03173nas a2200493 4500008004100000022001400041245012000055210006900175260001200244300001200256490000800268520172300276653001801999653002002017653001502037653001102052653002202063653001102085653001102096653001402107653001302121653000902134653001602143653003102159653001402190653002602204653001302230653001802243653001602261100001802277700002302295700002102318700002302339700002602362700002402388700001802412700001902430700001402449700002202463700002202485700002602507700003102533856011502564 2020 eng d a1573-737300aPotential differences between monolingual and bilingual patients in approach and outcome after awake brain surgery.0 aPotential differences between monolingual and bilingual patients c07/2020 a587-5980 v1483 a

INTRODUCTION: 20.8% of the United States population and 67% of the European population speak two or more languages. Intraoperative different languages, mapping, and localization are crucial. This investigation aims to address three questions between BL and ML patients: (1) Are there differences in complications (i.e. seizures) and DECS techniques during intra-operative brain mapping? (2) Is EOR different? and (3) Are there differences in the recovery pattern post-surgery?

METHODS: Data from 56 patients that underwent left-sided awake craniotomy for tumors infiltrating possible dominant hemisphere language areas from September 2016 to June 2019 were identified and analyzed in this study; 14 BL and 42 ML control patients. Patient demographics, education level, and the age of language acquisition were documented and evaluated. fMRI was performed on all participants.

RESULTS: 0 (0%) BL and 3 (7%) ML experienced intraoperative seizures (P = 0.73). BL patients received a higher direct DECS current in comparison to the ML patients (average = 4.7, 3.8, respectively, P = 0.03). The extent of resection was higher in ML patients in comparison to the BL patients (80.9 vs. 64.8, respectively, P = 0.04). The post-operative KPS scores were higher in BL patients in comparison to ML patients (84.3, 77.4, respectively, P = 0.03). BL showed lower drop in post-operative KPS in comparison to ML patients (- 4.3, - 8.7, respectively, P = 0.03).

CONCLUSION: We show that BL patients have a lower incidence of intra-operative seizures, lower EOR, higher post-operative KPS and tolerate higher DECS current, in comparison to ML patients.

10aBrain Mapping10aBrain Neoplasms10aCraniotomy10aFemale10aFollow-Up Studies10aGlioma10aHumans10aIncidence10aLanguage10aMale10aMiddle Aged10aMonitoring, Intraoperative10aPrognosis10aRetrospective Studies10aSeizures10aUnited States10aWakefulness1 aReFaey, Karim1 aTripathi, Shashwat1 aBhargav, Adip, G1 aGrewal, Sanjeet, S1 aMiddlebrooks, Erik, H1 aSabsevitz, David, S1 aJentoft, Mark1 aBrunner, Peter1 aWu, Adela1 aTatum, William, O1 aRitaccio, Anthony1 aChaichana, Kaisorn, L1 aQuinones-Hinojosa, Alfredo uhttps://neurotechcenter.org/publications/2020/potential-differences-between-monolingual-and-bilingual-patients03481nas a2200289 4500008004100000022001400041245009200055210006900147260001200216300001000228490000700238520264000245653001802885653002002903653002002923653001502943653002502958653002702983653001103010653002703021100001803048700001903066700002003085700001903105700001903124856004803143 2010 eng d a1525-506900aPassive real-time identification of speech and motor cortex during an awake craniotomy.0 aPassive realtime identification of speech and motor cortex durin c05/2010 a123-80 v183 a

Precise localization of eloquent cortex is a clinical necessity prior to surgical resections adjacent to speech or motor cortex. In the intraoperative setting, this traditionally requires inducing temporary lesions by direct electrocortical stimulation (DECS). In an attempt to increase efficiency and potentially reduce the amount of necessary stimulation, we used a passive mapping procedure in the setting of an awake craniotomy for tumor in two patients resection. We recorded electrocorticographic (ECoG) signals from exposed cortex while patients performed simple cue-directed motor and speech tasks. SIGFRIED, a procedure for real-time event detection, was used to identify areas of cortical activation by detecting task-related modulations in the ECoG high gamma band. SIGFRIED's real-time output quickly localized motor and speech areas of cortex similar to those identified by DECS. In conclusion, real-time passive identification of cortical function using SIGFRIED may serve as a useful adjunct to cortical stimulation mapping in the intraoperative setting.

10aBrain Mapping10aBrain Neoplasms10aCerebral Cortex10aCraniotomy10aElectric Stimulation10aElectroencephalography10aHumans10aNeurologic Examination1 aRoland, Jarod1 aBrunner, Peter1 aJohnston, James1 aSchalk, Gerwin1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/20478745