Optimal surgical resection for the treatment of drug-resistant epilepsy and many brain tumors relies on balancing the competing interests of maximal removal of pathological tissue with preservation of eloquent cortex and the functions it subserves. To this end, electrocortical stimulation mapping (ESM) remains the gold standard for defining the functional role of cortical anatomy and inferring the associated risk for postoperative neurologic deficit. ESM is a cumbersome, time-consuming technique often limited not only by the patient’s attentional capacity but also by the risk for stimulation-induced afterdischarge and seizure activity. In contrast to ESM, electrocorticographic mapping of task-related functional activation does not require the use of electric stimulation and may thus provide a safer alternative. Additionally, because functional activation mapping can investigate all electrode locations simultaneously, it may offer substantial reductions in the time required to perform cortical mapping compared with the serial approach of ESM.
Full text is available to all readers.