A Novel Intraoperative Brain Mapping Integrated Task-Presentation Platform

To be efficient, intraoperative task-presentation systems must accurately present various language and cognitive tasks to patients undergoing awake surgery, and record behavioral data without compromising convenience of surgery.

To present an integrated brain mapping task-presentation system we developed and evaluate its effectiveness in intraoperative task presentation.

The Brain Mapping Interactive Stimulation System (Brain MISS) is a flexible task presentation system that adjusts for patient comfort, needs of the surgeon, and operating team, with multivideo recording for patients' behavior. A total of 48 patients from 3 centers underwent intraoperative language task test during awake brain surgery with the Brain MISS. Each patient was assigned 5 questions each on picture naming, reading, and listening comprehension before and during awake surgeries. The accuracy of intraoperative stimulus-response (without electrical stimulation) was recorded. The Brain MISS was to be considered effective, if the lower limit of 95% CI of patients' intraoperative response was ≥80% and also if the accuracy of intraoperative response of all patients was statistically higher than 80%.

All patients successfully underwent intraoperative assessment with the Brain MISS. The overall accuracy of stimulus response was 95.8% (95% CI 90.18%-100.00%), with the lower limit being higher than 80% and the response accuracy also significantly being higher than 80% in all patients (P = .006).

The Brain MISS is a portable and effective system for presenting and streamlining complicated language and cognitive tasks during awake surgery. It can also record standardized patient response data for neuroscientific research.