Beniczky
- Department of Clinical Neurophysiology, Danish Epilepsy Center, Dianalund, Denmark; Department of Clinical Neurophysiology, Aarhus University, Aarhus, Denmark
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom
| | - Ritva Paetau
- Departments of Paediatric Neurology and Clinical Neurophysiology, Helsinki University Central Hospital, Helsinki, Finland
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Raghavan M, Li Z, Carlson C, Anderson CT, Stout J, Sabsevitz DS, Swanson SJ, Binder JR. MEG language lateralization in partial epilepsy using dSPM of auditory event-related fields. Epilepsy Behav 2017; 73:247-255. [PMID: 28662463 DOI: 10.1016/j.yebeh.2017.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/19/2017] [Accepted: 06/05/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Methods employed to determine hemispheric language dominance using magnetoencephalography (MEG) have differed significantly across studies in the choice of language-task, the nature of the physiological response studied, recording hardware, and source modeling methods. Our goal was to determine whether an analysis based on distributed source modeling can replicate the results of prior studies that have used dipole-modeling of event-related fields (ERFs) generated by an auditory word-recognition task to determine language dominance in patients with epilepsy. METHODS We analyzed data from 45 adult patients with drug-resistant partial epilepsy who performed an auditory word-recognition task during MEG recording and also completed a language fMRI study as part of their evaluation for epilepsy surgery. Source imaging of auditory ERFs was performed using dynamic statistical parametric mapping (dSPM). Language laterality indices (LIs) were calculated for four regions of interest (ROIs) by counting above-threshold activations within a 300-600ms time window after stimulus onset. Language laterality (LL) classifications based on these LIs were compared to the results from fMRI. RESULTS The most lateralized MEG responses to language stimuli were observed in a parietal region that included the angular and supramarginal gyri (AngSmg). In this region, using a half-maximal threshold, source activations were left dominant in 32 (71%) patients, right dominant in 8 (18%), and symmetric in 5 patients (11%). The best agreement between MEG and fMRI on the ternary classification of regional language dominance into left, right, or symmetric groups was also found at the AngSmg ROI (69%). This was followed by the whole-hemisphere and temporal ROIs (both 62%). The frontal ROI showed the least agreement with fMRI (51%). Gross discordances between MEG and FMRI findings were disproportionately of the type where MEG favored atypical right-hemispheric language in a patient with right-hemispheric seizure origin (p<0.05 at three of the four ROIs). SIGNIFICANCE In a parietal region that includes the angular and supramarginal gyri, language laterality estimates based on dSPM of ERFs during auditory word-recognition shows a degree of MEG-fMRI concordance that is comparable to previously published estimates for MEG-Wada concordance using dipole counting methods and the same task. Our data also suggest that MEG language laterality estimates based on this task may be influenced by the laterality of epileptic networks in some patients. This has not been reported previously and deserves further study.
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Affiliation(s)
- Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Zhimin Li
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Chad Carlson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Jeffrey Stout
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David S Sabsevitz
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sara J Swanson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jeffrey R Binder
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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Papanicolaou AC, Kilintari M, Rezaie R, Narayana S, Babajani-Feremi A. The Role of the Primary Sensory Cortices in Early Language Processing. J Cogn Neurosci 2017; 29:1755-1765. [PMID: 28557692 DOI: 10.1162/jocn_a_01147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The results of this magnetoencephalography study challenge two long-standing assumptions regarding the brain mechanisms of language processing: First, that linguistic processing proper follows sensory feature processing effected by bilateral activation of the primary sensory cortices that lasts about 100 msec from stimulus onset. Second, that subsequent linguistic processing is effected by left hemisphere networks outside the primary sensory areas, including Broca's and Wernicke's association cortices. Here we present evidence that linguistic analysis begins almost synchronously with sensory, prelinguistic verbal input analysis and that the primary cortices are also engaged in these linguistic analyses and become, consequently, part of the left hemisphere language network during language tasks. These findings call for extensive revision of our conception of linguistic processing in the brain.
