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Right Cortical and Axonal Structures Eliciting Ocular Deviation During Electrical Stimulation Mapping in Awake
Nicola Montemurro1, Guillaume Herbet2,3,4, Hugues Duffau5,6
1Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
Brain Topography
|April 13, 2016
Summary
Direct electrical stimulation (DES) in awake patients revealed distinct functional subregions within the frontal eye field (FEF) controlling eye movements. Subcortical mapping also identified white matter tracts crucial for ocular deviation.
Area of Science:
- Neuroscience
- Neurosurgery
- Ophthalmology
Background:
- Understanding the neural control of eye movements is crucial for neurosurgery.
- Intraoperative mapping aids in preserving critical brain functions during tumor resection.
Purpose of the Study:
- To investigate the cortical and subcortical neural networks controlling eye movements using direct electrical stimulation (DES).
- To map functional subregions within the frontal eye field (FEF) and associated white matter tracts.
Main Methods:
- Direct electrical stimulation (DES) performed on six awake patients undergoing surgery for right frontal low-grade glioma.
- Correlation of ocular deviation responses with anatomical locations of cortical and subcortical stimulation.
- Standard brain template used for visualization and comparison of stimulation sites.
Main Results:
- Cortical DES of the frontal eye field (FEF) elicited specific horizontal or upward eye movements, indicating functional subregions.
- Subcortical DES of white matter tracts beneath the FEF evoked conjugate contraversive ocular deviation.
- Stimulated subcortical regions represent a critical crossroads of major white matter tracts.
Conclusions:
- The frontal eye field (FEF) contains distinct functional subregions controlling different aspects of eye movements.
- Subcortical white matter tracts play a significant role in eye movement control.
- This study provides novel insights into the intricate neural pathways governing eye movements through intraoperative mapping.
