Cortical Stimulation Mapping and Speech Production When Penfield and Roberts (1959)  published their seminal text, Speech and Brain Mechanisms, they introduced new insights into cortical organization. Whereas previous attempts to localize functions in the brain had relied on observations of deficits following cerebral injury, cortical stimulation would now provide greater accuracy in mapping brain functions. The ... Article
Article  |   October 01, 2003
Cortical Stimulation Mapping and Speech Production
Author Affiliations & Notes
  • Rima Abou-Khalil
    Neurology Department, Vanderbilt University, Nashville, TN
  • Bassel Abou-Khalil
    Neurology Department, Vanderbilt University, Nashville, TN
Article Information
Speech, Voice & Prosody / Articles
Article   |   October 01, 2003
Cortical Stimulation Mapping and Speech Production
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2003, Vol. 13, 10-15. doi:10.1044/nnsld13.3.10
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2003, Vol. 13, 10-15. doi:10.1044/nnsld13.3.10
When Penfield and Roberts (1959)  published their seminal text, Speech and Brain Mechanisms, they introduced new insights into cortical organization. Whereas previous attempts to localize functions in the brain had relied on observations of deficits following cerebral injury, cortical stimulation would now provide greater accuracy in mapping brain functions.
The work of Penfield and collaborators was based predominantly on patients undergoing surgical treatment of epilepsy. The goal of surgery for epilepsy continues to be the excision of epileptogenic tissue in its entirety without resection of normal tissue or tissue essential for speech, language, and memory. Some neurosurgeons have suggested using anatomical landmarks to spare language cortex with dominant hemisphere surgery, such as the superior temporal gyrus and beyond 4 cm from the temporal tip. There is, however, considerable variability in cortical organization across individuals, and resections in anatomically “safe” areas have been associated with post-operative aphasias (Ojemann, 1993). Thus, reliance on anatomical landmarks may put language at risk in some patients. The surest method to exclude speech and language cortex from resection is to methodically map the cortical area housing the epileptogenic focus.
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