Commentary: A Novel Intraoperative Brain Mapping Integrated Task-Presentation Platform

2021 ◽  
Vol 20 (5) ◽  
pp. E340-E341
Author(s):  
Daniel G Eichberg ◽  
Iahn Cajigas
Keyword(s):  
Brain Mapping ◽  
Task Presentation

A Novel Intraoperative Brain Mapping Integrated Task-Presentation Platform

2021 ◽  
Author(s):  
N U Farrukh Hameed ◽  
Zehao Zhao ◽  
Jie Zhang ◽  
Linghao Bu ◽  
Yuyao Zhou ◽  
...  
Keyword(s):  
Lower Limit ◽  
Brain Mapping ◽  
Patient Comfort ◽  
Awake Surgery ◽  
Cognitive Tasks ◽  
Patient Response ◽  
Stimulus Response ◽  
Task Presentation ◽  
Stimulation System ◽  
The Brain

Abstract BACKGROUND To be efficient, intraoperative task-presentation systems must accurately present various language and cognitive tasks to patients undergoing awake surgery, and record behavioral data without compromising convenience of surgery. OBJECTIVE To present an integrated brain mapping task-presentation system we developed and evaluate its effectiveness in intraoperative task presentation. METHODS The Brain Mapping Interactive Stimulation System (Brain MISS) is a flexible task presentation system that adjusts for patient comfort, needs of the surgeon, and operating team, with multivideo recording for patients’ behavior. A total of 48 patients from 3 centers underwent intraoperative language task test during awake brain surgery with the Brain MISS. Each patient was assigned 5 questions each on picture naming, reading, and listening comprehension before and during awake surgeries. The accuracy of intraoperative stimulus-response (without electrical stimulation) was recorded. The Brain MISS was to be considered effective, if the lower limit of 95% CI of patients’ intraoperative response was ≥80% and also if the accuracy of intraoperative response of all patients was statistically higher than 80%. RESULTS All patients successfully underwent intraoperative assessment with the Brain MISS. The overall accuracy of stimulus response was 95.8% (95% CI 90.18%-100.00%), with the lower limit being higher than 80% and the response accuracy also significantly being higher than 80% in all patients (P = .006). CONCLUSION The Brain MISS is a portable and effective system for presenting and streamlining complicated language and cognitive tasks during awake surgery. It can also record standardized patient response data for neuroscientific research.

Atlas of Brain Mapping

1991 ◽  
Author(s):  
Konrad Maurer ◽  
Thomas Dierks
Keyword(s):  
Brain Mapping

Neurocognitive and functional outcomes in patients with diffuse frontal lower-grade gliomas undergoing intraoperative awake brain mapping

2020 ◽  
Vol 132 (6) ◽  
pp. 1683-1691 ◽  
Author(s):  
Kazuya Motomura ◽  
Lushun Chalise ◽  
Fumiharu Ohka ◽  
Kosuke Aoki ◽  
Kuniaki Tanahashi ◽  
...  
Keyword(s):  
Working Memory ◽  
Brain Mapping ◽  
Functional Outcomes ◽  
Digit Span ◽  
Awake Surgery ◽  
Motor Deficit ◽  
Lower Grade ◽  
Superior Frontal Gyrus ◽  
Neurocognitive Functions ◽  
Motor Disturbances

OBJECTIVELower-grade gliomas (LGGs) are often observed within eloquent regions, which indicates that tumor resection in these areas carries a potential risk for neurological disturbances, such as motor deficit, language disorder, and/or neurocognitive impairments. Some patients with frontal tumors exhibit severe impairments of neurocognitive function, including working memory and spatial awareness, after tumor removal. The aim of this study was to investigate neurocognitive and functional outcomes of frontal LGGs in both the dominant and nondominant hemispheres after awake brain mapping.METHODSData from 50 consecutive patients with diffuse frontal LGGs in the dominant and nondominant hemispheres who underwent awake brain surgery between December 2012 and September 2018 were retrospectively analyzed. The goal was to map neurocognitive functions such as working memory by using working memory tasks, including digit span testing and N-back tasks.RESULTSDue to awake language mapping, the frontal aslant tract was frequently identified as a functional boundary in patients with left superior frontal gyrus tumors (76.5%). Furthermore, functional boundaries were identified while evaluating verbal and spatial working memory function by stimulating the dorsolateral prefrontal cortex using the digit span and visual N-back tasks in patients with right superior frontal gyrus tumors (7.1%). Comparing the preoperative and postoperative neuropsychological assessments from the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) and Wechsler Memory Scale–Revised (WMS-R), significant improvement following awake surgery was observed in mean Perceptual Organization (Z = −2.09, p = 0.04) in WAIS-III scores. Postoperative mean WMS-R scores for Visual Memory (Z = −2.12, p = 0.03) and Delayed Recall (Z = −1.98, p = 0.04) were significantly improved compared with preoperative values for every test after awake surgery. No significant deterioration was noted with regard to neurocognitive functions in a comprehensive neuropsychological test battery. In the postoperative course, early transient speech and motor disturbances were observed in 30.0% and 28.0% of patients, respectively. In contrast, late permanent speech and motor disturbances were observed in 0% and 4.0%, respectively.CONCLUSIONSIt is noteworthy that no significant postoperative deterioration was identified compared with preoperative status in a comprehensive neuropsychological assessment. The results demonstrated that awake functional mapping enabled favorable neurocognitive and functional outcomes after surgery in patients with diffuse frontal LGGs.

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