Reliability of language mapping with magnetic source imaging in epilepsy surgery candidates

2006 ◽  
Vol 8 (4) ◽  
pp. 742-749 ◽  
Author(s):  
Dongwook Lee ◽  
Stephen M. Sawrie ◽  
Panagiotis G. Simos ◽  
Jeff Killen ◽  
Robert C. Knowlton
2003 ◽  
Vol 80 (1-4) ◽  
pp. 14-17 ◽  
Author(s):  
Joseph R. Smith ◽  
Don W. King ◽  
Yong D. Park ◽  
Anthony M. Murro ◽  
Gregory P. Lee ◽  
...  

2006 ◽  
Vol 59 (5) ◽  
pp. 835-842 ◽  
Author(s):  
Robert C. Knowlton ◽  
Rotem Elgavish ◽  
Jennifer Howell ◽  
Jeffery Blount ◽  
Jorge G. Burneo ◽  
...  

Neurosurgery ◽  
1995 ◽  
Vol 37 (6) ◽  
pp. 1113???1121 ◽  
Author(s):  
Maung Aung ◽  
David F. Sobel ◽  
Christopher C. Gallen ◽  
Eugene C. Hirschkoff

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. E1244-E1248 ◽  
Author(s):  
Stephanie A. Holowka ◽  
Hiroshi Otsubo ◽  
Koji Iida ◽  
Elizabeth Pang ◽  
Rohit Sharma ◽  
...  

Abstract OBJECTIVE: To determine the role of reconstructing three-dimensional magnetic source imaging (MSI) data on cortical resections for children undergoing epilepsy surgery using neuronavigation. METHODS: Magnetoencephalographic recordings were analyzed in 16 children under 18 years of age with intractable epilepsy. The data were transferred to the neuronavigation workstation for intraoperative localization of MSI spike sources in selected patients. With the aid of neuronavigation, the MSI spike sources were resected. Intraoperative electrocorticography was then used to survey the surrounding field for residual epileptiform activity. RESULTS: MSI spike sources were obtained in 13 of 16 patients. MSI spike sources localized the cortical and subcortical discharges before intraoperative electrocorticography in nine patients and before extraoperative subdural grid electroencephalographic monitoring in four patients. The localization of MSI spikes sources was characterized by clustered spike sources in 10 patients. By use of neuronavigation, the clustered spike sources were correlated to the interictal zone indicated by intraoperative electrocorticography in six patients and to the ictal onset zone shown on extraoperative subdural grid electroencephalography in three patients. Cortical excision of the spike cluster focus was then performed in these six patients. The technique used here to resect MSI spike source clusters that correlate with the ictal onset zone by invasive subdural grid monitoring is illustrated in one patient who underwent cortical resection for epilepsy surgery. CONCLUSION: Three-dimensional reconstruction of MSI data linked to neuronavigation is a promising technique to facilitate resections around eloquent cortex in children with epilepsy.


Neurosurgery ◽  
1995 ◽  
Vol 37 (6) ◽  
pp. 1113-1121 ◽  
Author(s):  
Maung Aung ◽  
David F. Sobel ◽  
Christopher C. Gallen ◽  
Eugene C. Hirschkoff

2001 ◽  
Vol 95 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Panagiotis G. Simos ◽  
Eduardo M. Castillo ◽  
Jack M. Fletcher ◽  
David J. Francis ◽  
Fernando Maestu ◽  
...  

Object. There are conflicting claims in the functional imaging literature concerning whether different languages are represented by distinct brain mechanisms in individuals who are proficient in more than one language. This interesting theoretical issue has practical implications when functional imaging methods are used for presurgical language mapping. To address this issue the authors compared the location and extent of receptive language cortex specific to English and Spanish in neurologically intact bilingual volunteers by using magnetic source imaging. Methods. Areas of the cortex that were specialized for receptive language functions were identified separately for each language in 11 healthy adults who were bilingual in English and Spanish. The authors performed exactly the same procedures used routinely for presurgical receptive language mapping. In each bilingual individual, the receptive language—specific map always encompassed the posterior portion of the superior temporal gyrus. In every case, however, substantial differences in the receptive language maps were also observed for the two languages, regardless of whether each participant's first language was English or Spanish. Conclusions. Although the reasons for such differences and their ultimate significance in identifying the cerebral mechanisms of language are subject to continuing investigation, their presence is noteworthy and has practical implications for the surgical management of patients with lesions in the temporal and parietal regions of the dominant hemisphere.


