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Proposal of an optimized strategy for intraoperative testing of speech and language during awake mapping

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Abstract

In this paper, we review the literature about the definitions of errors observed by direct electrical stimulation during language testing. As a practical application, we propose an optimized strategy for differentiating accurately motor arrest, speech arrest, and anomia in the context of intraoperative mapping. Finally, we also discuss the anatomical correlates of the networks sustaining these different errors, both cortically and axonally.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Lariboisière Hospital, APHP, 2 rue Ambroise Paré, 75010, Paris, France

    Emmanuel Mandonnet

  2. University Paris 7, Paris, France

    Emmanuel Mandonnet

  3. IMNC UMR8165, Orsay, France

    Emmanuel Mandonnet

  4. Department of Neurosciences, Division of Neurosurgery, Structural and Functional Connectivity Lab Project, S. Chiara Hospital, Trento, Italy

    Silvio Sarubbo

  5. Department of Biomedical and Surgical Sciences, Section of Neurological Psychiatric and Psychological Sciences, S. Anna University-Hospital, Ferrara, Italy

    Silvio Sarubbo

  6. Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier Medical University Center, Montpellier, France

    Hugues Duffau

  7. Institute of Neuroscience of Montpellier, INSERM U1051, Montpellier, France

    Hugues Duffau

Authors
  1. Emmanuel Mandonnet
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  2. Silvio Sarubbo
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  3. Hugues Duffau
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Corresponding author

Correspondence to Emmanuel Mandonnet.

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Comments

Krasimir Minkin, Sofia, Bulgaria

The idea for clear definitions of the errors during DES in awake surgery seems logical taking in consideration the expansion of this procedure as gold standard for intraoperative brain mapping. However, many important methodological differences exist regarding other parameters: set of naming objects, stimulation parameters, and afterdischarges registration. Studies of cortico-cortical evoked potentials raised the question of what we really stimulate beyond some threshold—cortical area, subcortical bundle, or a large network? The paper of Mandonnet et al. has to be considered as an important step in the unification of DES methodology for intraoperative brain mapping.

Reference

1. Matsumoto R, Nair DR, LaPresto E, Najm I, Bingaman W, Shibasaki H, Lüders HO. Functional connectivity in the human language system: a cortico-cortical evoked potential study. Brain. 2004 Oct. 127(Pt 10):2316–30.

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Mandonnet, E., Sarubbo, S. & Duffau, H. Proposal of an optimized strategy for intraoperative testing of speech and language during awake mapping. Neurosurg Rev 40, 29–35 (2017). https://doi.org/10.1007/s10143-016-0723-x

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  • DOI: https://doi.org/10.1007/s10143-016-0723-x

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