title: Intraoperative electrical stimulation in awake craniotomy: methodological aspects of current practice.
abstract: There is increasing evidence that the extent of tumor removal in low-grade glioma surgery is related to patient survival time. Thus, the goal of resecting the largest amount of tumor possible without leading to permanent neurological sequelae is a challenge for the neurosurgeon. Electrical stimulation of the brain to detect cortical and axonal areas involved in motor, language, and cognitive function and located within the tumor or along its boundaries has become an essential tool in combination with awake craniotomy. Based on a literature review, discussions within the European Low-Grade Glioma Group, and illustrative clinical experience, the authors of this paper provide an overview for neurosurgeons, neurophysiologists, linguists, and anesthesiologists as well as those new to the field about the stimulation techniques currently being used for mapping sensorimotor, language, and cognitive function in awake surgery for low-grade glioma. The paper is intended to help the understanding of these techniques and facilitate a comparison of results between users.
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe University, D-60528 Frankfurt am Main, Germany. A.Szelenyi@em.uni-frankfurt.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Szelényi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bello
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
authors.forename: Enrica
authors.initials: E
authors.lastname: Fava
authors.forename: Guenther C
authors.initials: GC
authors.lastname: Feigl
authors.forename: Miroslav
authors.initials: M
authors.lastname: Galanda
authors.forename: Georg
authors.initials: G
authors.lastname: Neuloh
authors.forename: Francesco
authors.initials: F
authors.lastname: Signorelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
mesh_terms: D001291:Attitude of Health Personnel; D001921:Brain / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D001931:Brain Mapping / Q000379:methods*; D001932:Brain Neoplasms / Q000601:surgery*; D002540:Cerebral Cortex / Q000502:physiology / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D004525:Efferent Pathways / Q000033:anatomy & histology / Q000502:physiology; D004558:Electric Stimulation / Q000009:adverse effects / Q000379:methods*; D005910:Glioma / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007802:Language; D016343:Monitoring, Intraoperative; D009434:Neural Pathways / Q000502:physiology; D009493:