Poster No:
30
Submission Type:
Abstract Submission
Authors:
Masashi Kinoshita1, Riho Nakajima2, Mitsutoshi Nakada1
Institutions:
1Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan, 2Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
First Author:
Masashi Kinoshita
Department of Neurosurgery, Kanazawa University
Kanazawa, Ishikawa, Japan
Co-Author(s):
Riho Nakajima
Pharmaceutical and Health Sciences, Kanazawa University
Kanazawa, Ishikawa, Japan
Mitsutoshi Nakada
Department of Neurosurgery, Kanazawa University
Kanazawa, Ishikawa, Japan
Introduction:
In recent years, awake surgery has become the treatment strategy for gliomas, with the aim of preserving cerebral function in both the left and right hemispheres. Cortical localization of various functions has been reported; however, the left-right characteristics related to the frequency of their detection are not known. In this study, we report on functional mapping of the bilateral cerebrum in awake glioma surgery, assuming cortical functional localization and frequency of positive detection.
Methods:
We performed intraoperative assessment tasks for motor, sensory, language (picture naming, semantic comprehension, and reading), social cognition (low-level and high-level mentalizing), and visual cognition (visuospatial recognition) in 135 glioma patients (WHO grades 1-4; 56 right, 79 left) who underwent awake surgery to preserve cognitive functions in the bilateral cerebrum at our hospital from 2014 to 2021. Cortical mapping points (MPs) where positive findings were obtained by direct electrical stimulation, and cortical areas where positive and negative findings were obtained were recorded. All MPs were extracted by MNI152 standard brain space analysis using SPM and MRIcron, classified into Brodmann areas (BA), and then each BA positivity rate in all cases was calculated, and brain functions and cortical areas per each positive detection rate were reflected in the standard brain atlas.
Results:
The BA 4, 6, and 1-3 areas exhibited positive detection rates >70%, with almost no difference between left and right sides of the brain. The left and right BA22, left BA37 and 44, and right BA7 and 43 areas showed 50-70% positivity, with language on the left and social cognition and visual cognition on the right. In contrast, all areas with positive detection rates >10% were widely located ventral to the temporal lobe on the left and dorsal to the frontal to parietal lobes on the right. In other words, the functional localization and high frequency of detection were consistent in the Roland's area and the peri-Sylvian area. Although the latter showed a left-right difference in positive function and detection area, intraoperative selective functional mapping ensured a nearly symmetrical high positive detection rate.
Conclusions:
It should be noted that although the cerebrum has functional anatomical differences between the left and right hemispheres, it is an organ with symmetrical features, as evidenced by similar positive detection frequencies on the left and right hemispheres during awake functional mapping.
Brain Stimulation:
Direct Electrical/Optogenetic Stimulation 1
Emotion, Motivation and Social Neuroscience:
Social Cognition
Language:
Language Comprehension and Semantics
Motor Behavior:
Visuo-Motor Functions
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping 2
Keywords:
Atlasing
Cortex
Language
Motor
Social Interactions
Somatosensory
1|2Indicates the priority used for review
Provide references using author date format
N.A.