Intraoperative mapping of expressive language cortex using passive real-time electrocorticography.

Area of Science:

• Neuroscience
• Neurosurgery
• Epileptology

Background:

• Brain tumors near eloquent cortex pose challenges for surgical resection.
• Accurate functional mapping is crucial to preserve language abilities.

Purpose of the Study:

• To evaluate the utility and practicality of intraoperative high-resolution electrocorticography (ECoG) for mapping expressive language cortex.
• To compare intraoperative ECoG findings with extraoperative mapping techniques.

Main Methods:

• Case report detailing a patient with a brain tumor near expressive language regions.
• Utilized intraoperative high-resolution ECoG, extraoperative ECoG with a subdural grid, electrical cortical stimulation (ECS), and functional magnetic resonance imaging (fMRI).

Main Results:

• Intraoperative high-resolution ECoG mapping is feasible and efficient, yielding results comparable to extraoperative methods.
• ECoG mapping demonstrated time efficiency and safety for functional language mapping.
• Integration of multiple mapping techniques enhanced confidence in functional localization.

Conclusions:

• Intraoperative high-resolution ECoG is a practical tool for functional language mapping during tumor resection.
• Combining various mapping modalities improves precision when pathology affects eloquent cortex.
• ECoG offers a safe and time-efficient alternative for intraoperative brain mapping.