02881nas a2200397 4500008004100000022001400041245011100055210006900166260001200235300001100247490000700258520172500265653001501990653002002005653001802025653002002043653002502063653002702088653002402115653001102139653001102150653001302161653002902174653003202203653001102235100002602246700001902272700002602291700002402317700001902341700001902360700001802379700002302397700001502420856004802435 2014 eng d a1933-071500aReal-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.0 aRealtime functional mapping potential tool for improving languag c09/2014 a287-950 v143 a

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.

10aAdolescent10aAnticonvulsants10aBrain Mapping10aCerebral Cortex10aElectric Stimulation10aElectroencephalography10aEpilepsies, Partial10aFemale10aHumans10aLanguage10aNeuropsychological Tests10aSensitivity and Specificity10aSpeech1 aKorostenskaja, Milena1 aChen, Po-Ching1 aSalinas, Christine, M1 aWesterveld, Michael1 aBrunner, Peter1 aSchalk, Gerwin1 aCook, Jane, C1 aBaumgartner, James1 aLee, Ki, H uhttp://www.ncbi.nlm.nih.gov/pubmed/2499581507936nas a2200361 4500008004100000022001400041245009600055210006900151260001200220300001100232490000800243520694900251653001507200653001007215653002807225653002007253653001007273653002507283653002407308653001107332653001107343653000907354653001607363653001907379653001607398100001607414700001907430700002207449700001707471700001707488700002107505856004807526 2010 eng d a1091-649000aCortical activity during motor execution, motor imagery, and imagery-based online feedback.0 aCortical activity during motor execution motor imagery and image c03/2010 a4430-50 v1073 a

Imagery of motor movement plays an important role in learning of complex motor skills, from learning to serve in tennis to perfecting a pirouette in ballet. What and where are the neural substrates that underlie motor imagery-based learning? We measured electrocorticographic cortical surface potentials in eight human subjects during overt action and kinesthetic imagery of the same movement, focusing on power in "high frequency" (76-100 Hz) and "low frequency" (8-32 Hz) ranges. We quantitatively establish that the spatial distribution of local neuronal population activity during motor imagery mimics the spatial distribution of activity during actual motor movement. By comparing responses to electrocortical stimulation with imagery-induced cortical surface activity, we demonstrate the role of primary motor areas in movement imagery. The magnitude of imagery-induced cortical activity change was approximately 25% of that associated with actual movement. However, when subjects learned to use this imagery to control a computer cursor in a simple feedback task, the imagery-induced activity change was significantly augmented, even exceeding that of overt movement.

10aAdolescent10aAdult10aBiofeedback, Psychology10aCerebral Cortex10aChild10aElectric Stimulation10aElectrocardiography10aFemale10aHumans10aMale10aMiddle Aged10aMotor Activity10aYoung Adult1 aMiller, K J1 aSchalk, Gerwin1 aFetz, Eberhard, E1 aNijs, Marcel1 aOjemann, J G1 aRao, Rajesh, P N uhttp://www.ncbi.nlm.nih.gov/pubmed/2016008403481nas 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