Mini-strokes within Broca-caudate connections during left insular glioma awake surgery cause transient severe naming deficits.

Objective: To provide an explanation for the intraoperative onset of severe naming deficits in the course of awake resection of left insular glioma.

Methods: We retrospectively reviewed a series of 14 patients operated on in awake conditions for a left insular IDH-mutated glioma. Preoperative MRI included high-resolution diffusion sequences, to which constrained spherical deconvolution pipeline was applied, to obtain a whole brain tractogram.

Impaired creative cognition after surgery for an IDH-mutated glioma: A proof-of-concept study.

Assessment of high cognitive functions, such as creativity, is often overlooked in medical practice. However, it is crucial to understand the impact of brain tumors, specifically low-grade gliomas, on creative cognition, as these tumors predominantly affect brain regions associated with cognitive creativity. In this study, we investigated creative cognition using the Alternative Uses Task (AUT) and the Combination of Associates Task (CAT) in a cohort of 29 patients who underwent brain surgery for a low-grade glioma, along with 27 control participants.

Verbal fluency predicts work resumption after awake surgery in low-grade glioma patients.

Background: Resuming professional activity after awake surgery for diffuse low-grade glioma (DLGG) is an important goal, which is not reached in every patient. Cognitive deficits can occur and persist after surgery. In this study, we analyzed the impact of mild cognitive impairments on the work resumption.

Oncological and functional outcomes support early resection of incidental IDH-mutated glioma.

Purpose: The main objective was to assess the neuropsychological, epileptical, and oncological outcomes in a series of patients operated on for a IDH-mutated diffuse low-grade glioma (DLGG) of incidental discovery (iDLGG).

Methods: We retrospectively reviewed a consecutive series of surgically treated adults with DLGG and selected cases incidentally discovered. Tumor volumes, growth rates, and extents of resection (EOR) were assessed by volumetric measures of fluid-attenuated inversion recovery magnetic resonance imaging.

Oncological, cognitive, and employment outcomes in a series of patients with IDH-mutated glioma resected following neoadjuvant chemotherapy.

Purpose: Maximal safe tumor resection is the first line of treatment for IDH-mutated gliomas. However, when upfront surgical resection is deemed unsatisfactory due to tumor size and location, chemotherapy could represent an interesting alternative for reducing glioma extension and allowing for a safer and more efficient removal.

Methods: We performed a retrospective study (June 2011 to December 2021) on patients with IDH-mutated gliomas undergoing chemotherapy with a neoadjuvant intent, followed by surgical excision in awake conditions.

DIMA-fr: a French adaptation and standardization of the Dutch Diagnostic Instrument for Mild Aphasia (DIMA-nl).

The Dutch Diagnostic Instrument for Mild Aphasia (DIMA-nl) is a standardized battery recently created for evaluating the language performance of patients during the perioperative period of glioma surgery. Our aim was to establish normative data for the DIMA-fr, a French version of the DIMA-nl. The DIMA-nl was first adapted to French.

Group-level stability but individual variability of neurocognitive status after awake resections of right frontal IDH-mutated glioma.

Awake surgery for low-grade gliomas is currently considered the best procedure to improve the extent of resection and guarantee a "worth living life" for patients, meaning avoiding not only motor but also cognitive deficits. However, tumors located in the right hemisphere, especially in the right frontal lobe, are still rarely operated on in awake condition; one of the reasons possibly being that there is little information in the literature describing the rates and nature of long-lasting neuropsychological deficits following resection of right frontal glioma. To investigate long-term cognitive deficits after awake surgery in right frontal IDH-mutated glioma.

When Right Is on the Left (and Vice Versa): A Case Series of Glioma Patients with Reversed Lateralization of Cognitive Functions.

We report a case series of four patients operated on for a glioma in awake conditions and in whom task-based functional magnetic resonance imaging (fMRI) demonstrated right-dominant activity during a language production task. Language functional sites were identified intraoperatively by electrical stimulations only in the patient with a right-sided lesion. Furthermore, the pre- or postoperative cognitive evaluations in the three patients operated on for a left-sided glioma revealed right spatial neglect and dysexecutive syndrome, hence demonstrating that, in patients with right-dominant activity on language fMRI, the left hemisphere is implicated in spatial consciousness and cognitive control.

The challenge of overcoming the language barrier for brain tumor awake surgery in migrants: a feasibility study in five patient cases.

Objective: To assess the feasibility of awake surgery for a brain tumor in a population of non-French-speaking migrants in Paris, France.

Methods: The Lariboisière database of awake surgeries was retrospectively reviewed, from the first case in 2011 up to July 2018. Inclusion criteria were patients being migrated in France during their adulthood, patients being unable to speak neither French nor English.

Dissociating motor-speech from lexico-semantic systems in the left frontal lobe: insight from a series of 17 awake intraoperative mappings in glioma patients.

Functional brain mapping during awake surgery procedures is the gold standard technique in the management of left frontal lobe tumors. Nevertheless, a unified picture of the language subsystems encountered during left frontal lobe mapping is still lacking. We retrospectively analyzed the 49 cortical and the 33 axonal sites of functional language mapping performed in 17 patients operated for a left frontal lobe glioma under awake conditions.

Electrically induced verbal perseveration: A striatal deafferentation model.

Objective: The present study aimed to elucidate the neural correlates of the deafferentation cognitive model of verbal perseveration (VP) by analyzing the connectomics of the sites where electric stimulation elicited VP during awake left glioma surgery.

Methods: We retrospectively reviewed the anatomic sites that generated VP when electrically stimulated in a series of 21 patients operated on while awake for a left glioma. Each stimulation point was manually located on the postoperative MRI and then registered to the Montreal Neurological Institute template.

Hotspots of small strokes in glioma surgery: an overlooked risk?

Background: Small deep infarcts constitute a well-known risk of motor and speech deficit in insulo-opercular glioma surgery. However, the risk of cognitive deterioration in relation to stroke occurrence in so-called silent areas is poorly known. In this paper, we propose to build a distribution map of small deep infarcts in glioma surgery, and to analyze patients' cognitive outcome in relation to stroke occurrence.

Initial experience using awake surgery for glioma: oncological, functional, and employment outcomes in a consecutive series of 25 cases.

Background: Awake glioma surgery aims to maximize resection to optimize prognosis while minimizing the risk of postoperative deficits.

Objective: To evaluate oncological, functional, and employment outcomes in the first cohort of patients having this type of surgery at our institution and to determine the effects of any learning curve.

Methods: All cases of awake adult (>18 years of age) glioma surgery were recorded between the introduction of this technique in 2011 until the end of 2013.