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Updated: May 7, 2026
Non-Invasive Modulation and Robotic Mapping of Motor Cortex in the Developing Brain
Published on: July 1, 2019
Safety and efficacy of motor mapping utilizing short pulse train direct cortical stimulation
Matthew C Tate1, Lanjun Guo, Jennifer McEvoy
1Department of Neurological Surgery, University of California, San Francisco, Calif., USA.
Background/Aims:
A major goal of intracranial surgery is to maximize resection while minimizing neurological morbidity, particularly motor dysfunction. Direct cortical stimulation (DCS) is a common intraoperative adjunct used to identify functional motor cortex. In this study, we report on the safety/efficacy of short pulse train DCS (direct cortical stimulation motor-evoked potential, dcMEP) for motor mapping and monitoring during intracranial surgery.
Methods:
A retrospective analysis of 29 patients undergoing elective craniotomy for lesions near the motor cortex was performed. dcMEP mapping (40-120 V, 500-1,000 Hz, 5-9 pulses/s, 1- to 3-ms interstimulus interval, monopolar, 50-μs pulse width) was performed either alone (n = 29) or in addition to standard DCS (n = 6). Outcome measures were positive MEPs and the presence of seizures during stimulation. dcMEP-based continuous corticospinal tract (CST) monitoring was also performed. Changes in stimulation threshold and new postoperative neurological deficits were recorded.
Results:
dcMEP mapping success was 96% and was not affected by preoperative motor status. Intraoperative seizure rates for dcMEP were 3% and were not related to preoperative seizure status. CST monitoring success rate was 96%, and changes in stimulation threshold were predictive of new permanent motor deficits.
Conclusions:
dcMEP is an effective method for mapping motor function and may prove useful for continuous CST monitoring.
