Table 1.
Clinical and demographic data.
Table 2.
Single-, two- and three- site stimulation functional effects.
Fig 1.
Examples of single and multi-site effects.
One case example of a multi-site temporal effect (a,d—patient 10), one case example of a cross-lobal multi-site effect (fronto-temporal; b,e—patient 8) and one case example of a multi-site frontal effect (c,f—patient 6). (a-c) intra-operative photography, (d-f) stimulation location on scheme (effects were aligned using both angio and navigation system photographs). (a) Patient 10: single site DCS found a single word deafness effect (1). A cortical strip was placed on the superior temporal gyrus, and a two-site stimulation retrieval disturbance effect was found (A-B). An Ojemann stimulator was simultaneously applied on location 5, causing a three site semantic paraphasia effect. (b) Patient 8: single site DCS found a speech arrest effect (4), a word deafness effect (2) and two motor effects (1,3). A cortical strip was placed crossing the sylvian fissure, and a two-site stimulation syntax disturbance effect was found using a frontal site and a temporal site.). An Ojemann stimulator was simultaneously applied on location C, causing a three site verb-generation effect. (c) Patient 6: single site DCS found a speech arrest effect (5), five semantic effects (1,2,3,7,8) and a word deafness effect (6). A cortical strip was placed upon the inferior and middle frontal gyri and a two-site stimulation phonological effect was found. Dashed lines represent 2-site and 3-site MSS affects.
Fig 2.
Schematic localization and classification of functional effects.
The locations of stimulation sites (both single and multi) causing functional effects is plotted on a scheme of the left hemisphere for 7 of the 11 patients with multi-site effects (for the remaining four patients: 1,4,11 and 12, intra-operative imaging was not sufficient to map stimulation locations). Single sites (SSS) are marked with unfilled shapes, multi-site (MSS) are marked with filled shapes. Language disturbances are classified to phonological (square), semantic (triangle), syntactic (diamond) and auditory hallucinations (pentagon).