Functional-Based Resection Does Not Worsen Quality of Life in Patients with a Diffuse Low-Grade Glioma Involving Eloquent Brain Regions: A Prospective Cohort Study.

Objective: We assessed the impact of surgery on postoperative cognitive function and ability to work in adult patients with a diffuse low-grade glioma involving eloquent brain regions and having a functional-based maximal surgical resection using intraoperative corticosubcortical mapping under awake conditions.

Methods: We prospectively included 39 consecutive patients with diffuse isocitrate dehydrogenase-mutant low-grade glioma without preoperative and adjuvant oncologic treatment and assessed preoperative (mean, 24.1 ± 21.

Peri- and intraoperative cognitive and language assessment for surgical resection in brain eloquent structures.

Neuropsychological care of patients suffering from an infiltrative glioma and candidates for a neurosurgery under awake condition with intraoperative functional mapping is a critical and mandatory stage in therapeutic management. It enables to estimate the functional impact of the tumor and, consequently, the efficacy of functional reorganization typically observed in these patients, not only to better predict surgery outcomes and select appropriate tasks for intraoperative functional mapping, but also to plan efficient and individualized postoperative cognitive rehabilitation strategies. Neuropsychological care management also enables patients to benefit from a solid psychological preparation both to the surgery and its associated transitory functional consequences, as well as provide a personalized psychological and emotional long-term support.

Direct electrical bipolar electrostimulation for functional cortical and subcortical cerebral mapping in awake craniotomy. Practical considerations.

Introduction: The aim of brain glioma surgery is to maximize the quality of resection, while minimizing the risk of sequelae. Due to the frequent location of gliomas near or within eloquent areas, owing to their infiltrative feature, and because of major interindividual variability, the anatomofunctional organization and connectivity must be studied individually. Therefore, to optimize the benefit-to-risk ratio of surgery, intraoperative functional mapping is extensively used.

Surgical resection of incidental diffuse gliomas involving eloquent brain areas. Rationale, functional, epileptological and oncological outcomes.

Objective: Incidentally discovered diffuse low-grade gliomas progress in a fashion similar to their symptomatic counterparts. Their early detection allows more effective pre-emptive and individualized oncological treatment. We assessed the safety and efficacy of maximal safe resection according to functional boundaries for incidental diffuse low-grade gliomas in eloquent areas.

Three-tesla functional MR language mapping: comparison with direct cortical stimulation in gliomas.

Objective: To evaluate the accuracy of functional MRI (fMRI) at 3T, as currently used in the preoperative mapping of language areas, compared with direct cortical stimulation (DCS) during awake surgery, in patients with supratentorial gliomas; and to identify clinical, histopathologic,and radiologic factors associated with fMRI/DCS discrepancies.

Methods: Language mapping with fMRI and DCS of 40 consecutive patients with gliomas(24 low-grade, 16 high-grade) in functional areas were retrospectively analyzed. Three block designed tasks were performed during fMRI (letter word generation, category word generation,semantic association).