ECoG high-gamma modulation versus electrical stimulation for presurgical language mapping

被引:43
|
作者
Arya, Ravindra [1 ]
Horn, Paul S. [1 ]
Crone, Nathan E. [2 ]
机构
[1] Cincinnati Childrens Hosp Med Ctr, Div Neurol, Comprehens Epilepsy Ctr, Cincinnati, OH 45229 USA
[2] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21205 USA
基金
美国国家卫生研究院;
关键词
Functional brain mapping; Language localization; Epilepsy surgery; TIME OSCILLATION ANALYSIS; ELECTROCORTICAL STIMULATION; LOCALIZATION; TASK; EPILEPSY; SPEECH; CORTEX; FMRI; SENSITIVITY; DISCHARGES;
D O I
10.1016/j.yebeh.2017.10.044
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Objective: This meta-analysis compared diagnostic validity of electrocorticographic (ECoG) high-? modulation (HGM) with electrical stimulation mapping (ESM) for presurgical language localization. Methods: From a structured literature search, studies with electrode level data comparing ECoG HGM and ESM for language localization were included in the meta-analysis. Outcomes included global measures of diagnostic validity: area under the summary receiver operating characteristic (SROC) curve (AUC), and diagnostic odds ratio (DOR); as well as pooled estimates of sensitivity and specificity. Clinical and technical determinants of sensitivity/specificity were explored. Results: Fifteen studies were included in qualitative synthesis, and 10 studies included in the meta-analysis (number of patients 1-17, mean age 10.3-53.6years). Overt picture naming was the most commonly used task for language mapping with either method. Electrocorticographic high-gamma modulation was analyzed at 50-400Hz with different bandwidths in individual studies. For ESM, pulse duration, train duration, and maximum current varied greatly among studies. Sensitivity (0.23-0.99), specificity (0.48-0.96), and DOR (1.45-376.28) varied widely across studies. The pooled estimates are: sensitivity 0.61 (95% CI 0.44, 0.76), specificity 0.79 (95% CI 0.68, 0.88), and DOR 6.44 (95% CI 3.47, 11.94). Area under the SROC curve was 0.77. Results of bivariate meta-regression were limited by small samples for individual variables. Conclusion: Electrocorticographic high-gamma modulation is a specific but not sensitive method for language localization compared with gold-standard ESM. Given the pooled DOR of 6.44 and AUC of 0.77, ECoG HGM can fairly reliably ascertain electrodes overlying ESM cortical language sites. (C) 2017 Elsevier Inc. All rights
引用
收藏
页码:26 / 33
页数:8
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