Intraoperative language mapping guided by real-time visualization of gamma band modulation electrocorticograms: case report and proof of concept

IF 2.4 Q2 CLINICAL NEUROLOGY Neuro-oncology practice Pub Date : 2023-09-18 DOI:10.1093/nop/npad059
Kyle R Noll, Priscella Asman, Israt Tasnim, Matthew Hall, Katherine Connelly, Chandra Swamy, Chibawanye Ene, Sudhakar Tummala, Roxana M Grasu, Ho-Ling Liu, Vinodh A Kumar, Matthew Muir, Sarah Prinsloo, Hayley Michener, Jeffrey S Wefel, Nuri F Ince, Sujit S Prabhu
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Abstract

Abstract Background Electrocorticography (ECoG) language mapping is often performed extraoperatively, frequently involves offline processing, and relationships with direct cortical stimulation (DCS) remain variable. We sought to determine the feasibility and preliminary utility of an intraoperative language mapping approach guided by real-time visualization of electrocorticograms. Methods A patient with astrocytoma underwent awake craniotomy with intraoperative language mapping, utilizing a dual iPad stimulus presentation system coupled to a real-time neural signal processing platform capable of both ECoG recording and delivery of DCS. Gamma band modulations in response to 4 language tasks at each electrode were visualized in real-time. Next, DCS was conducted for each neighboring electrode pair during language tasks. Results All language tasks resulted in strongest heat map activation at an electrode pair in the anterior to mid superior temporal gyrus. Consistent speech arrest during DCS was observed for Object and Action naming tasks at these same electrodes, indicating good correspondence with ECoG heat map recordings. This region corresponded well with posterior language representation via preoperative functional MRI. Conclusions Intraoperative real-time visualization of language task-based ECoG gamma band modulation is feasible and may help identify targets for DCS. If validated, this may improve the efficiency and accuracy of intraoperative language mapping.
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伽玛波段调制皮质电图实时可视化引导的术中语言映射:病例报告和概念证明
脑皮层电图(ECoG)语言映射通常在手术外进行,通常涉及离线处理,并且与直接皮层刺激(DCS)的关系仍然是可变的。我们试图确定术中语言映射方法的可行性和初步效用,该方法由脑皮质电图实时可视化指导。方法1例星形细胞瘤患者行清醒开颅术,术中语言定位,采用双iPad刺激呈现系统,结合实时神经信号处理平台,可同时记录ECoG和传送DCS。每个电极上响应4种语言任务的伽马波段调制实时可视化。然后,对语言任务中相邻的电极对进行DCS。结果在所有语言任务中,颞上回前至中上回电极对的热图激活最强。在这些相同的电极上,观察到DCS期间对象和动作命名任务的一致言语停止,表明与ECoG热图记录有良好的对应关系。通过术前功能性MRI检查,该区域与后验语言表征吻合良好。结论术中基于语言任务的脑电伽马波段调制实时可视化是可行的,有助于识别DCS的靶点。如果得到验证,这可能会提高术中语言映射的效率和准确性。
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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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Erratum to: Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients. Well-intentioned is not always beneficial: Why we should question prescription habits. Long-term effects on fertility after central nervous system cancer: A systematic review and meta-analysis. Socioeconomic driven disparities in neuro-oncology. Palliative care services in neuro-oncology: Mind the gap.
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