Performance of intraoperative neurocognitive tests during awake surgery for patients with diffuse low-grade glioma.

Journal: Neurosurgical review

Volume: 47

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Department of Neurosurgery, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil. lucasalverne@gmail.com. Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA. Department of Anesthesiology, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil. Neuropsychologist, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil. Speech Therapist, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. Division of Neurosurgery, Department of Neurology, Universidade de Campinas, Campinas, São Paulo, Brazil.

Abstract summary 

Despite great advancements and the diffusion of awake surgery for brain tumors, the literature shows that the tests applied during the procedure are heterogeneous and non-standardized. This prospective, observational, descriptive study collected data on intraoperative brain mapping and the performance of multiple neurocognitive tests in 51 awake surgeries for diffuse low-grade glioma. Frequency of use and rate of intraoperative findings of different neurocognitive tests were analyzed. Patients mean age at the time of surgery was 35.1 (20-57) years. We performed 26 (51.0%) surgeries on the left hemisphere (LH) and 25 (49.0%) on the right hemisphere (RH). Significant differences were observed between the total number of functional findings (cortical and subcortical) identified in the LH and RH (p = 0.004). In subcortical findings alone, the differences remained significant (p = 0.0004). The RH subcortical region showed the lowest number of intraoperative findings, and this was correlated with functional outcome: Karnofsky performance scale at five days (p = 0.022), three months (p = 0.002) and one year (p = 0.002) post-surgery. On average, more tests were used to map the RH, with a lower frequency of both cortical and subcortical functional findings. Even though subcortical findings were less frequent than cortical findings, they were crucial to defining the resection margins. Based on the intraoperative findings, frequency of use, and rate of findings per use of the tests analyzed, the most relevant tests for each hemisphere for awake brain mapping were identified.

Authors & Co-authors:  Albuquerque de Macêdo Filho Borges Diógenes Pessoa Rocha Almeida Ghizoni Joaquim

Study Outcome 

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Statistics
Citations :  Rofes A, Mandonnet E, Godden J, Baron MH, Colle H, Darlix A, de Aguiar V, Duffau H, Herbet G, Klein M, Lubrano V, Martino J, Mathew R, Miceli G, Moritz-Gasser S, Pallud J, Papagno C, Rech F, Robert E, Rutten GJ, Santarius T, Satoer D, Sierpowska J, Smits A, Skrap M, Spena G, Visch E, De Witte E, Zetterling M, Wager M (2017) Survey on current cognitive practices within the European Low-Grade Glioma Network: towards a European assessment protocol. Acta Neurochir (Wien) 159(7):1167–1178. https://doi.org/10.1007/s00701-017-3192-2
Authors :  9
Identifiers
Doi : 10.1007/s10143-024-02364-6
SSN : 1437-2320
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Awake surgery;Brain mapping;Connectome;Glioma;Neuropsychological tests
Study Design
Descriptive Study
Study Approach
Country of Study
Publication Country
Germany