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Brain Mapping to Protect Language during Surgery

Language mapping is often used to protect language functions during surgery for temporal lobe epilepsy or brain tumors.

Language mapping is done during surgery while the patient is awake and interactive.  This is possible because the brain itself does not have pain receptors.

The patient is shown sequential pictures of common objects, while a region of the brain is electrically stimulated in one centimeter increments.

When the patient cannot successfully name objects during stimulation of a particular part of the brain, that brain area is concluded to be important for visual object naming.

The widely held belief is that visual object naming is primarily a function of the lateral [outermost] temporal lobe.

Recent work published in the Annals of Neurology by Marla Hamberger, Ph.D, neuropsychologist at the Columbia Comprehensive Epilepsy Center, in collaboration with Robert R. Goodman, M.D., Ph.D and Guy M. McKhann, M.D., from the adult Epilepsy Center challenges this premise.

Their work shows that the hippocampus, a mesial [deeper] temporal lobe structure known to be critical for short term memory function, is also important for the visual object naming function.

The authors espouse that patients with an intact hippocampus on their language dominant side are at risk of visual naming decline following removal of the hippocampus.

According to Dr. McKhann, “This work needs to be confirmed across a larger patient population with a variety of pathologies.  These results will significantly alter how we counsel patients preoperatively; may impact how certain surgeries are performed; and will lead to new strategies to identify at risk functions in temporal lobe epilepsy patients to make surgery as safe and effective as possible.”

Watch this short video on the TODAY Show to see Dr. McKhann and brain mapping in action.

To learn more you can also read this research paper; Does Cortical Mapping Protect Naming if Surgery Includes Hippocampal Resection? in the Annals of Neurology 2010;67:345-352

The authors of this paper are Marla J. Hamberger, PhD, William T. Seidel, PhD, Robert R. Goodman, MD, PhD, and Guy M. McKhann II, MD.

patient journey

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