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Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
Functional outcome after language mapping for glioma resection.
Nader Sanai1, Zaman Mirzadeh, Mitchel S Berger
1Department of Neurological Surgery and the Brain Tumor Research Center, University of California at San Francisco, San Francisco, CA 94143-0112, USA. sanain@neurosurg.ucsf.edu
The New England Journal of Medicine
|January 4, 2008
Summary
Language mapping during awake brain surgery helps minimize speech deficits after glioma resection. Most patients retain language function, with persistent deficits rare at six months post-surgery.
Area of Science:
- Neurosurgery
- Neuroscience
- Oncology
Background:
- Individual language site variability in the brain necessitates precise mapping.
- Awake brain surgery with language mapping is crucial for minimizing deficits during tumor resection.
Purpose of the Study:
- To evaluate language function outcomes after glioma resection using intraoperative language mapping.
- To analyze the efficacy of tailored craniotomies in preserving language function.
Main Methods:
- Examined 250 glioma patients undergoing awake surgery with language mapping.
- Identified and mapped positive language sites using bipolar electrode stimulation.
- Resected tumors up to 1 cm from identified language areas, without requiring localization within the exposure field.
Main Results:
- 58% of patients experienced speech arrest, 33% anomia, and 9% alexia during stimulation.
- 94% of cortical sites showed no language deficit upon stimulation.
- While 14% had new deficits post-surgery, only 1.6% had persistent deficits at 6 months.
Conclusions:
- Tailored craniotomies allow aggressive glioma resection with minimal language deficits, even without precise positive language site localization.
- Observed language variability challenges current models of human language organization in the dominant hemisphere.
