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Concept
Cortical stimulation mapping
Summary
Cortical stimulation mapping (CSM) is a type of electrocorticography that involves a physically invasive procedure and aims to localize the function of specific brain regions through direct electrical stimulation of the cerebral cortex. It remains one of the earliest methods of analyzing the brain and has allowed researchers to study the relationship between cortical structure and systemic function. Cortical stimulation mapping is used for a number of clinical and therapeutic applications, and remains the preferred method for the pre-surgical mapping of the motor cortex and language areas to prevent unnecessary functional damage. There are also some clinical applications for cortical stimulation mapping, such as the treatment of epilepsy.
The history of cortical stimulation mapping dates back to the late 19th century. Neurologist David Ferrier and neurosurgeon Victor Horsley were some of the first to utilize this technique. Ferrier and Horsley employed CSM to further grasp the structure and function of the pre-Rolandic and post-Rolandic areas, also known as the pre central gyrus and post central gyrus. Prior to the development of more advanced methods, in 1888 C.B. Nancrede utilized a battery operated bipolar probe in order to map the motor cortex. In 1937, Wilder Penfield and Boldrey were able to show that stimulating the precentral gyrus elicited a response contralaterally; a significant finding given that it correlated to the anatomy based on which part of the brain was stimulated. In the early 1900s Charles Sherrington began to use monopolar stimulation in order to elicit a motor response. This technique allowed Sherrington to determine that the precentral gyrus (pre-Rolandic area) is a motor cortex and the postcentral gyrus (post-Rolandic area) is a sensory cortex. These findings, which were repeated by Harvey Cushing through the early 1900s, show that the Rolandic fissure is the point of separation between the motor and sensory cortices.
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