03481nas a2200289 4500008004100000022001400041245009200055210006900147260001200216300001000228490000700238520264000245653001802885653002002903653002002923653001502943653002502958653002702983653001103010653002703021100001803048700001903066700002003085700001903105700001903124856004803143 2010 eng d a1525-506900aPassive real-time identification of speech and motor cortex during an awake craniotomy.0 aPassive realtime identification of speech and motor cortex durin c05/2010 a123-80 v183 a

Precise localization of eloquent cortex is a clinical necessity prior to surgical resections adjacent to speech or motor cortex. In the intraoperative setting, this traditionally requires inducing temporary lesions by direct electrocortical stimulation (DECS). In an attempt to increase efficiency and potentially reduce the amount of necessary stimulation, we used a passive mapping procedure in the setting of an awake craniotomy for tumor in two patients resection. We recorded electrocorticographic (ECoG) signals from exposed cortex while patients performed simple cue-directed motor and speech tasks. SIGFRIED, a procedure for real-time event detection, was used to identify areas of cortical activation by detecting task-related modulations in the ECoG high gamma band. SIGFRIED's real-time output quickly localized motor and speech areas of cortex similar to those identified by DECS. In conclusion, real-time passive identification of cortical function using SIGFRIED may serve as a useful adjunct to cortical stimulation mapping in the intraoperative setting.

10aBrain Mapping10aBrain Neoplasms10aCerebral Cortex10aCraniotomy10aElectric Stimulation10aElectroencephalography10aHumans10aNeurologic Examination1 aRoland, Jarod1 aBrunner, Peter1 aJohnston, James1 aSchalk, Gerwin1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/2047874502591nas a2200433 4500008004100000022001400041245012500055210006900180260001200249300001100261490000700272520133300279653001001612653001801622653002001640653002501660653002601685653002701711653001301738653001101751653001101762653000901773653001601782653003301798653004101831653001601872100001901888700001801907700002201925700002201947700002001969700002401989700002302013700002002036700001902056700001502075700001902090856004802109 2009 eng d a1525-506900aA practical procedure for real-time functional mapping of eloquent cortex using electrocorticographic signals in humans.0 apractical procedure for realtime functional mapping of eloquent  c07/2009 a278-860 v153 a

Functional mapping of eloquent cortex is often necessary prior to invasive brain surgery, but current techniques that derive this mapping have important limitations. In this article, we demonstrate the first comprehensive evaluation of a rapid, robust, and practical mapping system that uses passive recordings of electrocorticographic signals. This mapping procedure is based on the BCI2000 and SIGFRIED technologies that we have been developing over the past several years. In our study, we evaluated 10 patients with epilepsy from four different institutions and compared the results of our procedure with the results derived using electrical cortical stimulation (ECS) mapping. The results show that our procedure derives a functional motor cortical map in only a few minutes. They also show a substantial concurrence with the results derived using ECS mapping. Specifically, compared with ECS maps, a next-neighbor evaluation showed no false negatives, and only 0.46 and 1.10% false positives for hand and tongue maps, respectively. In summary, we demonstrate the first comprehensive evaluation of a practical and robust mapping procedure that could become a new tool for planning of invasive brain surgeries.

10aAdult10aBrain Mapping10aCerebral Cortex10aElectric Stimulation10aElectrodes, Implanted10aElectroencephalography10aEpilepsy10aFemale10aHumans10aMale10aMiddle Aged10aPractice Guidelines as Topic10aSignal Processing, Computer-Assisted10aYoung Adult1 aBrunner, Peter1 aRitaccio, A L1 aLynch, Timothy, M1 aEmrich, Joseph, F1 aWilson, Adam, J1 aWilliams, Justin, C1 aAarnoutse, Erik, J1 aRamsey, Nick, F1 aLeuthardt, E C1 aBischof, H1 aSchalk, Gerwin uhttp://www.ncbi.nlm.nih.gov/pubmed/1936663804391nas a2200409 4500008004100000022001400041245010700055210006900162260001200231300002900243490000700272520323000279653001003509653002203519653001803541653002503559653002603584653002703610653001103637653000903648653001103657653000903668653001603677653001703693653001703710653004103727653001103768100001903779700002003798700002603818700001903844700002003863700002003883700001303903700001703916856004803933 2007 eng d a1524-404000aElectrocorticographic Frequency Alteration Mapping: A Clinical Technique for Mapping the Motor Cortex.0 aElectrocorticographic Frequency Alteration Mapping A Clinical Te c04/2007 a260-70; discussion 270-10 v603 a

OBJECTIVE: 

Electrocortical stimulation (ECS) has been well established for delineating the eloquent cortex. However, ECS is still coarse and inefficient in delineating regions of the functional cortex and can be hampered by after-discharges. Given these constraints, an adjunct approach to defining the motor cortex is the use of electrocorticographic signal changes associated with active regions of the cortex. The broad range of frequency oscillations are categorized into two main groups with respect to the sensorimotor cortex: low and high frequency bands. The low frequency bands tend to show a power reduction with cortical activation, whereas the high frequency bands show power increases. These power changes associated with the activated cortex could potentially provide a powerful tool in delineating areas of the motor cortex. We explore electrocorticographic signal alterations as they occur with activated regions of the motor cortex, as well as its potential in clinical brain mapping applications.

METHODS: 

We evaluated seven patients who underwent invasive monitoring for seizure localization. Each patient had extraoperative ECS mapping to identify the motor cortex. All patients also performed overt hand and tongue motor tasks to identify associated frequency power changes in regard to location and degree of concordance with ECS results that localized either hand or tongue motor function.

RESULTS: 

The low frequency bands had a high sensitivity (88.9-100%) and a lower specificity (79.0-82.6%) for identifying electrodes with either hand or tongue ECS motor responses. The high frequency bands had a lower sensitivity (72.7-88.9%) and a higher specificity (92.4-94.9%) in correlation with the same respective ECS positive electrodes.

CONCLUSION: 

The concordance between stimulation and spectral power changes demonstrate the possible utility of electrocorticographic frequency alteration mapping as an adjunct method to improve the efficiency and resolution of identifying the motor cortex.

10aAdult10aBiological Clocks10aBrain Mapping10aElectric Stimulation10aElectrodes, Implanted10aElectroencephalography10aFemale10aHand10aHumans10aMale10aMiddle Aged10aMotor Cortex10aOscillometry10aSignal Processing, Computer-Assisted10aTongue1 aLeuthardt, E C1 aMiller, John, W1 aAnderson, Nicholas, R1 aSchalk, Gerwin1 aDowling, Joshua1 aMiller, John, W1 aMoran, D1 aOjemann, J G uhttp://www.ncbi.nlm.nih.gov/pubmed/17415162