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Rapid Passive Gamma Mapping as an Adjunct to Electrical Stimulation Mapping for Functional Localization in Resection
Hao Tan1, Joseph G Nugent1, Adeline Fecker1
1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.
World Neurosurgery
|October 23, 2023
Summary
Passive high gamma mapping (HGM) may improve survival outcomes for glioma patients undergoing awake craniotomy. This technique appears safe and comparable to conventional mapping, with a trend toward fewer seizures during surgery.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Brain Mapping
Background:
- Awake brain mapping is crucial for glioma resection to preserve function.
- High gamma mapping (HGM) is an emerging technique for intraoperative brain mapping.
Purpose of the Study:
- To evaluate the utility of passive high gamma mapping (HGM) as an adjunct to conventional awake brain mapping.
- To compare functional and survival outcomes before and after HGM implementation in glioma surgery.
Main Methods:
- Retrospective cohort study of 75 patients undergoing awake craniotomy for glioma resection.
- Patients were divided into pre- and post-HGM implementation groups (July 2017).
- Outcomes analyzed included extent of resection, functional status, overall survival, and progression-free survival.
Main Results:
- No significant differences in intraoperative time or extent of resection between groups.
- Post-HGM implementation cohort showed significantly improved overall survival (HR 0.10, P=0.002).
- Progression-free survival and Karnofsky performance status were comparable; a nonsignificant trend for reduced intraoperative seizures was observed post-HGM.
Conclusions:
- Passive HGM appears to be a safe adjunct to electrical stimulation mapping for awake cortical mapping.
- HGM may confer comparable functional and survival outcomes with a potential reduction in epileptiform events.
- Further research is needed to define optimal use cases for HGM in glioma surgery.
