My Editor’s Choice

Professor Ulf Ziemann,Editor-in-Chief, Clinical Neurophysiology

Professor Ulf Ziemann
Editor-in-Chief, Clinical Neurophysiology

The Editor’s Choice—

Passive functional mapping of receptive language cortex during general anesthesia using electrocorticography

Clinical Neurophysiology Volume 147 (March 2023)

Nourmohammadi A, Swift JR, de Pesters A, Guay CS, Adamo MA, Dalfino JC, Ritaccio AL, Schalk G, Brunner P. Passive functional mapping of receptive language cortex during general anesthesia using electrocorticography. Clinical Neurophysiology 2023; 147: 31–44

Resective brain surgery is a standard surgical procedure for removing pathological brain tissue such as congenital structural abnormalities, vascular anomalies, tumors, or the seizure onset zone. The ultimate objectives in resective brain surgery are to maximally ablate the anomaly while preserving the integrity of brain function. For decades, the gold-standard technique to assess perilesional function has been electrocortical stimulation during awake craniotomy, a demanding procedure that requires full cooperation of the patient. In this volume of Clinical Neurophysiology, Nourmohammadi and colleagues use subdural electrocorticography (ECoG) grids to record cortical responses to speech stimuli during awake and anesthesia conditions in 20 patients with therapy refractory epilepsy or brain tumors. They found that ECoG broad-band gamma responses during general anesthesia effectively identify cortical regions associated with receptive language function, with an average sensitivity and specificity of respectively 49% and 100%. Findings demonstrate that passive mapping of receptive language cortex during general anesthesia is feasible. This approach may significantly expand the population of patients for intraoperative assessment of language cortex, circumventing the risks associated with electrocortical stimulation during awake craniotomy.

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