Evidence map›Paper›PMID 28220524›Full record

ArticleAnnals of neurology2017

Language functional MRI and direct cortical stimulation in epilepsy preoperative planning.

Alison Austermuehle, John Cocjin, Richard Reynolds, Shubhi Agrawal, Leigh Sepeta, William D Gaillard, Kareem A Zaghloul, Sara Inati, William H Theodore

Abstract readComparative Study
In one paragraph

Article in Annals of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  5. A Rapid fMRI Paradigm for Localisation of the Language Network.The European journal of neuroscience · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Alison AustermuehleClinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
John CocjinSurgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
Richard ReynoldsScientific and Statistical Computing Core, National Institute of Mental Health, Bethesda, MD.
Shubhi AgrawalClinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
Leigh SepetaClinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
William D GaillardClinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
Kareem A ZaghloulSurgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
Sara InatiElectroencephalography Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.
William H TheodoreClinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD.

Funding

Investigating the neural mechanisms of human cognitive function through intracranial recordingsZIANS003144 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI ZAGHLOUL, KAREEM · 2014 to 2025
$36.1M
Scientific and Statistical Computing CoreZICMH002888 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI TAYLOR, PAUL · 2009 to 2025
$30.9M
Physiologic And Pharmacologic Studies In EpilepsyZIANS002236 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI THEODORE, WILLIAM · 2009 to 2020
$14.2M
PHYSIOLOGIC AND PHARMACOLOGIC STUDIES IN EPILEPSYZ01NS002236 · NINDS · NEUROLOGICAL DISORDERS AND STROKE · PI THEODORE, WILLIAM H · 1985 to 2008
$1.1M
Intramural NIH HHS Z01 NS002236
6 · The paper itself

Abstract

objectivePresurgical language assessment can help minimize damage to eloquent cortex during resective epilepsy surgery. Two methods for presurgical language mapping are functional MRI (fMRI) and direct cortical stimulation (DCS) of implanted subdural electrodes. We compared fMRI results to DCS to help optimize noninvasive language localization and assess its validity.

methodsWe studied 19 patients referred for presurgical evaluation of drug-resistant epilepsy. Patients completed four language tasks during preoperative fMRI. After subdural electrode implantation, we used DCS to localize language areas. For each stimulation site, we determined whether language positive electrode pairs intersected with significant fMRI activity clusters for language tasks.

resultsSensitivity and specificity depended on electrode region of interest radii and statistical thresholding. For patients with at least one language positive stimulation site, an auditory description decision task provided the best trade-off between sensitivity and specificity. For patients with no language positive stimulation sites, fMRI was a dependable method of excluding eloquent language processing.

interpretationLanguage fMRI is an effective tool for determining language lateralization before electrode implantation and is especially useful for excluding unexpected critical language areas. It can help guide subdural electrode implantation and narrow the search for eloquent cortical areas by DCS. Ann Neurol 2017;81:526-537.

Indexed as

LanguageAdultBrain MappingCerebral CortexDrug Resistant EpilepsyElectric StimulationElectrodes, ImplantedFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPreoperative CareSensitivity and SpecificityYoung Adult

Identifiers

PMID28220524
PMCPMC5401636

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.