Abstract
Objective To localize the functional language area based on high gamma activity recorded from electrocorticography for patients with refractory epilepsy. Methods Electrocorticographic signals were recorded during an auditory-language task for 8 patients with refractory epilepsy who underwent intracranial recording to localize the epileptogenic zone and language area from October 2012 to February 2014. The high gamma activities were analyzed with event-related synchronization and adaptive directed transfer function(ADTF). The results were compared to that of electoral cortical stimulation (ECS). Results The ADTF analysis for auditory-language task provided dynamic information about the connectivity pattern of cortical interaction. The temporal lobe produced the predominant event-related information outflow during listening period, and inferior frontal lobe produced the predominant event-related information outflow during answering period. A total of 111 cortical sites were identified as the predominant sites in the event-related information outflow according to the ADTF analysis, and 76 of the sites lied in frontal or central area, 35 lied in temporal area. Twenty-two cortical sites were identified as language related sites according to electric cortical stimulation in 7 of the 8 patients, and 19 sites lied in frontal area, 3 lied in temporal area. Excluding the number of one patient without electrodes covering temporal area, the positive numbers of ADTF analysis and ECS were 60 vs 17 in frontal area and 35 vs 3 in temporal area (χ2=3.563, P=0.059). The process of recording electrocorticographic signals for this method was quick and safe. Conclusion This method based on analysis of high gamma activity may be a useful complement to traditional electrocortical stimulation in the localization of language area for patients with refractory epilepsy. Key words: Epilepsy; Language; Cerebral cortex; Electroencephalography
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