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Affiliation(s)
- Andrew C Papanicolaou
- University of Tennessee Health Science Center.,Le Bonheur Children's Hospital, Memphis, TN
| | - Marina Kilintari
- University of Tennessee Health Science Center.,Le Bonheur Children's Hospital, Memphis, TN.,University College London
| | - Roozbeh Rezaie
- University of Tennessee Health Science Center.,Le Bonheur Children's Hospital, Memphis, TN
| | - Shalini Narayana
- University of Tennessee Health Science Center.,Le Bonheur Children's Hospital, Memphis, TN
| | - Abbas Babajani-Feremi
- University of Tennessee Health Science Center.,Le Bonheur Children's Hospital, Memphis, TN
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Lateralization of language function in epilepsy patients: A high-density scalp-derived event-related potentials (ERP) study. Clin Neurophysiol 2017; 128:472-479. [DOI: 10.1016/j.clinph.2016.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/01/2016] [Accepted: 12/21/2016] [Indexed: 11/20/2022]
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Ishikawa T, Muragaki Y, Maruyama T, Abe K, Kawamata T. Roles of the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas. Neurol Med Chir (Tokyo) 2016; 57:28-34. [PMID: 27980284 PMCID: PMC5243162 DOI: 10.2176/nmc.oa.2016-0042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean ± standard deviation age of 42.7 ± 13.6 years (range: 13 to 70 years); 71 right-handed, 2 left-handed, and 1 ambidextrous] with gliomas located near speech areas. All patients underwent the Wada test and fMRI, and 34 patients underwent awake surgery. The “last-and-first” task was administered during fMRI. The Wada test was successful in determining the language-dominant hemisphere in 73 patients (98.6%): left hemisphere in 68 patients (91.9%), right hemisphere in 4 patients (5.4%), and bilateral in 1 patient (1.4%). The dominant hemisphere for right-handed patients (n = 71) was the left hemisphere in 67 patients (94.3%), right hemisphere in 3 patients (4.2%), and undetectable in 1 patient (1.4%). The fMRI was successful in determining the language-dominant hemisphere in 53 patients (71.6%). The results of the Wada test and fMRI were inconsistent in 5 patients (8.6%), of which 3 (5.2%) exhibited dominance in opposite hemispheres. Furthermore, 2 of these 3 cases (2.7%) were contralateral false positive cases, whereby fMRI identified the right-hemisphere as language dominant for right-handed individuals with tumors in the left hemisphere. Based on these findings, we concluded that the Wada test can be skipped if language dominancy can be detected by fMRI.
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Gallagher A, Tremblay J, Vannasing P. Language mapping in children using resting-state functional connectivity: comparison with a task-based approach. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:125006. [PMID: 27992629 DOI: 10.1117/1.jbo.21.12.125006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
Patients with brain tumor or refractory epilepsy may be candidates for neurosurgery. Presurgical evaluation often includes language investigation to prevent or reduce the risk of postsurgical language deficits. Current techniques involve significant limitations with pediatric populations. Recently, near-infrared spectroscopy (NIRS) has been shown to be a valuable neuroimaging technique for language localization in children. However, it typically requires the child to perform a task (task-based NIRS), which may constitute a significant limitation. Resting-state functional connectivity NIRS (fcNIRS) is an approach that can be used to identify language networks at rest. This study aims to assess the utility of fcNIRS in children by comparing fcNIRS to more conventional task-based NIRS for language mapping in 33 healthy participants: 25 children (ages 3 to 16) and 8 adults. Data were acquired at rest and during a language task. Results show very good concordance between both approaches for language localization (Dice similarity coefficient = 0.81 ± 0.13 ) and hemispheric language dominance ( kappa = 0.86 , p < 0.006 ). The fcNIRS technique may be a valuable tool for language mapping in clinical populations, including children and patients with cognitive and behavioral impairments.
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Affiliation(s)
- Anne Gallagher
- CHU Sainte-Justine Research Center, Laboratoire d'Imagerie Optique en Neurodéveloppement (LIONLab), 3175 Chemin de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, CanadabUniversité de Montréal, Centre de Recherche en Neuropsychologie et Cognition, Department of Psychology, Marie-Victorin Building, P.O. Box 6128 Centre-ville Station, 2900 Boulevard Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada
| | - Julie Tremblay
- CHU Sainte-Justine Research Center, Laboratoire d'Imagerie Optique en Neurodéveloppement (LIONLab), 3175 Chemin de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, CanadabUniversité de Montréal, Centre de Recherche en Neuropsychologie et Cognition, Department of Psychology, Marie-Victorin Building, P.O. Box 6128 Centre-ville Station, 2900 Boulevard Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada
| | - Phetsamone Vannasing
- CHU Sainte-Justine Research Center, Laboratoire d'Imagerie Optique en Neurodéveloppement (LIONLab), 3175 Chemin de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, CanadabUniversité de Montréal, Centre de Recherche en Neuropsychologie et Cognition, Department of Psychology, Marie-Victorin Building, P.O. Box 6128 Centre-ville Station, 2900 Boulevard Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada
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