Intraoperative Techniques for Language Mapping in Brain Surgery: A Comparison Between Direct Electrical Stimulation...

Area of Science:

• Neuroscience
• Neurosurgery
• Speech Science

Background:

• Intraoperative language mapping is crucial for successful brain surgery.
• Direct Electrical Stimulation (DES) is the established gold standard for cortical brain mapping.
• Electrocorticography (ECoG) monitors brain activity, offering insights into speech production.

Purpose of the Study:

• To compare Direct Electrical Stimulation (DES) and Electrocorticography (ECoG) for language mapping.
• To assess the strengths, limitations, and roles of DES and ECoG in awake brain surgery.
• To highlight advancements and evolving applications of these neurosurgical techniques.

Main Methods:

• Comparative overview of Direct Electrical Stimulation (DES) and Electrocorticography (ECoG).
• Summarization of recent advances in mechanisms and applications of both techniques.
• Analysis of their roles in improving surgical outcomes for language mapping.

Main Results:

• ECoG provides high-resolution language mapping via high-gamma activity detection, reducing seizure risk.
• DES remains reliable but carries a higher risk of intraoperative seizures.
• ECoG advancements show potential in speech decoding and brain-computer interfaces (BCIs) for communication restoration.

Conclusions:

• While DES is the gold standard, ECoG is a promising complementary or alternative technique for language mapping.
• ECoG's role is expanding into speech decoding and BCIs, enhancing surgical outcomes.
• These techniques offer improved quality of life for patients undergoing brain surgery.