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Brain Imaging

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Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
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Disrupting self-evaluative processing with electrostimulation mapping during awake brain surgery.

Sam Ng^1,2, Guillaume Herbet^3,4,5, Anne-Laure Lemaitre^3,4

¹Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Av Augustin Fliche, 34295, Montpellier, France. s-ng@chu-montpellier.fr.

Scientific Reports

|May 1, 2021

Summary

This summary is machine-generated.

Direct electrostimulation during awake brain surgery can disrupt self-evaluation. Researchers identified critical brain pathways, like the inferior fronto-occipital fasciculus, involved in self-assessment, using a novel intraoperative tool.

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Area of Science:

Neuroscience
Neurosurgery
Cognitive Psychology

Background:

Awake brain surgery with cognitive monitoring is standard for functional tumor removal.
Patient awareness of cognitive task responses during direct electrostimulation (DES) is understudied.
Understanding self-evaluation disruptions during surgery is crucial for patient outcomes.

Purpose of the Study:

To report disruptions in self-evaluative processing induced by DES during awake surgery.
To investigate the cortico-subcortical structures involved in self-assessment.
To report the utility of an intraoperative self-assessment tool, the self-confidence index (SCI).

Main Methods:

Seventy-two patients undergoing awake brain tumor resections were analyzed.
Inclusion criteria involved DES-induced task disruptions with impaired self-awareness or SCI dissociation.
Disconnectome analyses using a tractography-based atlas were performed.

Main Results:

Disruptions of self-evaluation were frequently linked to semantic disorders.
Critical sites were primarily located along the left/right ventral semantic streams.
The inferior fronto-occipital fasciculus was identified as a likely transitory disconnected pathway.

Conclusions:

White matter pathways within the ventral semantic stream are critically involved in human self-evaluative processing.
The self-confidence index (SCI) shows potential as an intraoperative tool for multimodal monitoring.
Further research into intraoperative self-assessment can refine surgical strategies and improve functional preservation.