Concordance Between Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging (MRI) Derived Localization of Language in a Clinical Cohort
| Autor: | Tamekia L. Jones, Shalini Narayana, James W. Wheless, Katherine Schiller, Christen Holder, Asim F. Choudhri |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent genetic structures medicine.medical_treatment Concordance Audiology behavioral disciplines and activities 050105 experimental psychology Lateralization of brain function Temporal lobe Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans 0501 psychology and cognitive sciences Epilepsy surgery Child Language Brain Mapping Epilepsy medicine.diagnostic_test Brain Neoplasms business.industry 05 social sciences Brain Magnetic Resonance Imaging Transcranial Magnetic Stimulation body regions Transcranial magnetic stimulation nervous system Frontal lobe Pediatrics Perinatology and Child Health Diagnostic odds ratio Female Neurology (clinical) Functional magnetic resonance imaging business psychological phenomena and processes 030217 neurology & neurosurgery |
| Zdroj: | Journal of Child Neurology. 35:363-379 |
| ISSN: | 1708-8283 0883-0738 |
| DOI: | 10.1177/0883073820901415 |
| Popis: | Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)–derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI–derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI–derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters. |
| Databáze: | OpenAIRE |
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