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Will Lyon, Tej I. Mehta, Kelli B. Pointer, Daniel Walden, Ardem Elmayan, Kyle I. Swanson, and John S. Kuo

Hopkins, Wilder Penfield was also seeking insights into cortical localization. Penfield focused on human neuroanatomy and made significant contributions to neuroscience—notably creating the somatosensory “homunculus,” a visual representation of the cortex distribution devoted to the body's sensory reception. 10 The study establishing the homunculus was published 1 year after Woolsey's chimpanzee brain mapping experiments began, although Woolsey's findings would not be published for another decade. 5 To qualitatively keep track of his data, Woolsey produced the ape

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Nader Pouratian, Sameer Sheth, Susan Y. Bookheimer, Neil A. Martin, and Arthur W. Toga

Dr. Pouratian received support from the Medical Scientist Training Program (no. GM08042). Additional support provided by research grants to Drs. Bookheimer (nos. NCRR RR12169) and Toga (NIMH MH/NS52083 and RR00865). Support has also been provided by The Brain Mapping Medical Research Organization, Brain Mapping Support Foundation, Pierson-Lovelace Foundation, The Ahmanson Foundation, Tamkin Foundation, Jennifer Jones-Simon Foundation, Capital Group Companies Charitable Foundation, Rob-son Family, and the Northstar Fund.

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H. Charles Manning, Sheila D. Shay, and Robert A. Mericle

B rain mapping strategies aim to localize the presence or absence of neurological function to specific regions of the human brain. 6 , 12 Today, a diversity of sophisticated brain mapping strategies exists, including electrophysiological methods as well as imaging-based techniques such as functional MR imaging. 3 , 4 , 13 , 14 , 16 , 18 Within the context of clinical neurosurgery, the utility of brain mapping is to determine the presence or absence of neurological function adjacent to a targeted resection area prior to removing any tissue. There is

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Franck-Emmanuel Roux, Imène Djidjeli, Romain Quéhan, Emilie Réhault, Carlo Giussani, and Jean-Baptiste Durand

E lectrostimulation for brain mapping in awake patients has been used in neurosurgery for more than a century, and its protocols were largely established by Penfield and Roberts and Ojemann et al. 15 , 18 Despite a large body of clinical articles published over decades, the practice of this technique relies mainly on empirical data. Moreover, articles discussing its electrophysiological and theoretical basis are sparse. 9 , 13 , 19 , 20 , 29 , 32 In a previous paper on brain mapping, we analyzed variations in electrostimulation responses due to variations in

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Elisabeth Le Rumeur, Michèle Allard, Eric Poiseau, and Pierre Jannin

imaging. 1, 16 One of the crucial limitations encountered in fMR imaging—based brain mapping is the inability to localize with high reliability the cortical area involved in the sensory task. The difficulty in interpreting an fMR imaging signal stems from the fact that although the hemodynamic response originates primarily in the microvasculature of the activated cortical area, the signal is continuously transported into the venous network. 3, 8, 14 It seems obvious that signals from the microvasculature are highly specific to activated areas, whereas BOLD contrast

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Miran Skrap, Dario Marin, Tamara Ius, Franco Fabbro, and Barbara Tomasino

of 90% (range 49%–100%), whereas patients in the present study had a mean EOR of 95% (range 73%–100%). Discussion Mapping and Functions Maximal resection is currently the first therapeutic option for LGGs to prolong overall survival. 19 , 24 , 34 , 36 , 38 , 39 Given the ability of LGGs to infiltrate eloquent cortical areas and subcortical functional pathways, 19 , 23 brain mapping techniques and awake surgery have become mandatory in dealing with such lesions. 3 , 9 , 10 , 19 , 20 , 35 In contrast to the situation for cortical DES, only a few studies

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Jose L. Sanmillan, Alejandro Fernández-Coello, Isabel Fernández-Conejero, Gerard Plans, and Andreu Gabarrós

eloquent area, can be essential for neurological function and is often disrupted even during the resection of extraaxial tumors. We argue that neurological outcome could be improved after surgical treatment of brain metastases in eloquent areas by using a planned intraoperative functional approach for those tumors. Indeed, intraoperative brain mapping techniques have been demonstrated to be useful for the resection of intrinsic lesions. In a recent meta-analysis, the use of intraoperative stimulation brain mapping was associated with fewer late severe neurological

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Michael D. Taylor and Mark Bernstein

T he standard surgical approach for removal of a supratentorial intraaxial tumor is craniotomy performed with the patient in the state of general anesthesia. In the past, awake craniotomy was usually reserved for epilepsy surgery and removal of lesions (tumors and arteriovenous malformations) from areas of eloquent cortex. Awake craniotomy was deemed necessary in these instances to allow the opportunity for brain mapping. We show that awake craniotomy is a useful technique for a variety of tumor locations, tumor histological characteristics, and patient

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Robert A. Mericle, Erich O. Richter, Eric Eskioglu, Courtney Watkins, Laszlo Prokai, Christopher Batich, and Swadeshmukul Santra

B rain mapping is the attempt to specify in as much detail as possible the localization of function in the human brain. 58 Many brain mapping techniques exist, all of which have strengths and weaknesses, and these procedures are useful for specific aspects of research in cognitive neuroscience. The primary use of brain mapping in clinical neurosurgery is the determination of the presence or absence of function in a potential site of resection. Currently existing brain mapping techniques do not allow direct, real-time intraoperative visualization of

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Allen M. Kaplan, Daniel J. Bandy, Kim H. Manwaring, Kewei Chen, Michael A. Lawson, S. David Moss, Johnny D. Duncan, David L. Wodrich, James A. Schnur, and Eric M. Reiman

T he localization or mapping of cortical functions by noninvasive techniques is rapidly becoming a useful tool in the preoperative assessment of neurosurgical procedures for epilepsy, vascular malformations, and brain tumor resections. 3, 6, 9, 13, 15 Functional brain mapping using positron emission tomography (PET) to measure regional cerebral blood flow (rCBF) has characterized regions of the central nervous system involved in visual, sensory, motor, auditory, memory, attention, and language functions. 7, 8, 16, 17, 20, 21 Although used in adult patients