Penfield’s stimulation for direct cortical motor mapping: An outdated technique?

Neurosurgeons worldwide are indebted to Dr. Wilder Penfield for his seminal work on intraoperative cortical mapping. Although Penfield was not the first to apply electrical current to the human brain in Neurosurgery - Robert Bartholow's case dates back to 1874 (Bartholow, 1874) -, he certainly pioneered the development of cortical stimulation into a routine neurosurgical procedure (Ladino et al., 2018). The original work by Penfield and Boldrey in 1937 reads: "Stimulation is carried out by either unipolar or bipolar platinum electrodes which emerge from a glass handle and are attached to insulated wires […] In recent years we have found a thyratron stimulator […] and have usually employed a wave frequency of from 55 to 65 per second […] The current is thus constant and may be altered accurately in rate and intensity" (Penfield and Boldrey, 1937).

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