Faculty Collaboration Database

The changing landscape of electrical stimulation language mapping with subdural electrodes and stereoelectroencephalography for pediatric epilepsy: A literature review and commentary. Epilepsia 2024 Jul;65(7):1879-1898

Date

05/24/2024

Pubmed ID

38787551

DOI

10.1111/epi.18009

Scopus ID

2-s2.0-85193956252 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

Electrical stimulation mapping (ESM) is used to locate the brain areas supporting language directly within the human cortex to minimize the risk of functional decline following epilepsy surgery. ESM is completed by utilizing subdural grid or depth electrodes (stereo-electroencephalography [sEEG]) in combination with behavioral evaluation of language. Despite technological advances, there is no standardized method of assessing language during pediatric ESM. To identify current clinical practices for pediatric ESM of language, we surveyed neuropsychologists in the Pediatric Epilepsy Research Consortium. Results indicated that sEEG is used for functional mapping at >80% of participating epilepsy surgery centers (n = 13/16) in the United States. However, >65% of sites did not report a standardized protocol to map language. Survey results indicated a clear need for practice recommendations regarding ESM of language. We then utilized PubMed/Medline and PsychInfo to identify 42 articles that reported on ESM of language, of which 18 met inclusion criteria, which included use of ESM/signal recording to localize language regions in children (<21 years) and a detailed account of the procedure and language measures used, and region-specific language localization outcomes. Articles were grouped based on the language domain assessed, language measures used, and the brain regions involved. Our review revealed the need for evidence-based clinical guidelines for pediatric language paradigms during ESM and a standardized language mapping protocol as well as standardized reporting of brain regions in research. Relevant limitations and future directions are discussed with a focus on considerations for pediatric language mapping.

Author List

Reecher HM, Bearden DJ, Koop JI, Berl MM, Patrick KE, Ailion AS

Authors

Jennifer I. Koop Olsta PhD Professor in the Neurology department at Medical College of Wisconsin
Hope M. Reecher BS, MD Postdoctoral Researcher in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Brain Mapping
Child
Electric Stimulation
Electrodes, Implanted
Electroencephalography
Epilepsy
Humans
Language
Stereotaxic Techniques
Subdural Space