Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions

Tal Gonen, Tomer Gazit, Akiva Korn, Adi Kirschner, Daniella Perry, Talma Hendler, Zvi Ram*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intraoperative cortical mapping.

Original languageEnglish
Article numbere0180740
JournalPLoS ONE
Issue number7
StatePublished - Jul 2017


FundersFunder number
Seventh Framework Programme270460


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