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A direct comparison of PET activation and electrocortical stimulation mapping for language localization
S Y Bookheimer1, T A Zeffiro, T Blaxton
1Epilepsy Research Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Neurology
|April 1, 1997
Summary
Positron emission tomography (PET) accurately maps language cortex in epilepsy patients, offering a less invasive alternative to direct cortical stimulation for presurgical planning.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Presurgical language cortex mapping is crucial for epilepsy surgery.
- Direct cortical stimulation (DCS) is invasive and can be challenging.
- Noninvasive functional imaging methods require validation against established techniques.
Purpose of the Study:
- To validate functional imaging using positron emission tomography (PET) for language cortex mapping.
- To compare PET activation mapping with direct cortical stimulation (DCS) in presurgical epilepsy patients.
Main Methods:
- Seven epilepsy patients underwent both DCS and PET language activation mapping.
- Identical language tasks were used for both stimulation and PET.
- MRI, PET, and CT scans were coregistered for precise anatomical comparison.
Main Results:
- PET activation showed increased cerebral blood flow in regions homologous to DCS-identified language areas.
- Regions where DCS did not disrupt language showed no significant PET activation.
- PET mapping demonstrated similar language localization to DCS with greater brain coverage.
Conclusions:
- PET activation mapping is a valid, noninvasive method for localizing language cortex.
- PET offers a less invasive alternative to DCS for presurgical planning in epilepsy.
- This technique provides comprehensive language area mapping with reduced patient invasiveness.