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Updated: Sep 8, 2025

Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
Published on: January 6, 2011
Awake surgery with direct electrical stimulation mapping and real-time cognitive monitoring for functionally guided
Fabien Almairac1,2, Hugues Duffau3,4
1Neurosurgery department, Pasteur 2 Hospital, University Hospital of Nice, 30 Voie romaine, Nice, 06000, France. almairac.f@chu-nice.fr.
Background:
Awake surgery is the reference for diffuse low-grade glioma resection, allowing maximal tumor removal while preserving neurocognitive functions. It is also applicable to other brain tumors. However, key technical elements must be followed to ensure optimal conditions for intraoperative cognitive testing and reliable functional mapping.
Method:
We describe the asleep-awake-asleep technique with real-time cognitive monitoring and provide practical guidance for safe and effective implementation.
Conclusion:
Success relies on rigorous intraoperative standards to optimize functional mapping. Beyond oncological outcomes, this surgical philosophy preserves quality of life by respecting individual brain organization, reflecting a shift toward personalized functional neurooncology.
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