Evidence map›Paper›PMID 41021378›Full record

ReviewBrain and behavior2025

Intraoperative Techniques for Language Mapping in Brain Surgery: A Comparison Between Direct Electrical Stimulation (DES) and Electrocorticography (ECoG).

Patricia Silva de Camargo, Giovanna de Oliveira Santos E Souza, Analía Arévalo, Guilherme Lepski

Abstract readReviewComparative Study
In one paragraph

Review in Brain and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Beyond Broca and Wernicke: Epilepsy surgery in the language areas.Epileptic disorders : international epilepsy journal with videotape · 2026
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Patricia Silva de CamargoInstitute of Biosciences, University of São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-0983-7811
Giovanna de Oliveira Santos E SouzaDepartments of Neurology and Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0009-0005-8520-0486
Analía ArévaloDepartment of Experimental Surgery, Medical School, University of São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-3793-8081
Guilherme LepskiDepartments of Neurology and Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-9030-4192

Funding

Fundação de Amparo à Pesquisa do Estado de São Paulo 2018/18900-1Fundação de Amparo à Pesquisa do Estado de São Paulo 2023/17520-9
6 · The paper itself

Abstract

purposeThe purpose of this overview is to compare Direct Electrical Stimulation (DES) and Electrocorticography (ECoG) techniques, assessing their respective strengths, limitations, and roles in ensuring successful language mapping during awake brain surgeries.

methodThis overview aims to compare two techniques used in intraoperative language mapping during awake brain surgery: Direct Electrical Stimulation (DES) and Electrocorticography (ECoG). By summarizing recent advances in both methods, we highlight their respective mechanisms, applications, and roles in improving surgical outcomes. DES is widely considered the gold standard for cortical brain mapping and is applicable in both awake and anesthetized surgeries for treating epilepsy and brain tumors. In contrast, ECoG involves monitoring the brain's electrical activity with or without direct stimulation, as it provides valuable insight into high gamma activity (70-150 Hz), which is strongly associated with speech production. FINDING: ECoG offers a high-resolution approach to language mapping by detecting high-gamma activity, reducing the risk of intraoperative seizures, and serving as a complementary or alternative tool to DES in specific clinical scenarios. While DES continues to be the most reliable technique for identifying functional brain areas, it does carry a higher risk of inducing seizures. Furthermore, recent advancements in ECoG-based speech decoding and brain-computer interfaces (BCIs) underscore the growing potential of ECoG in restoring communication in patients with severe language impairments, extending its applications beyond surgical mapping.

conclusionIn conclusion, while DES remains the gold standard for intraoperative language mapping, ECoG is emerging as a promising complementary or alternative technique in some clinical cases. This overview highlights the evolving role of ECoG, particularly in the context of speech decoding and BCIs, offering new possibilities for improving surgical outcomes and postoperative quality of life in patients.

Indexed as

BrainBrain MappingElectric StimulationElectrocorticographyIntraoperative Neurophysiological MonitoringLanguageHumansNeurosurgical Proceduresawake brain surgerybrain mappingdirect electrical stimulationelectrocorticographylanguage mapping

Identifiers

PMID41021378
PMCPMC12478441

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.