High-resolution cortical mapping within and across the central sulcus using 1024-electrode micro-electrocorticography...

Central sulcus identification using phase reversal on electrocorticography (ECoG) is a critical tool for neurosurgical intervention around the primary motor and somatosensory cortices. This mapping is typically performed using cortical arrays with a resolution of several millimeters.

A 30-year-old female underwent a right frontoparietal craniotomy for resection of a 4-cm contrast-enhancing lesion within the central sulcus. Central sulcus localization was performed using a standard ECoG array. High-resolution micro-ECoG (µECoG) arrays were then placed over the pre- and postcentral gyri, giving 2048-electrode recordings across the central sulcus. Combining this high-resolution µECoG with an augmented reality imaging overlay to identify the tumor, the central sulcus was split, revealing the underlying tumor. A safe, gross-total resection was obtained with no postoperative complications. Through the use of µECoG arrays spanning into the central sulcus, a high-resolution phase-reversal contour was identified across the central sulcus.

The authors demonstrate the feasibility and utility of µECoG for sensorimotor mapping within the central sulcus, revealing a phase reversal at a resolution of approximately 400 microns. Compared to standard mapping, which records gyral surface electrophysiology, they further demonstrate phase-reversal electrophysiology within a dissected central sulcus. High-resolution cortical mapping from µECoG may foster several neurosurgical advancements, from tumor resection to brain-computer interfaces. https://thejns.org/doi/10.3171/CASE25534.