Discrepant expressive language lateralization in children and adolescents with epilepsy.
Alisa PasichnikMelissa TsuboyamaAli JannatiClemente VegaHarper L KayeUgur DamarJeffrey BoltonScellig S D StoneJoseph R MadsenRalph O SuarezAlexander RotenbergPublished in: Annals of clinical and translational neurology (2022)
Neuronavigated transcranial magnetic stimulation (nTMS) has emerged as a presurgical language mapping tool distinct from the widely used functional magnetic resonance imaging (fMRI). We report fMRI and nTMS language-mapping results in 19 pediatric-epilepsy patients and compare those to definitive testing by electrical cortical stimulation, Wada test, and/or neuropsychological testing. Most discordant results occurred when fMRI found right-hemispheric language. In those cases, when nTMS showed left-hemispheric or bilateral language representation, left-hemispheric language was confirmed by definitive testing. Therefore, we propose nTMS should be considered for pediatric presurgical language-mapping when fMRI shows right-hemispheric language, with nTMS results superseding fMRI results in those scenarios.
Keyphrases
- resting state
- autism spectrum disorder
- functional connectivity
- magnetic resonance imaging
- transcranial magnetic stimulation
- high resolution
- end stage renal disease
- high frequency
- squamous cell carcinoma
- chronic kidney disease
- newly diagnosed
- climate change
- computed tomography
- radiation therapy
- peritoneal dialysis
- young adults
- case report
- patient reported outcomes
- rectal cancer
- patient reported