TY - JOUR
T1 - Intra-operative multi-site stimulation
T2 - Expanding methodology for cortical brain mapping of language functions
AU - Gonen, Tal
AU - Gazit, Tomer
AU - Korn, Akiva
AU - Kirschner, Adi
AU - Perry, Daniella
AU - Hendler, Talma
AU - Ram, Zvi
N1 - Publisher Copyright:
© 2017 Gonen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/7
Y1 - 2017/7
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85022327779&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0180740
DO - 10.1371/journal.pone.0180740
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C2 - 28700619
AN - SCOPUS:85022327779
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 7
M1 - e0180740
ER -