Right parietal cortex and calculation processing: Intraoperative functional mapping of multiplication and addition in patients affected by a brain tumor Clinical article

Alessandro Della Puppa, Serena De Pellegrin, Elena D'Avella, Giorgio Gioffrè, Marina Munari, Marina Saladini, Elena Salillas, Renato Scienza, Carlo Semenza

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1107-1111
Number of pages5
JournalJournal of Neurosurgery
Volume119
Issue number5
DOIs
Publication statusPublished - Nov 2013

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Keywords

  • Addition
  • Awake surgery
  • Electrostimulation
  • Functional mapping
  • Functional neurosurgery
  • Multiplication
  • Right parietal lobe

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Della Puppa, A., De Pellegrin, S., D'Avella, E., Gioffrè, G., Munari, M., Saladini, M., Salillas, E., Scienza, R., & Semenza, C. (2013). Right parietal cortex and calculation processing: Intraoperative functional mapping of multiplication and addition in patients affected by a brain tumor Clinical article. Journal of Neurosurgery, 119(5), 1107-1111. https://doi.org/10.3171/2013.6.JNS122445