Neuropsychological outcomes after resection of cortical sites with visual naming associated electrocorticographic high-gamma modulation.
Epilepsy surgery
Functional brain mapping
Intracranial EEG
Neuropsychological evaluation
Journal
Epilepsy research
ISSN: 1872-6844
Titre abrégé: Epilepsy Res
Pays: Netherlands
ID NLM: 8703089
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
27
06
2018
revised:
24
10
2018
accepted:
28
01
2019
pubmed:
6
2
2019
medline:
13
7
2019
entrez:
6
2
2019
Statut:
ppublish
Résumé
Language mapping with high-gamma modulation (HGM) has compared well with electrical cortical stimulation mapping (ESM). However, there is limited prospective data about its functional validity. We compared changes in neuropsychological evaluation (NPE) performed before and 1-year after epilepsy surgery, between patients with/without resection of cortical sites showing HGM during a visual naming task. Pediatric drug-resistant epilepsy (DRE) patients underwent pre-surgical language localization with ESM and HGM using a visual naming task. Surgical decisions were based solely on ESM results. NPE difference scores were compared between patients with/without resection of HGM naming sites using principal component (PC) analysis. Follow-up NPE scores were modeled with resection group as main effect and respective pre-surgical score as a covariate, using analysis of covariance. Seventeen native English speakers (12 females), aged 6.5-20.2 years, were included. One year after epilepsy surgery, first PC score increased by (mean ± standard deviation) 14.4 ± 16.5 points in patients without resection, whereas it decreased by 7.6 ± 24.6 points in those with resection of HGM naming sites (p = 0.040). This PC score represented verbal comprehension, working memory, perceptual reasoning (Wechsler subscales); Woodcock-Johnson Tests of Achievement; and Peabody Picture Vocabulary Test. Subsequent analysis showed significant difference in working memory score between patients with/without resection of HGM naming sites (-15.2 points, 95% confidence limits -29.7 to -0.7, p = 0.041). We highlight the functional consequences of resecting HGM language sites, and suggest that NPE of DRE patients should include comprehensive assessment of multiple linguistic and cognitive domains besides naming ability.
Sections du résumé
BACKGROUND
Language mapping with high-gamma modulation (HGM) has compared well with electrical cortical stimulation mapping (ESM). However, there is limited prospective data about its functional validity. We compared changes in neuropsychological evaluation (NPE) performed before and 1-year after epilepsy surgery, between patients with/without resection of cortical sites showing HGM during a visual naming task.
METHODS
Pediatric drug-resistant epilepsy (DRE) patients underwent pre-surgical language localization with ESM and HGM using a visual naming task. Surgical decisions were based solely on ESM results. NPE difference scores were compared between patients with/without resection of HGM naming sites using principal component (PC) analysis. Follow-up NPE scores were modeled with resection group as main effect and respective pre-surgical score as a covariate, using analysis of covariance.
RESULTS
Seventeen native English speakers (12 females), aged 6.5-20.2 years, were included. One year after epilepsy surgery, first PC score increased by (mean ± standard deviation) 14.4 ± 16.5 points in patients without resection, whereas it decreased by 7.6 ± 24.6 points in those with resection of HGM naming sites (p = 0.040). This PC score represented verbal comprehension, working memory, perceptual reasoning (Wechsler subscales); Woodcock-Johnson Tests of Achievement; and Peabody Picture Vocabulary Test. Subsequent analysis showed significant difference in working memory score between patients with/without resection of HGM naming sites (-15.2 points, 95% confidence limits -29.7 to -0.7, p = 0.041).
CONCLUSION
We highlight the functional consequences of resecting HGM language sites, and suggest that NPE of DRE patients should include comprehensive assessment of multiple linguistic and cognitive domains besides naming ability.
Identifiants
pubmed: 30721879
pii: S0920-1211(18)30316-4
doi: 10.1016/j.eplepsyres.2019.01.011
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
17-23Subventions
Organisme : NINDS NIH HHS
ID : R01 NS062756
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS062806
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS065020
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.