Cortico-cortical evoked potential and language mapping: A meta-analysis.

Area of Science:

• Neuroscience
• Neurosurgery
• Clinical Neurology

Background:

• Accurate language mapping is crucial for neurosurgical planning to minimize post-operative deficits.
• Cortico-cortical evoked potentials (CCEPs) offer a potential method for real-time intraoperative language mapping.

Purpose of the Study:

• To synthesize the existing evidence on the efficacy of CCEPs for language mapping.
• To evaluate the predictive value of CCEPs for post-surgical language outcomes.

Main Methods:

• A meta-analysis was conducted, searching multiple electronic databases (PubMed, Medline, Scopus, etc.).
• Included studies reported CCEP data, resection details, and post-resection language outcomes in patients undergoing language mapping.
• Studies with >5 patients, in English or Spanish, were included; reviews and case series <5 patients were excluded.

Main Results:

• Seven studies comprising 59 patients were analyzed.
• The presence of CCEPs in Broca's area or the posterior perisylvian region during resection predicted post-operative language deficits.
• Diagnostic odds ratios indicated a high likelihood of language deficits if these areas were resected, with improved negative predictive value over time.

Conclusions:

• CCEPs are a valuable tool for predicting the probability of long-term language deficits following neurosurgery.
• This evidence supports the intraoperative use of CCEPs to guide surgical decisions and improve patient outcomes.