TY - JOUR
T1 - Right parietal cortex and calculation processing
T2 - Intraoperative functional mapping of multiplication and addition in patients affected by a brain tumor Clinical article
AU - Della Puppa, Alessandro
AU - De Pellegrin, Serena
AU - D'Avella, Elena
AU - Gioffrè, Giorgio
AU - Munari, Marina
AU - Saladini, Marina
AU - Salillas, Elena
AU - Scienza, Renato
AU - Semenza, Carlo
PY - 2013/11
Y1 - 2013/11
N2 - Object: The role of parietal areas in number processing is well known. The significance of intraoperative functional mapping of these areas has been only partially explored, however, and only a few discordant data are available in the surgical literature with regard to the right parietal lobe. The purpose of this study was to evaluate the clinical impact of simple calculation in cortical electrostimulation of right-handed patients affected by a right parietal brain tumor. Methods: Calculation mapping in awake surgery was performed in 3 right-handed patients affected by high-grade gliomas located in the right parietal lobe. Preoperatively, none of the patients presented with calculation deficits. In all 3 cases, after sensorimotor and language mapping, cortical and intraparietal sulcus areas involved in singledigit multiplication and addition calculations were mapped using bipolar electrostimulation. Results: In all patients, different sites of the right parietal cortex, mainly in the inferior lobule, were detected as being specifically related to calculation (multiplication or addition). In 2 patients the intraparietal sulcus was functionally specific for multiplication. No functional sites for language were detected. All sites functional for calculation were spared during tumor resection, which was complete in all cases without postoperative neurological deficits. Conclusions: These findings provide intraoperative data in support of an anatomofunctional organization for multiplication and addition within the right parietal area. Furthermore, the study shows the potential clinical relevance of intraoperative mapping of calculation in patients undergoing surgery in the right parietal area. Further and larger studies are needed to confirm these data and assess whether mapped areas are effectively essential for function.
AB - Object: The role of parietal areas in number processing is well known. The significance of intraoperative functional mapping of these areas has been only partially explored, however, and only a few discordant data are available in the surgical literature with regard to the right parietal lobe. The purpose of this study was to evaluate the clinical impact of simple calculation in cortical electrostimulation of right-handed patients affected by a right parietal brain tumor. Methods: Calculation mapping in awake surgery was performed in 3 right-handed patients affected by high-grade gliomas located in the right parietal lobe. Preoperatively, none of the patients presented with calculation deficits. In all 3 cases, after sensorimotor and language mapping, cortical and intraparietal sulcus areas involved in singledigit multiplication and addition calculations were mapped using bipolar electrostimulation. Results: In all patients, different sites of the right parietal cortex, mainly in the inferior lobule, were detected as being specifically related to calculation (multiplication or addition). In 2 patients the intraparietal sulcus was functionally specific for multiplication. No functional sites for language were detected. All sites functional for calculation were spared during tumor resection, which was complete in all cases without postoperative neurological deficits. Conclusions: These findings provide intraoperative data in support of an anatomofunctional organization for multiplication and addition within the right parietal area. Furthermore, the study shows the potential clinical relevance of intraoperative mapping of calculation in patients undergoing surgery in the right parietal area. Further and larger studies are needed to confirm these data and assess whether mapped areas are effectively essential for function.
KW - Addition
KW - Awake surgery
KW - Electrostimulation
KW - Functional mapping
KW - Functional neurosurgery
KW - Multiplication
KW - Right parietal lobe
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U2 - 10.3171/2013.6.JNS122445
DO - 10.3171/2013.6.JNS122445
M3 - Article
C2 - 23930858
AN - SCOPUS:84887065529
VL - 119
SP - 1107
EP - 1111
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 5
ER -