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Study Design for Navigated Repetitive Transcranial Magnetic Stimulation for Speech Cortical Mapping
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A novel tablet computer platform for advanced language mapping during awake craniotomy procedures.

Melanie A Morrison1,2, Fred Tam1, Marco M Garavaglia3

  • 1Physical Sciences, Sunnybrook Research Institute, Toronto;

Journal of Neurosurgery
|October 17, 2015
PubMed
Summary

A new computerized platform improves intraoperative language mapping during awake craniotomy by standardizing behavioral tests. This system enhances the detection of language deficits and spatial agreement between brain mapping techniques.

Keywords:
DCES = direct cortical electrical stimulationDVR = digital video recorderIV = intravenousLCD = liquid crystal displaySOP = standard operating procedurebrain mappingbrain tumorfMRI = functional MRIfunctional neurosurgerygliomalanguagesurgerysurgical techniquetablet computing

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Area of Science:

  • Neurosurgery
  • Cognitive Neuroscience
  • Medical Technology

Background:

  • Intraoperative language mapping is crucial during awake craniotomy to preserve speech function.
  • Traditional behavioral testing methods can be limiting and lack standardization.
  • Preoperative functional MRI (fMRI) offers valuable insights but requires integration with intraoperative assessments.

Observation:

  • A novel computerized platform was developed for intraoperative behavioral testing.
  • The platform is compatible with operating room environments and preoperative fMRI.
  • It enables standardized language paradigms for improved brain mapping.

Findings:

  • The platform demonstrated efficacy in four case studies, improving language deficit detection.
  • A written word generation task identified speech apraxia and arrest missed by traditional methods.
  • Excellent spatial agreement was observed between intraoperative mapping and preoperative fMRI.

Implications:

  • This technology enhances surgical precision in identifying critical language areas.
  • It supports more comprehensive and ecologically valid language function assessment.
  • The platform facilitates better spatial correlation between functional MRI and intraoperative mapping.