• World Neurosurg · Nov 2018

    Location and Threshold of Electrical Cortical Stimulation for Functional Brain Mapping.

    • Aya Kanno, Rei Enatsu, Satoshi Ookawa, Satoko Ochi, and Nobuhiro Mikuni.
    • Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
    • World Neurosurg. 2018 Nov 1; 119: e125-e130.

    Background And ObjectiveAlthough many studies have investigated functional localization by electrical stimulation, the threshold to identify each area remains controversial. The present study aimed to elucidate the threshold of a cortical stimulation for functional mapping.MethodsWe analyzed data from 17 patients with medically intractable epilepsy who underwent a 50-Hz electrical cortical stimulation for functional mapping between October 2013 and May 2017. The symptoms induced by the stimulation and the thresholds of the stimulation for these responses were evaluated.ResultsMotor responses were observed after the stimulation of the primary motor cortex, supplementary motor area, and frontal eye field, and sensory responses after the stimulation of the primary and secondary sensory cortex. Regarding negative responses, language impairment was observed after the stimulation of the anterior, posterior, and basal temporal language areas, negative motor responses after the stimulation of the premotor cortex, posterior parietal cortex, and the pre- supplementary motor area, and an impairment in spatial recognition after the stimulation of the right posterior parietal cortex. Negative or positive auditory symptoms were observed with the stimulation of the posterior superior temporal gyrus. The thresholds for positive phenomena were significantly lower than those for negative phenomena (Mann-Whitney U test, P < 0.01), and sensory responses were induced at significantly lower intensities than motor responses (P < 0.01).ConclusionsPositive and sensory effects are induced by lower intensities than negative and motor responses, respectively. The present results provide not only a practical guide for functional mapping, but also a hierarchal concept of processing in the brain.Copyright © 2018 Elsevier Inc. All rights reserved.

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