@article {3407, title = {Real-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.}, journal = {J Neurosurg Pediatr}, volume = {14}, year = {2014}, month = {09/2014}, pages = {287-95}, abstract = {

Accurate language localization expands surgical treatment options for epilepsy patients and reduces the risk of postsurgery language deficits. Electrical cortical stimulation mapping (ESM) is considered to be the clinical gold standard for language localization. While ESM affords clinically valuable results, it can be poorly tolerated by children, requires active participation and compliance, carries a risk of inducing seizures, is highly time consuming, and is labor intensive. Given these limitations, alternative and/or complementary functional localization methods such as analysis of electrocorticographic (ECoG) activity in high gamma frequency band in real time are needed to precisely identify eloquent cortex in children. In this case report, the authors examined 1) the use of real-time functional mapping (RTFM) for language localization in a high gamma frequency band derived from ECoG to guide surgery in an epileptic pediatric patient and 2) the relationship of RTFM mapping results to postsurgical language outcomes. The authors found that RTFM demonstrated relatively high sensitivity (75\%) and high specificity (90\%) when compared with ESM in a "next-neighbor" analysis. While overlapping with ESM in the superior temporal region, RTFM showed a few other areas of activation related to expressive language function, areas that were eventually resected during the surgery. The authors speculate that this resection may be associated with observed postsurgical expressive language deficits. With additional validation in more subjects, this finding would suggest that surgical planning and associated assessment of the risk/benefit ratio would benefit from information provided by RTFM mapping.

}, keywords = {Adolescent, Anticonvulsants, Brain Mapping, Cerebral Cortex, Electric Stimulation, Electroencephalography, Epilepsies, Partial, Female, Humans, Language, Neuropsychological Tests, Sensitivity and Specificity, Speech}, issn = {1933-0715}, doi = {10.3171/2014.6.PEDS13477}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24995815}, author = {Korostenskaja, Milena and Chen, Po-Ching and Salinas, Christine M and Westerveld, Michael and Peter Brunner and Gerwin Schalk and Cook, Jane C and Baumgartner, James and Lee, Ki H} } @article {2242, title = {Advances in the application of technology to epilepsy: the CIMIT/NIO Epilepsy Innovation Summit.}, journal = {Epilepsy Behav}, volume = {16}, year = {2009}, month = {09/2009}, pages = {3-46}, abstract = {

In 2008, a group of clinicians, scientists, engineers, and industry representatives met to discuss advances in the application of engineering technologies to the diagnosis and treatment of patients with epilepsy. The presentations also provided a guide for further technological development, specifically in the evaluation of patients for epilepsy surgery, seizure onset detection and seizure prediction, intracranial treatment systems, and extracranial treatment systems. This article summarizes the discussions and demonstrates that cross-disciplinary interactions can catalyze collaborations between physicians and engineers to address and solve many of the pressing unmet needs in epilepsy.

}, keywords = {Adult, Anticonvulsants, Brain Mapping, Child, Drug Resistance, Electric Stimulation Therapy, Electroencephalography, Engineering, Epilepsy, Humans, Magnetic Resonance Imaging, Medical Laboratory Science, Microelectrodes, Nanoparticles, Neurons, Neurosurgery, Neurotoxins, Predictive Value of Tests, Seizures, Spectroscopy, Near-Infrared, Tomography, Emission-Computed, Single-Photon, Tomography, Optical, Transcranial Magnetic Stimulation}, issn = {1525-5069}, doi = {10.1016/j.yebeh.2009.06.028}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19780225}, author = {Schachter, Steven C and Guttag, John and Schiff, Steven J and Schomer, Donald L} }