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Letter: Introducing New Tasks for Intraoperative Mapping in Awake Glioma Surgery: Clearing the Line Between Patient Care and Scientific Research
Ist Teil von
Neurosurgery, 2020-02, Vol.86 (2), p.E256-E257
Ort / Verlag
United States: Oxford University Press
Erscheinungsjahr
2020
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
Over the past two decades, it has been demonstrated that brain mapping in an awake patient is a very reliable tool for brain tumor resection, allowing us to maximize the extent of resection while minimizing the functional risk.1 This methodology is becoming more and more popular, and different teams have introduced many new tasks in their intraoperative battery, for motor functions2 as well as for cognitive functions.3,4 While the aim of preserving functions better and better cannot be blamed, it should be kept in mind that selecting for each case a personalized minimal set of tasks is crucial: the awake surgery team has to find an optimal trade-off between the number of tasks incorporated in the intraoperative battery and the limited amount of time of the awake period (about 2 h, in keeping with the onset of the patient's tiredness, which renders monitoring unreliable). More than that, there is a risk of introducing tasks that would be too sensitive, in the sense that the removal of a positive site would not necessarily lead to a permanent deficit of the function, meaning that brain mapping would restrict the extent of resection for no good reasons. We, thus, would like to highlight in this letter that the introduction of a new task tapping a specific sensorimotor, cognitive, or emotional process should follow a strict scientific plan.