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Epileptic Disorders

The Educational Journal of the International League Against Epilepsy

Lessons learned from a comparison of language localisation using fMRI and electrocortical mapping: case studies of neocortical epilepsy patients Volume 13, issue 4, December 2011

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Authors
Department of Neurology, Dongguk University International Hospital, Gooyang-shi, Kyeonggi-do, Korea, Department of Neurology, University of Cincinnati,, Cincinnati Epilepsy Center, University of Cincinnati,, Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
  • Key words: functional MRI (fMRI), electrocortical mapping (ECM), language, outcomes, epilepsy, surgery
  • DOI : 10.1684/epd.2011.0473
  • Page(s) : 368-74
  • Published in: 2011

Electrocortical mapping (ECM) is recognised as an established method for localisation of eloquent cortex in patients undergoing resective surgery for epilepsy management. Functional MRI (fMRI) has been utilised for language and other cortical function localisation. We describe language localisation in two patients using both ECM and fMRI. Co-registration of fMRI and ECM revealed that although two fMRI tasks localised multiple language areas, the verb generation task had an advantage over the semantic decision/tone decision task in that there was a clear overlap between the language areas identified by the verb generation task and ECM. In addition to the language areas detected by ECM, fMRI showed other language-related areas that may be important for post-operative language outcome. Therefore, fMRI may provide additional and complementary information to ECM in presurgical evaluation of patients with epilepsy. The correlation between fMRI and ECM may depend on the language testing methods utilised during the procedures.