Kavli Affiliate: Edward Chang
| Authors: Vardhaan S Ambati, Amit S Persad, Jasleen Kaur, Sanjeev Herr, Emily Cunningham, Abraham Dada, Justyna O Ekert, Quinn Greicius, Alexander Silva, Paul McMillan Villalobos, Niels Olshausen, Youssef Sibih, Sena Oten, Hunter S. Yamada, Gray Umbach, Alexander A Aabedi, Wajd Al-Holou, Jacob Young, Madhumita Sushil, Edward F Chang, Mitchel S. Berger, David Brang and Shawn L Hervey-Jumper
| Summary:
Direct cortical stimulation (DCS) is the clinical gold standard for identifying functional cortex in the human brain, which is essential for the safe removal of brain lesions. Defining the electro-physiological properties of DCS− positive cortical regions may facilitate the identification of critical language regions, thereby permitting safe glioma resections in communities without access. Leveraging a multicenter electrophysiologic dataset of DCS− positive language regions spatially matched with subdural arrays, we analyzed regions identified as functionally critical (DCS+) versus functionally non-critical (DCS–) during intraoperative language mapping. In IDH-mutant gliomas, DCS+ regions exhibited significantly greater speech-related neural activity and enhanced encoding and decoding of linguistic and semantic features. We demonstrate that resting-state classifiers distinguish DCS+ from DCS– regions in IDH-mutant tumors. Task-based and resting-state electrophysiologic distinctions were pathology-specific and not present in IDH-wildtype glioblastomas. These findings may accelerate DCS mapping by guiding surgeons to priority regions, improving efficiency, and patient outcomes.