Operative neurosurgery (Hagerstown, Md.) · 2026
Use of a Novel Intraoperative Neurocognitive Monitoring Task During Awake Craniotomy for Tumor Resection in the Language-Dominant Parietal Lobe.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Mazurek Mercy H, Maguire Amy J, Sixkiller James D, West Timothy R, Perez Nicole A, Wetzel Ethan A, Wang Alexander F, Gal Zsombor T, See Reiner B, Ritzl Eva K, Rapalino Otto, Choi Bryan D, Nahed Brian V
Аннотация
BACKGROUND AND OBJECTIVES: The identification of eloquent structures in the parietal lobe during awake craniotomy remains challenging, particularly for higher-order functions such as reading, calculation, and sensorimotor integration essential for writing and typing. Our study introduces a novel task as part of intraoperative neurocognitive monitoring (iNM) to enhance real-time assessment during tumor resection.
METHODS: We introduced a novel tactile symbol recognition task during iNM to assess sensorimotor function of patients undergoing awake craniotomy at a single-center from January to February 2025.
RESULTS: We present 2 cases of left parietal low-grade gliomas in right-handed males who underwent awake craniotomy with mapping and iNM. Intraoperatively, errors during tactile symbol recognition provided surgical guidance by indicating when to halt resection. Both patients achieved gross-total resection and demonstrated largely preserved postoperative function.
CONCLUSION: Our findings suggest that real-time iNM can effectively complement traditional stimulation mapping, especially in complex regions such as the parietal lobe where critical functions are mediated by distributed neural networks. A tactile symbol recognition task is feasible and easy to implement as a patient-centered preservation approach in settings that may not have consistent access to other surgical mapping adjuncts and may offer a sensitive means of guiding intraoperative decisions and optimizing outcomes in eloquent cortex resections.
METHODS: We introduced a novel tactile symbol recognition task during iNM to assess sensorimotor function of patients undergoing awake craniotomy at a single-center from January to February 2025.
RESULTS: We present 2 cases of left parietal low-grade gliomas in right-handed males who underwent awake craniotomy with mapping and iNM. Intraoperatively, errors during tactile symbol recognition provided surgical guidance by indicating when to halt resection. Both patients achieved gross-total resection and demonstrated largely preserved postoperative function.
CONCLUSION: Our findings suggest that real-time iNM can effectively complement traditional stimulation mapping, especially in complex regions such as the parietal lobe where critical functions are mediated by distributed neural networks. A tactile symbol recognition task is feasible and easy to implement as a patient-centered preservation approach in settings that may not have consistent access to other surgical mapping adjuncts and may offer a sensitive means of guiding intraoperative decisions and optimizing outcomes in eloquent cortex resections.