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[Broca's area intraoperative mapping with cortico-cortical evoked potentials]. 2020

A E Bykanov, and D I Pitskhelauri, and O Yu Titov, and Ming-Chin Lin, and E V Gulaev, and A A Ogurtsova, and S A Maryashev, and V Yu Zhukov, and S B Buklina, and A Yu Lubnin, and Sh T Beshplav, and T A Konakova, and I N Pronin
Burdenko Neurosurgical Center, Moscow, Russia.

OBJECTIVE Mapping of effective speech connections between the frontal and temporal lobes with cortico-cortical evoked potentials. METHODS There were 3 patients with brain tumors in the left frontoparietal region. The neoplasms were localized in the dominant hemisphere near cortical speech centers and pathways. Cortico-cortical evoked potentials were intraoperatively recorded in response to bipolar stimulation with a direct current delivered through the subdural electrodes (single rectangular biphasic impulses with duration of 300 μs and frequency of 1 Hz). Stimulation intensity was gradually increased from 2 mA within 3-4 mA. Registration was carried out by averaging ECoG (30-50 stimuli in each session) in the 300-ms epoch after stimulus. Direct cortical stimulation was used to validate the results of cortico-cortical speech mapping with cortico-cortical evoked potentials. RESULTS In our cases, we obtained cortico-cortical evoked potentials from inferior frontal gyrus after stimulation of superior temporal gyrus. In one case, this effective relationship was unidirectional, in the other two patients reciprocal. Mean latency of N1 peak was 65 ms (range 49.6-90 ms), mean amplitude 71 µV (range 50-100 µV). Cortico-cortical mapping data were confirmed by detection of Broca's area in 2 out of 3 cases out during direct cortical stimulation with maximum amplitude of N1 wave. «Awake craniotomy» protocol was applied. In one case, Broca's area was not detected during direct stimulation. No postoperative speech impairment was noted. CONCLUSIONS Initial results of cortical mapping with cortico-cortical evoked potentials in a small sample confirmed its practical significance for analysis of cortical projections of effective speech communications between the frontal and temporal lobes. Further study of this method in large samples is required.

