When removing a piece of the brain, location makes a world of difference. If the surgeon cuts one millimeter in the wrong direction, the patient may lose the ability to speak, or a pathway that controls thumb movement, or worse.

For five decades, neurosurgeons seeking to avoid damaging critical brain tissue have used the same technique to map the brain before surgery. Researchers at Albany Medical Center, however, are developing a new technique they hope will be quicker, safer and more accurate.

"It's passive, bed-side, real-time; it takes seconds," said Dr. Anthony L. Ritaccio, a neurologist and director of the epilepsy and human brain mapping program at Albany Med. Most important, he added, is that the technique can create an instant snapshot of brain activity by charting different parts of the brain as its cells fire.

Early results of the work done by Ritaccio and Gerwin Schalk, a professor of neurology at Albany Medical College and a research scientist at New York state's Wadsworth Center, were published in the July edition of the journal Epilepsy & Behavior.

Surgery to remove part of the brain is sometimes the only remaining option for epilepsy patients who haven't responded to drug treatment.

When that occurs, the gold standard for mapping the functions of the brain before surgery is electrical cortical stimulation, in which the surgeon lays a plastic grid of platinum electrodes on the surface of the brain. The contacts along the grid are electrically stimulated and the surgeon observes the effect on the patient.

Often, the patient is awake; the technique can take two to seven hours. While usually safe, the technique has risks, including the possibility that the electrical current could trigger seizures in patients with epilepsy.

But at the Wadsworth Center, researchers developed sophisticated software to analyze brain waves -- the electrical signals created by brain activity. The technology, called Brain Computer Interface 2000, is already being used to help quadriplegics control a computer keyboard with their thoughts.

Ritaccio and Schalk have adapted the technology to essentially "listen to the surface of the brain," and identify the functions each area controls.

Using their method, the same plastic grid is laid on the surface of the brain, but the grid is attached to a computer running BCI2000 and original software called Signal Modeling For Real-Time Identification and Event Detection, or SIGFRIED.

The doctor can watch the patient's brain activity as the patient runs through certain exercises, like playing with a toy, speaking, moving his or her fingers or listening to a story. The software identifies electrodes that buzz from the brain's natural electrical activity, instantly recognizing the areas that control a skill.

Ritaccio played back a recorded session of a patient being studied. Video in the corner of the screen showed a patient holding a Rubik's cube while another part of the screen had dots that represented the electrodes on the grid. Some of the dots lit up in red as the patient turned the cube. The red dots represented the brain cells that were humming in the same electrical frequency -- a sign that they were involved in turning the cube.

"We are like voyeurs," Ritaccio said. "We are listening to the language of the brain."

Instead of hours, the technique takes minutes to map the brain function because the software monitors all the electrodes simultaneously. It doesn't use outside electrical stimulation, so there is no danger of provoking a seizure.

The researchers are working with epilepsy patients, but the new technique can also be used for those undergoing surgery to remove brain tumors or other invasive brain procedures.

"This is really a huge step forward," said Dr. Ian Miller, a physician and director of neuroinformatics at Miami Children's Hospital, which has used SIGFRIED brain mapping on a dozen children. The SIGFRIED software is free -- a requirement of a National Institutes of Health grant that helped fund the Wadsworth Center's research.

Mapping the brain of a 3-year-old can be difficult because the child may not be capable of staying still or following a doctor's instructions, but the Albany Med technique can complete the analysis quickly. Miller said it hasn't replaced his hospital's usual methods, but "it's definitely informing our standard techniques."

Steven Schachter, professor of neurology at Harvard Medical School and chief academic officer at the Center for Integration of Medicine and Innovative Technology, said the technology has advantages for patients with epilepsy and may open other therapies for cognitive problems.

Schachter credited the collaborative effort between Ritaccio, a physician, and Schalk, a computer engineer.

"The power of that combination goes beyond what either the engineer or the clinician alone could do," he said. "This is an emerging trend in medical development, and it's exciting."