Intraoperative Mapping of Language Using High Gamma

使用高伽玛进行术中语言映射

• 批准号: 7298399
• 负责人: Robert Thomas Knight
• 金额: $ 7.6万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7298399
• 关键词: Acute; Address; Adverse effects; Animals; Anomia; Anterior; Area; Arteriovenous malformation; Auditory; Binding; Brain; Brain Neoplasms; California; Cerebral cortex; Collaborations; Congenital arteriovenous malformation; Count; Data; Depth; Electric Stimulation; Electrocorticogram; Electrodes; Epilepsy; Excision; Fractionation; Frequencies; Generations; Goals; Gray unit of radiation dose; Human; Implant; Invasive; Laboratories; Language; Lead; Lesion; Maps; Measures; Memory; Methods; Monitor; Morbidity - disease rate; Motor; Motor Cortex; Movement; Names; Neurosurgeon; Neurosurgical Procedures; Numbers; Operating Rooms; Operative Surgical Procedures; Outcome; Patients; Physiologic pulse; Postoperative Period; Procedures; Production; Pulse taking; Range; Research; Risk; San Francisco; Seizures; Series; Short-Term Memory; Site; Speech; Standards of Weights and Measures; Stimulus; Superior temporal gyrus; Surgeon; Techniques; Theta Rhythm; Time; Tissues; Universities; awake; base; cognitive function; deviant; improved; indexing; language processing; neurosurgery; novel; response; tool; tumor

DESCRIPTION (provided by applicant): Neurosurgical patients who need a brain tumor, epileptic region or other structural lesion removed that might be near language cortex require an invasive 45 min procedure (intra-operative electrical stimulation mapping; ESM) to map language and motor function and guide the neurosurgeon's operative approach. The information gained from ESM is critical to spare language areas and has been shown to improve post-operative morbidity. The methods used in this mapping procedure have remained unchanged for 60 years. The procedure requires passing current into the patient's brain to temporarily disrupt function and is associated with problems such as seizure induction during surgery. Further, the procedure typically takes 45 minutes, is not well tolerated in many patients and must be aborted in up to 25% of cases. Hence, a new method to map language is needed. The goal of this proposal is to assess whether high gamma activity (70-250 Hz) in the human electrocorticogram (ECoG) can be used to accurately and rapidly track critical language cortex in the operating room. It is hypothesized that high gamma activity, a likely index of cortical activation, can aid surgeons identify critical language areas and potentially replace classic intra-operative ESM eliminating the risks associated with this procedure and shortening the surgical time. In order to investigate this issue, two studies will be conducted. First, we will record ECoG in the awake neurosurgical patient in the operating room during the picture naming/number counting study traditionally employed by neurosurgeons. Second, we will perform a brief verb generation study in the OR in these same patients. It is predicted that during picture naming and number counting regions showing arrest during ESM will elicit high gamma activity. We further predict that the high gamma map of language obtained in the verb generation task will also correlate with the stimulation mapping results obtained during study one. If obtained the results would provide evidence that language mapping using ECoG and high gamma recording might provide a safer and faster alternative method to the traditional intra-operative ESM method resulting in reduced intra-operative morbidity and improved post-surgical outcome. Neurosurgeons need to identify critical language areas in the human brain to avoid causing a language problem when removing tumors and other brain abnormalities. The current method to accomplish this requires a 60 year old approach that has serious side-effects such as causing a seizure in the operating room. We propose to apply a novel method of brain electrical analysis to replace the traditional method employed. If successful the results would lead to safer and more effective neurosurgical procedures.

描述（由申请人提供）：需要脑肿瘤，癫痫区或其他结构性病变的神经外科患者，这些病变可能靠近语言皮质，需要进行45分钟的侵入性45分钟的程序（术中电气刺激图； ESM）才能映射语言和运动功能，并指导神经外科医生的手术手术。从ESM获得的信息对于备用语言领域至关重要，已被证明可以改善术后发病率。此映射程序中使用的方法一直保持不变60年。该过程需要将电流传递到患者的大脑中，以暂时破坏功能，并与手术期间癫痫发作等问题有关。此外，该程序通常需要45分钟，在许多患者中不可忍受，必须在多达25％的病例中流产。因此，需要一种新的映射语言方法。该提案的目的是评估人类电形图（ECOG）中的高γ活性（70-250 Hz）是否可用于准确，快速跟踪手术室中的关键语言皮层。假设高γ活性是皮质激活的可能指标，可以帮助外科医生确定关键的语言领域，并有可能替代经典的术中术中ESM，从而消除了与此过程相关的风险并缩短了手术时间。为了调查此问题，将进行两项研究。首先，在图片命名/数字计数研究中，我们将在手术室的清醒神经外科患者中记录ECOG。其次，我们将在这些同一患者中进行简短的动词生成研究。据预测，在图片命名和数量计数中显示ESM中被捕的区域将引起高伽马活动。我们进一步预测，在动词生成任务中获得的高伽马语图也将与研究中的刺激映射结果相关。如果获得的结果，结果将提供证据表明，使用ECOG和高伽马记录的语言映射可能会为传统的术中ESM方法提供更安全，更快的方法，从而减少术中发病率和改善的外部外部结果。神经外科医生需要识别人脑中的关键语言领域，以避免在去除肿瘤和其他脑部异常时引起语言问题。当前完成此操作的方法需要一种60年历史的方法，该方法具有严重的副作用，例如在手术室癫痫发作。我们建议采用一种新型的大脑电气分析方法来替代所采用的传统方法。如果成功，结果将导致更安全，更有效的神经外科手术。