03481nas a2200289 4500008004100000022001400041245009200055210006900147260001200216300001000228490000700238520264000245653001802885653002002903653002002923653001502943653002502958653002702983653001103010653002703021100001803048700001903066700002003085700001903105700001903124856004803143 2010 eng d a1525-506900aPassive real-time identification of speech and motor cortex during an awake craniotomy.0 aPassive realtime identification of speech and motor cortex durin c05/2010 a123-80 v183 a

Precise localization of eloquent cortex is a clinical necessity prior to surgical resections adjacent to speech or motor cortex. In the intraoperative setting, this traditionally requires inducing temporary lesions by direct electrocortical stimulation (DECS). In an attempt to increase efficiency and potentially reduce the amount of necessary stimulation, we used a passive mapping procedure in the setting of an awake craniotomy for tumor in two patients resection. We recorded electrocorticographic (ECoG) signals from exposed cortex while patients performed simple cue-directed motor and speech tasks. SIGFRIED, a procedure for real-time event detection, was used to identify areas of cortical activation by detecting task-related modulations in the ECoG high gamma band. SIGFRIED's real-time output quickly localized motor and speech areas of cortex similar to those identified by DECS. In conclusion, real-time passive identification of cortical function using SIGFRIED may serve as a useful adjunct to cortical stimulation mapping in the intraoperative setting.

10aBrain Mapping10aBrain Neoplasms10aCerebral Cortex10aCraniotomy10aElectric Stimulation10aElectroencephalography10aHumans10aNeurologic Examination1 aRoland, Jarod1 aBrunner, Peter1 aJohnston, James1 aSchalk, Gerwin1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/20478745