Cognitive and Emotional Mapping With SEEG

Abstract

Mapping of cortical functions is critical for the best clinical care of patients undergoing epilepsy and tumor surgery, but also to better understand human brain function and connectivity. The purpose of this review is to explore existing and potential means of mapping higher cortical functions, including stimulation mapping, passive mapping, and connectivity analyses. We examine the history of mapping, differences between subdural and stereoelectroencephalographic approaches, and some risks and safety aspects, before examining different types of functional mapping. Much of this review explores the prospects for new mapping approaches to better understand other components of language, memory, spatial skills, executive, and socio-emotional functions. We also touch on brain-machine interfaces, philosophical aspects of aligning tasks to brain circuits, and the study of consciousness. We end by discussing multi-modal testing and virtual reality approaches to mapping higher cortical functions.

Multimodal approach leads to seizure-freedom in a case of highly refractory drug-resistant focal epilepsy

“…The “NeuroMapper” was used during intraoperative ESM [6] . It is an open-source, tablet-based cognitive testing application that can be used to administer a variety of cognitive paradigms while stimulation is applied to delineate eloquent cortex [16] . This tool allows for standardization of ESM, records accuracy and reaction time, and helped define the posterior resection border.…”

On seizure semiology

“…In fact, “interictal semiology” (eg, psychiatric 107,108 and cognitive 109 symptoms) could be an interesting line of study, the neural correlates of which may prove to be related to epilepsy organization 108 and even ictal semiology 107 . Mapping approaches using intracerebral data to study cortical correlates of cognition and emotion could also help to advance knowledge of the neural correlates of higher brain functions 110 …”

“…107 Mapping approaches using intracerebral data to study cortical correlates of cognition and emotion could also help to advance knowledge of the neural correlates of higher brain functions. 110 For future advances in semiological analysis, harnessing technological advances in quantifying semiology via video analysis seems of interest, 111 for example, facial expression 112 and body/limb movements. 91,113 These methods require expert supervision and/or specific technical capacities and are not yet widely used but may become more available if they prove effective.…”

Intra-operative mapping and language protection in glioma

“…SEEG is known to identify the cortical function in epilepsy surgery, but its reliability in other clinical situations is rarely documented. [62,63] It also has some limitations in terms of spatial resolution and lability. [64] Although DCS has some limitations, it should still be recommended for the delineation of the distribution of cortical functions in glioma treatments.…”