Lesion-Behavior Awake Mapping with Direct Cortical and Subcortical Stimulation

Abstract

AbstractElectrical stimulation during awake brain surgery is a classic method yielding direct information about brain-behavior relationships. This technique has provided key leaps in our understanding of the organization of the brain, including the discovery of the somatotopic organization of the primary sensory and motor cortices by Wilder Penfield and his colleagues in the 1950s or the previously unsuspected degree of inter-individual variability in the cortical representations of speech and language functions by George Ojemann and colleagues. The electrical stimulation technique, combined with an array of advanced neuroimaging methods, has expanded allowing us to test not only cortical functions but also the role of underlying white matter tracts in behavior. In this chapter, we will describe the method, its evolution, and the novel types of discoveries enabled by direct cortical and subcortical electrical stimulation of the human brain.Key wordsDirect electrical stimulationAwake brain surgeryInter-individual variabilityNeuroplasticityCortical mapping Subcortical mapping