Abstracts

Rationale: Electrical cortical stimulation mapping (CSM), remains a preferred method for identification of functional areas prior to neurosurgery to minimize or prevent functional loss. Influenced by Ferrier's initial experience with CSM across several species published in 1873, 19th century experiments applying electric current to exposed human brain soon followed. Bartholow is commonly credited with the first report of CSM in a conscious human in 1874. What is not well established is that prominent Italian neurologist, Ezio Sciammana, localized sensorimotor function in a human demonstration of CSM shortly thereafter in 1882. Methods: Ezio Sciamanna (1850-1905) was a founder of what is now The School of Medicine at Sapienza University of Rome. After obtaining his degree at the Rome University in 1876, Sciamanna continuing studies included an apprenticeship with Charcot in Paris. He was a member of the Accademia dei Lincei ("Academy of the Lynx"), an elite Italian scientific society founded in 1603, whose membership over centuries has included Galileo Galilei and Albert Einstein. His case was published in Academy annals in 1882. Results: Sciamanna performed CSM on a trauma victim who underwent trepanation for bone fragment removal and repair of parietal region skull fracture. Extradural and subdural stimulation using both Faradic and Galvanic currents produced reliable contralateral motor responses in face, head/neck, and forearm. Testing was terminated after four days, due to death. Bartholow's patient had a malignancy and infection that eroded skull and exposed cortex. Electrical stimulation was accomplished with penetrating needles and may actually represent white matter tract stimulation, giving further importance to Sciammana's clearer extradural and subdural explorations. Conclusions: Sciammana represents a vital historical link between 19th century investigators like Ferrier and 20th century icons of CSM such as Cushing and Penfield. He was in the vanguard of functional localization of brain function through direct stimulation of human gray matter. Unlike Bartholow, who has been canonized in the annals of CSM, Sciamanna has remained obscure, despite the fact that his case may represent a better example of true subdural CSM than his better known contemporary. References: 1. Sciamanna E. 1882. Fenomeni prodotti dall'applicazione della cor- rente elettrica sulla dura madre e modificazione del polso cere- brale. Ricerche sperimentali sull'uomo. Atti della R. Accademia dei Lincei. Memorie della Classe di scienze Fisiche, Matematiche e Naturali 13:25?"42. 2. Bartholow R. 1874a. Experimental investigations into the functions of the human brain. Am J Med Sci 134:305?"13. Funding: Fondazione Neurone