Subcortical language and non-language mapping in awake brain surgery: the use of multimodal tests

Abstract

Administration of multimodal tests during subcortical DES such as the experimental QMT may facilitate identification of eloquent pathways leading to avoidance of permanent neurological impairments.

Words are not enough: nonword repetition as an indicator of arcuate fasciculus integrity during brain tumor resection

“…conclUsions The authors suggest that monitoring NWR intraoperatively may complement the standard naming tasks and could permit better preservation of the important language production functions subserved by the AF. production, 12,13 comprehension and semantic processing, 45 semantic and phonological fluency, 2,54 sentence processing, 42 reading, 44 and writing. 30 However, these tasks are mostly designed for ESM procedures at the cortical level, and in most cases the treated lesions do not only affect the cortex but also infiltrate the deep white matter, disturbing crucial subcortical connectivity.…”

“…In this context the routine use of neuropsychological monitoring at the subcortical white matter level has been proposed, but until presently it has been mainly described in unique case studies of particular patients. 12,14,15,29 In the present study, we focus on monitoring arcuate fasciculus (AF) function, considering its crucial role in the correct transfer of information and conversion of sounds (phonology) into articulatory output patterns (language production).…”

“…33 This simple task allowed one to capture a variety of errors and still is the most commonly used task. 12,15,41,42 Recently, more developed protocols have come into play allowing for the exploration of more sophisticated facets of language processing such as verb generation, 19,33,42 spontaneous speech abbreviations AF = arcuate fasciculus; CA = conduction aphasia; CUSA = cavitron ultrasonic surgical aspirator; DTI = diffusion tensor imaging; ESM = electrical stimulation mapping; MNI = Montreal Neurological Institute; NWR = nonword repetition; ROI = region of interest; Spt = sylvian parietotemporal; WR = word repetition. sUbMitteD July 10, 2015. accePteD February 16, 2016.…”

Network Plasticity and Intraoperative Mapping for Personalized Multimodal Management of Diffuse Low-Grade Gliomas

“…Proper choice and execution of brain mapping techniques has improved the precision and safety of the surgical treatment for some of the most challenging cases and can currently allow a more radical surgical resection than indicated by presumed preoperative functional localization. This entails an optimization of the intraoperative tests’ selection based on the functional cortico-subcortical networks expected to be encountered as well as on the specific preoperative neurological and neuropsychological assessments of each patient ( 85 – 87 ).…”

Epilepsy surgery near or in eloquent cortex in children—Practice patterns and recommendations for minimizing and reporting deficits

“…Irrespective of one's biases toward the handling of EC, wider usage of protective strategies such as awake surgery when feasible, tractography and intraoperative navigation tools, and intraoperative functional mapping is justified and strongly recommended. 3,20,32,33,34,35 There is also increasing emphasis on ensuring the integrity of white matter tracts via subcortical mapping to maximize preservation of eloquent function 36 and deployment of minimally invasive surgical strategies. 37 The respondents varied considerably in their expectation of the chances of seizure freedom that were considered acceptable thresholds to "justify" a new deficit ranging from 50% to exceeding 90%.…”