title: Axono-cortical evoked potentials: A proof-of-concept study.
abstract: Awake surgery is currently considered the best method to tailor intraparenchymatous resections according to functional boundaries. However, the exact mechanisms by which electrical stimulation disturbs behavior remain largely unknown. In this case report, we describe a new method to explore the propagation toward cortical sites of a brief pulse applied to an eloquent white matter pathway. We present a patient, operated on in awake condition for removal of a cavernoma of the left ventral premotor cortex. At the end of the resection, the application of 60Hz stimulation in the white matter of the operculum induced anomia. Stimulating the same site at a frequency of 1Hz during 70seconds allowed to record responses on electrodes put over Broca's area and around the inferior part of central sulcus. Axono-cortical evoked potentials were then obtained by averaging unitary responses, time-locked to the stimulus. We then discuss the origin of these evoked axono-cortical potentials and the likely pathway connecting the stimulation site to the recorded cortical sites.
authors.affiliation: Department of Neurosurgery, Lariboisière Hospital, 75010 Paris, France; Université Paris Diderot Sorbonne Paris Cité, 75010 Paris, France; IMNC, UMR 8165, 91400 Orsay, France. Electronic address: emmanuel.mandonnet@aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Mandonnet
authors.affiliation: École Polytechnique, 91477 Palaiseau, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Dadoun
authors.affiliation: Department of Neurology, Lariboisière Hospital, 75010 Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Poisson
authors.affiliation: Department of Anesthesiology, Lariboisière Hospital, 75010 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Madadaki
authors.affiliation: Department of Neurosurgery, Lariboisière Hospital, 75010 Paris, France; Université Paris Diderot Sorbonne Paris Cité, 75010 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Froelich
authors.affiliation: Université Paris Diderot Sorbonne Paris Cité, 75010 Paris, France; Department of Neurophysiology, Lariboisière Hospital, 75010 Paris, France; Inserm U965, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Lozeron
mesh_terms: D000328:Adult; D000849:Anomia / Q000209:etiology*; D000927:Anticonvulsants / Q000627:therapeutic use; D001369:Axons / Q000502:physiology*; D065711:Broca Area / Q000503:physiopathology; D004568:Electrodiagnosis / Q000379:methods*; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000209:etiology; D005071:Evoked Potentials / Q000502:physiology*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D007807:Language Tests; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D015173:Supratentorial Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000601:surgery; D014851:Wakefulness / Q000502:physiology*; D066127:White Matter / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Axono-cortical evoked potentials; Brain mapping; Brain surgery; Cartographie cérébrale; Chirurgie cérébrale; Cortico-cortical evoked potentials; Electrical stimulation; Potentiels évoqués axono-corticaux; Potentiels évoqués cortico-corticaux; Stimulation électrique