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Related Experiment Video

Updated: Nov 15, 2025

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Intraoperative Brain Mapping by Cortico-Cortical Evoked Potential.

Yukihiro Yamao1, Riki Matsumoto2, Takayuki Kikuchi2

  • 1Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Frontiers in Human Neuroscience
|March 8, 2021
PubMed
Summary

Cortico-cortical evoked potentials (CCEPs) offer real-time mapping of brain networks during surgery. This electrophysiological method aids neurosurgeons in preserving brain function by monitoring large-scale cortical connectivity.

Keywords:
awake craniotomybrain functionbrain mappingcortico-cortical evoked potentialelectrical stimulationintraoperative monitoringlarge-scale cortical network

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Area of Science:

  • Neurosurgery
  • Electrophysiology
  • Neuroscience

Background:

  • Preserving postoperative brain function requires understanding brain structure, vasculature, and function.
  • Current methods like intraoperative electrical stimulation map focal functions but not large-scale networks in real-time.
  • Awake craniotomy with electrical stimulation is the gold standard for cortical and white matter mapping.

Purpose of the Study:

  • To evaluate the utility of cortico-cortical evoked potentials (CCEPs) for intraoperative mapping of large-scale brain networks.
  • To assess the potential of CCEPs in real-time monitoring of language pathways and frontal lobe networks.
  • To establish the clinical applicability of CCEP technique for preserving brain function under general anesthesia.

Main Methods:

  • An in vivo electrophysiological method using CCEPs induced by single-pulse electrical cortical stimulation was developed.
  • CCEP connectivity patterns were utilized intraoperatively for mapping and real-time monitoring.
  • The technique was applied to map language pathways (dorsal and ventral) and frontal lobe networks.

Main Results:

  • Intraoperative CCEP mapping enabled real-time monitoring of the dorsal language pathway.
  • The method successfully mapped the frontal aslant tract and connectivity within the frontal lobe motor network.
  • CCEPs demonstrated connectivity between frontal and temporal lobes via the ventral language pathway.

Conclusions:

  • Intraoperative CCEP mapping provides a valuable tool for real-time monitoring of large-scale cortical networks.
  • This electrophysiological technique aids neurosurgeons in preserving brain function, even under general anesthesia.
  • CCEPs show significant potential for clinical applications in brain mapping and network monitoring.