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Updated: Jun 27, 2026

Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function
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Cortical calculation localization using electrostimulation.

Franck-Emmanuel Roux1, Leila Boukhatem, Louisa Draper

  • 1Institut National de la Santé et de la Recherche Médicale Unité 825 and Institut Fédératif de Recherche 96, Hôpital Purpan, France. franck.roux@club-internet.fr

Journal of Neurosurgery
|December 3, 2008
PubMed
Summary
This summary is machine-generated.

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Brain mapping with calculation tasks during surgery helps spare calculation areas, preventing arithmetic difficulties. This is crucial for patients undergoing brain surgery, especially near the dominant parietal lobe.

Area of Science:

  • Neuroscience
  • Neurosurgery
  • Cognitive Science

Background:

  • Cortical areas involved in language are often spared during surgery using naming tasks.
  • The precise localization and function of calculation areas are less understood.
  • Brain surgery for lesions near calculation centers poses a risk of acquired anarithmetia (inability to perform calculations).

Purpose of the Study:

  • To investigate the use of a calculation task during intraoperative brain mapping to identify and spare cortical areas essential for calculation.
  • To analyze the organization of language and calculation areas in relation to surgical interventions.
  • To reduce the risk of postoperative calculation deficits in patients undergoing brain surgery.

Main Methods:

  • Prospective study of 20 patients with brain lesions near potential calculation areas (dominant parietal lobe and frontal area 2).

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Electrode Positioning and Montage in Transcranial Direct Current Stimulation
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  • Intraoperative electrostimulation mapping was performed during awake surgery.
  • Patients with preoperative acalculia symptoms were excluded from mapping.
  • Calculation performance was assessed during stimulation.

    • Main Results:

    • Electrostimulation identified small cortical areas (< 2 cm²) causing calculation interferences in 16 patients.
    • 53 calculation interferences were recorded, with 23 distinct from language areas, particularly in the inferior left parietal lobule.
    • Sparing calculation areas prevented postoperative arithmetic difficulties, while failure to spare them led to significant acalculia symptoms.
    • Improvements in acalculia were observed in patients with preoperative difficulties whose calculation areas were spared.

    Conclusions:

    • A calculation task during brain mapping is essential for sparing calculation-specific cortical areas.
    • This approach is particularly important when operating in the dominant parietal lobe to prevent acquired anarithmetia.
    • Intraoperative mapping of calculation functions can significantly mitigate risks associated with brain surgery in eloquent areas.