A probabilistic map of motor and cognitive functions: a meta-analysis of 4325 stimulation sites

Direct electrical stimulation (DES) is a spatially controlled, clinically informed form of lesion-deficit analysis. This study aims to generate the first meta-analytic, probabilistic cognitive maps based on DES and subdural stimulation data. We systematically searched PubMed, Embase, and Web of Science for studies that used intraoperative DES or subdural electrodes and reported coordinates linked with disrupted performance of a behavioural task. These positive loci and their corresponding intraoperative tasks were collated and grouped into behavioural categories. Data were analysed to determine the relationship between a locus in standard stereotactic space and reported behaviours. Barycentric coordinates, focal maps, and outputs of disconnectome and functionnectomic analysis are provided. We identified 21 eligible studies totalling 954 patients with 4325 positive stimulation sites. Sites were categorized into seven behaviours. Five behaviours yielded significant clusters, including (1) motor with clusters within the pre-central gyri and anterior right cingulate gyrus; (2) somatosensory in the bilateral post-central gyri; (3) auditory comprehension in the left superior temporal gyrus; (4) visuospatial, namely face perception, in the fusiform gyrus; and (5) speech and language, specifically, naming associated with the left posterior superior temporal gyrus, perseveration in left insular cortex and white matter, and speech arrest within precentral gyri. Disconnectome analysis generated 56 significant clusters across seven behaviours. Our meta-analysis generates novel, probabilistic cognitive maps which provide converging evidence for well-established functional-anatomical relationships, as well as areas of ongoing study.