Multimodality language mapping in patients with left-hemispheric language dominance on Wada test |
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Authors: | Kojima Katsuaki Brown Erik C Rothermel Robert Carlson Alanna Matsuzaki Naoyuki Shah Aashit Atkinson Marie Mittal Sandeep Fuerst Darren Sood Sandeep Asano Eishi |
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Affiliation: | Department of Pediatrics, Wayne State University, Detroit Medical Center, Detroit, MI 48201, USA. |
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Abstract: |
ObjectiveWe determined the utility of electrocorticography (ECoG) and stimulation for detecting language-related sites in patients with left-hemispheric language-dominance on Wada test.MethodsWe studied 13 epileptic patients who underwent language mapping using event-related gamma-oscillations on ECoG and stimulation via subdural electrodes. Sites showing significant gamma-augmentation during an auditory-naming task were defined as language-related ECoG sites. Sites at which stimulation resulted in auditory perceptual changes, failure to verbalize a correct answer, or sensorimotor symptoms involving the mouth were defined as language-related stimulation sites. We determined how frequently these methods revealed language-related sites in the superior-temporal, inferior-frontal, dorsolateral-premotor, and inferior-Rolandic regions.ResultsLanguage-related sites in the superior-temporal and inferior-frontal gyri were detected by ECoG more frequently than stimulation (p < 0.05), while those in the dorsolateral-premotor and inferior-Rolandic regions were detected by both methods equally. Stimulation of language-related ECoG sites, compared to the others, more frequently elicited language symptoms (p < 0.00001). One patient developed dysphasia requiring in-patient speech therapy following resection of the dorsolateral-premotor and inferior-Rolandic regions containing language-related ECoG sites not otherwise detected by stimulation.ConclusionsLanguage-related gamma-oscillations may serve as an alternative biomarker of underlying language function in patients with left-hemispheric language-dominance.SignificanceMeasurement of language-related gamma-oscillations is warranted in presurgical evaluation of epileptic patients. |
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Keywords: | Pediatric epilepsy surgery Speech Intracranial EEG Electrical stimulation |
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