Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study.

Area of Science:

• Neurosurgery
• Cognitive Neuroscience
• Virtual Reality Technology

Background:

• Awake brain surgery typically maps language but neglects other social cognition functions like visuospatial skills and nonverbal communication.
• Existing mapping tasks are often incompatible with the constraints of awake surgery environments.
• There's a need for novel methods to assess these crucial cognitive functions during surgery.

Purpose of the Study:

• To assess the safety and feasibility of using a virtual reality headset with eye-tracking for patients undergoing awake craniotomy.
• To provide an immersive visuospatial and social virtual reality (VR) experience during surgery.
• To explore VR as a tool for mapping cognitive functions beyond language.

Main Methods:

• Recruited 15 patients with brain tumors near critical language/motor areas.
• Performed language mapping using a naming task (DO 80) on a tablet and within VR (2D/3D).
• Immersed patients in a visuospatial and social VR experience, with eye-tracking data collected.

Main Results:

• No patients reported VR sickness; two experienced seizures unrelated to VR.
• Patients successfully completed VR tasks, demonstrating feasibility.
• Eye-tracking data provided insights into patient attention and visual exploration within the VR environment.

Conclusions:

• Immersive VR environments can be safely utilized during awake brain surgery.
• This approach enables new VR-based brain mapping for cognitive functions.
• The technology facilitates the assessment of visuospatial and social cognition in surgical patients.