Karim ReFaey1, Shashwat Tripathi1,2, Adip G Bhargav3, Sanjeet S Grewal1, Erik H Middlebrooks1,4, David S Sabsevitz1,5, Mark Jentoft6, Peter Brunner7,8, Adela Wu9, William O Tatum10, Anthony Ritaccio10, Kaisorn L Chaichana1, Alfredo Quinones-Hinojosa11,12. 1. Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA. 2. Department of Mathematics, University of Texas at Austin, Austin, TX, USA. 3. Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA. 4. Department of Radiology, Mayo Clinic, Jacksonville, FL, USA. 5. Department of Psychology, Mayo Clinic, Jacksonville, FL, USA. 6. Department of Pathology, Mayo Clinic, Jacksonville, FL, USA. 7. Albany Medical College, Albany, NY, USA. 8. National Center for Adaptive Neurotechnologies, Albany, NY, USA. 9. Department of Neurologic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA. 10. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. 11. Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA. quinones@mayo.edu. 12. Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, FloridaJacksonville, FL, 32224, USA. quinones@mayo.edu.
Abstract
INTRODUCTION: 20.8% of the United States population and 67% of the European population speak two or more languages. Intraoperative different languages, mapping, and localization are crucial. This investigation aims to address three questions between BL and ML patients: (1) Are there differences in complications (i.e. seizures) and DECS techniques during intra-operative brain mapping? (2) Is EOR different? and (3) Are there differences in the recovery pattern post-surgery? METHODS: Data from 56 patients that underwent left-sided awake craniotomy for tumors infiltrating possible dominant hemisphere language areas from September 2016 to June 2019 were identified and analyzed in this study; 14 BL and 42 ML control patients. Patient demographics, education level, and the age of language acquisition were documented and evaluated. fMRI was performed on all participants. RESULTS: 0 (0%) BL and 3 (7%) ML experienced intraoperative seizures (P = 0.73). BL patients received a higher direct DECS current in comparison to the ML patients (average = 4.7, 3.8, respectively, P = 0.03). The extent of resection was higher in ML patients in comparison to the BL patients (80.9 vs. 64.8, respectively, P = 0.04). The post-operative KPS scores were higher in BL patients in comparison to ML patients (84.3, 77.4, respectively, P = 0.03). BL showed lower drop in post-operative KPS in comparison to ML patients (- 4.3, - 8.7, respectively, P = 0.03). CONCLUSION: We show that BL patients have a lower incidence of intra-operative seizures, lower EOR, higher post-operative KPS and tolerate higher DECS current, in comparison to ML patients.
INTRODUCTION: 20.8% of the United States population and 67% of the European population speak two or more languages. Intraoperative different languages, mapping, and localization are crucial. This investigation aims to address three questions between BL and ML patients: (1) Are there differences in complications (i.e. seizures) and DECS techniques during intra-operative brain mapping? (2) Is EOR different? and (3) Are there differences in the recovery pattern post-surgery? METHODS: Data from 56 patients that underwent left-sided awake craniotomy for tumors infiltrating possible dominant hemisphere language areas from September 2016 to June 2019 were identified and analyzed in this study; 14 BL and 42 ML control patients. Patient demographics, education level, and the age of language acquisition were documented and evaluated. fMRI was performed on all participants. RESULTS: 0 (0%) BL and 3 (7%) ML experienced intraoperative seizures (P = 0.73). BL patients received a higher direct DECS current in comparison to the ML patients (average = 4.7, 3.8, respectively, P = 0.03). The extent of resection was higher in ML patients in comparison to the BL patients (80.9 vs. 64.8, respectively, P = 0.04). The post-operative KPS scores were higher in BL patients in comparison to ML patients (84.3, 77.4, respectively, P = 0.03). BL showed lower drop in post-operative KPS in comparison to ML patients (- 4.3, - 8.7, respectively, P = 0.03). CONCLUSION: We show that BL patients have a lower incidence of intra-operative seizures, lower EOR, higher post-operative KPS and tolerate higher DECS current, in comparison to ML patients.
Entities:
Keywords:
Bilingual patients; Direct cortical stimulation; Electrocorticography; Extent of resection; Intraoperative speech mapping; Language cortex
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