2020 ◽  
Vol 48 (4) ◽  
pp. E16
Author(s):  
Ismail Sidky Mohamed ◽  
Dènahin Hinnoutondji Toffa ◽  
Manon Robert ◽  
Patrick Cossette ◽  
Arline-Aude Bérubé ◽  
...  

OBJECTIVEFor patients with nonlesional refractory focal epilepsy (NLRFE), localization of the epileptogenic zone may be more arduous than for other types of epilepsy and frequently requires information from multiple noninvasive presurgical modalities and intracranial EEG (icEEG). In this prospective, blinded study, the authors assessed the clinical added value of magnetic source imaging (MSI) in the presurgical evaluation of patients with NLRFE.METHODSThis study prospectively included 57 consecutive patients with NLRFE who were considered for epilepsy surgery. All patients underwent noninvasive presurgical evaluation and then MSI. To determine the surgical plan, discussion of the results of the presurgical evaluation was first undertaken while discussion participants were blinded to the MSI results. MSI results were then presented. MSI influence on the initial management plan was assessed.RESULTSMSI results influenced patient management in 32 patients. MSI results led to the following changes in surgical strategy in 14 patients (25%): allowing direct surgery in 6 patients through facilitating the detection of subtle cortical dysplasia in 4 patients and providing additional concordant diagnostic information to other presurgical workup in another 2 patients; rejection of surgery in 3 patients originally deemed surgical candidates; change of plan from direct surgery to icEEG in 2 patients; and allowing icEEG in 3 patients deemed not surgical candidates. MSI results led to changed electrode locations and contact numbers in another 18 patients. Epilepsy surgery was performed in 26 patients influenced by MSI results and good surgical outcome was achieved in 21 patients.CONCLUSIONSThis prospective, blinded study showed that information provided by MSI allows more informed icEEG planning and surgical outcome in a significant percentage of patients with NLRFE and should be included in the presurgical workup in those patients.


2007 ◽  
Vol 107 (3) ◽  
pp. 488-494 ◽  
Author(s):  
Jeffrey I. Berman ◽  
Mitchel S. Berger ◽  
Sungwon Chung ◽  
Srikantan S. Nagarajan ◽  
Roland G. Henry

Object Resecting brain tumors involves the risk of damaging the descending motor pathway. Diffusion tensor (DT)–imaged fiber tracking is a noninvasive magnetic resonance (MR) technique that can delineate the subcortical course of the motor pathway. The goal of this study was to use intraoperative subcortical stimulation mapping of the motor tract and magnetic source imaging to validate the utility of DT-imaged fiber tracking as a tool for presurgical planning. Methods Diffusion tensor-imaged fiber tracks of the motor tract were generated preoperatively in nine patients with gliomas. A mask of the resultant fiber tracks was overlaid on high-resolution T1- and T2-weighted anatomical MR images and used for stereotactic surgical navigation. Magnetic source imaging was performed in seven of the patients to identify functional somatosensory cortices. During resection, subcortical stimulation mapping of the motor pathway was performed within the white matter using a bipolar electrode. Results A total of 16 subcortical motor stimulations were stereotactically identified in nine patients. The mean distance between the stimulation sites and the DT-imaged fiber tracks was 8.7 ±3.1 mm (±standard deviation). The measured distance between subcortical stimulation sites and DT-imaged fiber tracks combines tracking technique errors and all errors encountered with stereotactic navigation. Conclusions Fiber tracks delineated using DT imaging can be used to identify the motor tract in deep white matter and define a safety margin around the tract.


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