Intraoperative Assessment of Right Cingulum Function Using the Williams Inhibition Test During Awake Surgery for...

Area of Science:

• Neurosurgery
• Cognitive Neuroscience
• Neuro-oncology

Background:

• The cingulum plays a vital role in cognitive control and is implicated in neurological disorders.
• Assessing cingulum function is crucial during surgery for brain tumors affecting this region.

Purpose of the Study:

• To evaluate the utility of the Williams Inhibition Test (WIT) for assessing cingulum function during awake surgery.
• To determine if WIT use impacts neurocognitive outcomes in patients with right frontal gliomas.

Main Methods:

• Retrospective analysis of 46 patients undergoing awake surgery for World Health Organization grade 2 or 3 right frontal gliomas.
• Intraoperative administration of the WIT to monitor cingulum function.
• Comparison of tumor resection extent, Karnofsky Performance Status, and neurocognitive outcomes between WIT and non-WIT groups.

Main Results:

• Positive WIT mappings were found along the cingulum in 35.7% of the WIT group.
• The WIT group demonstrated significantly better Karnofsky Performance Status and Trail Making Test performance at 3 months postoperatively.
• The Trail Making Test scores improved significantly after surgery only in the WIT group.

Conclusions:

• Intraoperative WIT application can help delineate functional cingulum areas during awake surgery.
• The use of WIT is associated with improved neurocognitive outcomes and comparable resection rates.
• WIT is a potentially valuable tool for monitoring cognitive control during awake surgery for right frontal gliomas.