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CortiQ-based Real-Time Functional Mapping for Epilepsy Surgery.

Christoph Kapeller1, Milena Korostenskaja, Robert Prueckl

  • 1*g.tec Medical Engineering GmbH, Graz, Austria; †Johannes Kepler University, Linz, Austria; ‡Milena's Functional Brain Mapping and Brain-Computer Interface Lab, Florida Hospital for Children, Orlando, Florida, U.S.A.; §MEG Lab, Florida Hospital for Children, Orlando, Florida, U.S.A.; ‖Comprehensive Pediatric Epilepsy Center, Florida Hospital for Children, Orlando, Florida, U.S.A.; ¶Division of Neuropsychology, Florida Hospital for Children, Orlando, Florida, U.S.A.; and #Department of Radiology, Florida Hospital, Orlando, Florida, U.S.A.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|March 12, 2015
PubMed
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This summary is machine-generated.

Real-time functional mapping (RTFM) using the cortiQ system accurately localizes brain functions like motor and sensory tasks. This method shows high concordance with electrical cortical stimulation mapping (ESM) and functional MRI (fMRI), offering potential for improved surgical guidance.

Area of Science:

  • Neuroscience
  • Medical Technology
  • Epilepsy Research

Background:

  • Intractable epilepsy necessitates precise localization of critical brain functions for surgical planning.
  • Electrical cortical stimulation mapping (ESM) and functional magnetic resonance imaging (fMRI) are standard but have limitations.
  • Real-time functional mapping (RTFM) offers a potential alternative or adjunct for intraoperative brain mapping.

Observation:

  • Electrocorticographic activity was recorded in three patients with intractable epilepsy using the cortiQ system.
  • High gamma band power (60-170 Hz) changes were analyzed in real-time to identify task-related activations.
  • The sensitivity and specificity of RTFM were evaluated against established ESM and fMRI results.

Findings:

  • RTFM demonstrated high sensitivity (100%) and good specificity (73.87-84.4%) for localizing hand motor and sensory functions compared to ESM and fMRI.

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  • RTFM successfully identified language areas, achieving 87% specificity against ESM and correlating with fMRI findings.
  • The 'next-neighbor' analysis showed strong concordance between RTFM and both ESM and fMRI.

    • Implications:

    • RTFM using the cortiQ system provides accurate, real-time brain mapping, potentially enhancing surgical navigation and planning.
    • This technique offers a more flexible alternative to ESM, with fewer limitations and broader applicability for activation paradigms.
    • RTFM can guide extraoperative ESM and improve localization, especially when ESM findings are negative or inconclusive.