Multi-component intrinsic brain activities as a safe alternative to cortical stimulation for sensori-motor mapping in neurosurgery

• Published in: Clinical neurophysiology Vol. 129; no. 9; pp. 2038 - 2048
• Main Authors: Neshige, Shuichiro, Matsuhashi, Masao, Kobayashi, Katsuya, Sakurai, Takeyo, Shimotake, Akihiro, Hitomi, Takefumi, Kikuchi, Takayuki, Yoshida, Kazumichi, Kunieda, Takeharu, Matsumoto, Riki, Takahashi, Ryosuke, Miyamoto, Susumu, Maruyama, Hirofumi, Matsumoto, Masayasu, Ikeda, Akio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2018
• Subjects: Electrocorticography; Event-related de-synchronization; Event-related synchronization; Movement-related cortical potential; Primary motor area; Primary sensory area; Event-related de-synchronization; Primary motor area; Event-related synchronization; Movement-related cortical potential; Electrocorticography; Primary sensory area
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2018.06.007

•Wide-spectrum, intrinsic brain activities allow for non-stimulus functional brain mapping.•Multi-component mapping yielded significantly higher accuracy than single-component mapping.•Multi-component ECoG-based mapping may be a feasible alternative to cortical stimulation mapping. To assess the feasibility of multi-component electrocorticography (ECoG)-based mapping using “wide-spectrum, intrinsic-brain activities” for identifying the primary sensori-motor area (S1-M1). We evaluated 14 epilepsy patients with 1514 subdural electrodes implantation covering the perirolandic cortices at Kyoto University Hospital between 2011 and 2016. We performed multi-component, ECoG-based mapping (band-pass filter, 0.016–300/600 Hz) involving combined analyses of the single components: movement-related cortical potential (<0.5–1 Hz), event-related synchronization (76–200 Hz), and event-related de-synchronization (8–24 Hz) to identify the S1-M1. The feasibility of multi-component mapping was assessed through comparisons with single-component mapping and electrical cortical stimulation (ECS). Among 54 functional areas evaluation, ECoG-based maps showed significantly higher rate of localization concordances with ECS maps when the three single-component maps were consistent than when those were inconsistent with each other (p < 0.001 in motor, and p = 0.02 in sensory mappings). Multi-component mapping revealed high sensitivity (89–90%) and specificity (94–97%) as compared with ECS. Wide-spectrum, multi-component ECoG-based mapping is feasible, having high sensitivity/specificity relative to ECS. This safe (non-stimulus) mapping strategy, alternative to ECS, would allow clinicians to rule in/out the possibility of brain function prior to resection surgery.