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Electrical Stimulation Mapping of the Brain: Basic Principles and Emerging Alternatives

Ritaccio, Anthony, L.*,†; Brunner, Peter*,†; Schalk, Gerwin*,†

Journal of Clinical Neurophysiology: March 2018 - Volume 35 - Issue 2 - p 86–97
doi: 10.1097/WNP.0000000000000440
Invited Review

Summary: The application of electrical stimulation mapping (ESM) of the brain for clinical use is approximating a century. Despite this long-standing history, the value of ESM for guiding surgical resections and sparing eloquent cortex is documented largely by small retrospective studies, and ESM protocols are largely inherited and lack standardization. Although models are imperfect and mechanisms are complex, the probabilistic causality of ESM has guaranteed its perpetuation into the 21st century. At present, electrical stimulation of cortical tissue is being revisited for network connectivity. In addition, noninvasive and passive mapping techniques are rapidly evolving to complement and potentially replace ESM in specific clinical situations. Lesional and epilepsy neurosurgery cases now offer different opportunities for multimodal functional assessments.

*Department of Neurology, Albany Medical College, Albany, New York, U.S.A.; and

National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, New York, U.S.A.

Address correspondence and reprint requests to Anthony L. Ritaccio, MD, Department of Neurology, Albany Medical College, 47 New Scotland Avenue, MC-70, Albany, NY 12208-3479, U.S.A.; e-mail:

The authors have no conflicts of interest to disclose.

Supported by the NIH (EB018783), the US Army Research Office (W911NF-14-1-0440), and Fondazione Neurone. The authors own intellectual property in ECoG-based functional mapping, and may derive licensing income related to it.

© 2018 by the American Clinical Neurophysiology Society