UI MeSH Term Description Entries
D001931 Brain Mapping Imaging techniques used to colocalize sites of brain functions or physiological activity with brain structures. Brain Electrical Activity Mapping,Functional Cerebral Localization,Topographic Brain Mapping,Brain Mapping, Topographic,Functional Cerebral Localizations,Mapping, Brain,Mapping, Topographic Brain
D001932 Brain Neoplasms Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. Brain Cancer,Brain Metastases,Brain Tumors,Cancer of Brain,Malignant Primary Brain Tumors,Neoplasms, Intracranial,Benign Neoplasms, Brain,Brain Neoplasm, Primary,Brain Neoplasms, Benign,Brain Neoplasms, Malignant,Brain Neoplasms, Malignant, Primary,Brain Neoplasms, Primary Malignant,Brain Tumor, Primary,Brain Tumor, Recurrent,Cancer of the Brain,Intracranial Neoplasms,Malignant Neoplasms, Brain,Malignant Primary Brain Neoplasms,Neoplasms, Brain,Neoplasms, Brain, Benign,Neoplasms, Brain, Malignant,Neoplasms, Brain, Primary,Primary Brain Neoplasms,Primary Malignant Brain Neoplasms,Primary Malignant Brain Tumors,Benign Brain Neoplasm,Benign Brain Neoplasms,Benign Neoplasm, Brain,Brain Benign Neoplasm,Brain Benign Neoplasms,Brain Cancers,Brain Malignant Neoplasm,Brain Malignant Neoplasms,Brain Metastase,Brain Neoplasm,Brain Neoplasm, Benign,Brain Neoplasm, Malignant,Brain Neoplasms, Primary,Brain Tumor,Brain Tumors, Recurrent,Cancer, Brain,Intracranial Neoplasm,Malignant Brain Neoplasm,Malignant Brain Neoplasms,Malignant Neoplasm, Brain,Neoplasm, Brain,Neoplasm, Intracranial,Primary Brain Neoplasm,Primary Brain Tumor,Primary Brain Tumors,Recurrent Brain Tumor,Recurrent Brain Tumors,Tumor, Brain
D003399 Craniotomy Surgical incision into the cranium. Craniectomy,Craniectomies,Craniotomies
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D005071 Evoked Potentials Electrical responses recorded from nerve, muscle, SENSORY RECEPTOR, or area of the CENTRAL NERVOUS SYSTEM following stimulation. They range from less than a microvolt to several microvolts. The evoked potential can be auditory (EVOKED POTENTIALS, AUDITORY), somatosensory (EVOKED POTENTIALS, SOMATOSENSORY), visual (EVOKED POTENTIALS, VISUAL), or motor (EVOKED POTENTIALS, MOTOR), or other modalities that have been reported. Event Related Potential,Event-Related Potentials,Evoked Potential,N100 Evoked Potential,P50 Evoked Potential,N1 Wave,N100 Evoked Potentials,N2 Wave,N200 Evoked Potentials,N3 Wave,N300 Evoked Potentials,N4 Wave,N400 Evoked Potentials,P2 Wave,P200 Evoked Potentials,P50 Evoked Potentials,P50 Wave,P600 Evoked Potentials,Potentials, Event-Related,Event Related Potentials,Event-Related Potential,Evoked Potential, N100,Evoked Potential, N200,Evoked Potential, N300,Evoked Potential, N400,Evoked Potential, P200,Evoked Potential, P50,Evoked Potential, P600,Evoked Potentials, N100,Evoked Potentials, N200,Evoked Potentials, N300,Evoked Potentials, N400,Evoked Potentials, P200,Evoked Potentials, P50,Evoked Potentials, P600,N1 Waves,N2 Waves,N200 Evoked Potential,N3 Waves,N300 Evoked Potential,N4 Waves,N400 Evoked Potential,P2 Waves,P200 Evoked Potential,P50 Waves,P600 Evoked Potential,Potential, Event Related,Potential, Event-Related,Potential, Evoked,Potentials, Event Related,Potentials, Evoked,Potentials, N400 Evoked,Related Potential, Event,Related Potentials, Event,Wave, N1,Wave, N2,Wave, N3,Wave, N4,Wave, P2,Wave, P50,Waves, N1,Waves, N2,Waves, N3,Waves, N4,Waves, P2,Waves, P50
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013702 Temporal Lobe Lower lateral part of the cerebral hemisphere responsible for auditory, olfactory, and semantic processing. It is located inferior to the lateral fissure and anterior to the OCCIPITAL LOBE. Anterior Temporal Lobe,Brodmann Area 20,Brodmann Area 21,Brodmann Area 22,Brodmann Area 37,Brodmann Area 38,Brodmann Area 52,Brodmann's Area 20,Brodmann's Area 21,Brodmann's Area 22,Brodmann's Area 37,Brodmann's Area 38,Brodmann's Area 52,Inferior Temporal Gyrus,Middle Temporal Gyrus,Parainsular Area,Fusiform Gyrus,Gyrus Fusiformis,Gyrus Temporalis Superior,Inferior Horn of Lateral Ventricle,Inferior Horn of the Lateral Ventricle,Lateral Occipito-Temporal Gyrus,Lateral Occipitotemporal Gyrus,Occipitotemporal Gyrus,Planum Polare,Superior Temporal Gyrus,Temporal Cortex,Temporal Gyrus,Temporal Horn,Temporal Horn of the Lateral Ventricle,Temporal Operculum,Temporal Region,Temporal Sulcus,Anterior Temporal Lobes,Area 20, Brodmann,Area 20, Brodmann's,Area 21, Brodmann,Area 21, Brodmann's,Area 22, Brodmann,Area 22, Brodmann's,Area 37, Brodmann,Area 37, Brodmann's,Area 38, Brodmann,Area 38, Brodmann's,Area 52, Brodmann,Area 52, Brodmann's,Area, Parainsular,Areas, Parainsular,Brodmanns Area 20,Brodmanns Area 21,Brodmanns Area 22,Brodmanns Area 37,Brodmanns Area 38,Brodmanns Area 52,Cortex, Temporal,Gyrus, Fusiform,Gyrus, Inferior Temporal,Gyrus, Lateral Occipito-Temporal,Gyrus, Lateral Occipitotemporal,Gyrus, Middle Temporal,Gyrus, Occipitotemporal,Gyrus, Superior Temporal,Gyrus, Temporal,Horn, Temporal,Lateral Occipito Temporal Gyrus,Lobe, Anterior Temporal,Lobe, Temporal,Occipito-Temporal Gyrus, Lateral,Occipitotemporal Gyrus, Lateral,Operculum, Temporal,Parainsular Areas,Region, Temporal,Sulcus, Temporal,Temporal Cortices,Temporal Gyrus, Inferior,Temporal Gyrus, Middle,Temporal Gyrus, Superior,Temporal Horns,Temporal Lobe, Anterior,Temporal Lobes,Temporal Lobes, Anterior,Temporal Regions
D065711 Broca Area Functional neuroanatomical region of the inferior frontal gyrus consisting of pars opercularis and pars triangularis. It is important in SPEECH and LANGUAGE production. Injuries to Broca area are associated with BROCA APHASIA and APRAXIA. Brodmann Area 44,Brodmann Area 45,Brodmann's Area 44,Brodmann's Area 45,Broca's Area,Broca's Region,Broca's Speech Area,Pars Opercularis,Pars Triangularis,Area 44, Brodmann,Area 44, Brodmann's,Area 45, Brodmann,Area 45, Brodmann's,Area, Broca,Area, Broca's,Area, Broca's Speech,Broca Region,Broca Speech Area,Brocas Area,Brocas Region,Brocas Speech Area,Brodmanns Area 44,Brodmanns Area 45,Operculari, Pars,Opercularis, Pars,Pars Operculari,Region, Broca's,Speech Area, Broca's,Triangularis, Pars

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