Electrical stimulation mapping of the visual cortex for epilepsy surgery

Jacques Jonas, Jérôme Aupy, Ana Maria Petrescu, Marion Marchive, Suzanne Perguilhem, Victoria Guinet, Virginie Laguitton, Véronique Sabadell, Mathilde Chipaux, Marie-Thérèse Dangles
Neurophysiologie Clinique. 2026-06-01; 56(3): 103145
DOI: 10.1016/j.neucli.2026.103145

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https://www.bordeaux-neurocampus.fr/12715

Jonas J(1), Aupy J(2), Petrescu AM(3), Marchive M(4), Perguilhem S(5), Guinet V(6), Laguitton V(7), Sabadell V(7), Chipaux M(5), Dangles MT(5).

Author information:
(1)Université de Lorraine, CHRU-Nancy, Service de Neurologie, Nancy, France;
Université de Lorraine, IMoPA, UMR CNRS 7365, Nancy, France. Electronic address:
.
(2)Université de Bordeaux, IMN, UMR CNRS 5293, Bordeaux, France.
(3)Université Paris Saclay-APHP, Neurophysiologie et Epileptologie, Le Kremlin
Bicêtre, Paris, France.
(4)Université de Lorraine, IMoPA, UMR CNRS 7365, Nancy, France.
(5)Pediatric Neurosurgery Department, CCMR Epilepsies Rares, European Reference
Network EpiCare Member, Rothschild Foundation Hospital, Paris, France.
(6)Department of Functional Neurology and Epileptology, Hospices Civils de Lyon,
Lyon, France.
(7)Timone Hospital, AP-HM, Marseille, France.

Limiting the post-operative sensory, motor, and cognitive deficits is a primary
goal in epilepsy surgery, for which direct electrical stimulation (ES) remains
an essential tool. However, the value of ES to predict potential deficits of
visual functions, especially in cases of focal posterior epilepsy, remains
unclear. In this review, we will summarize ES findings in the visual cortex,
assess its predictive value for visual functions and propose recommendations to
improve this value. We will examine the value of ES in the primary visual
cortex, as well as in the ventral and dorsal streams. In the ventral stream, we
will focus on face recognition and reading functions given their high social
consequences if altered. Current evidence suggests that ES has limited utility
in predicting potential visual field defects, except in the primary visual
cortex. ES may help to predict face recognition and reading deficits, but the
literature still lacks prospective data and group studies. For these two main
functions, well-designed tasks should be used accurately to detect critical
regions. Face recognition tasks should be more systematically used especially
when targeting the right occipito-temporal cortex, since this function occupies
a large cortical territory with severe recognition deficits if damaged. We
advocate for more systematic use of ES in the visual cortex, using well-designed
tasks depending on the targeted visual functions, as well as a more systematic
evaluation of their predictive value, ideally through prospective group studies.