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Epilepsy Behav Case Rep. 2016 Mar 16;5:46-51. doi: 10.1016/j.ebcr.2016.03.003. eCollection 2016.

Intraoperative mapping of expressive language cortex using passive real-time electrocorticography.

Author information

1
Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
2
National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
3
National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Neurology, Albany Medical College, Albany, NY, USA.
4
Department of Psychology, Stanford University, Stanford, CA, USA.
5
Department of Neurology, Albany Medical College, Albany, NY, USA.
6
National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; Department of Neurology, Albany Medical College, Albany, NY, USA.

Abstract

In this case report, we investigated the utility and practicality of passive intraoperative functional mapping of expressive language cortex using high-resolution electrocorticography (ECoG). The patient presented here experienced new-onset seizures caused by a medium-grade tumor in very close proximity to expressive language regions. In preparation of tumor resection, the patient underwent multiple functional language mapping procedures. We examined the relationship of results obtained with intraoperative high-resolution ECoG, extraoperative ECoG utilizing a conventional subdural grid, extraoperative electrical cortical stimulation (ECS) mapping, and functional magnetic resonance imaging (fMRI). Our results demonstrate that intraoperative mapping using high-resolution ECoG is feasible and, within minutes, produces results that are qualitatively concordant to those achieved by extraoperative mapping modalities. They also suggest that functional language mapping of expressive language areas with ECoG may prove useful in many intraoperative conditions given its time efficiency and safety. Finally, they demonstrate that integration of results from multiple functional mapping techniques, both intraoperative and extraoperative, may serve to improve the confidence in or precision of functional localization when pathology encroaches upon eloquent language cortex.

KEYWORDS:

Electrical cortical stimulation; Electrocorticography; High-density grid; Intraoperative; Language mapping; fMRI

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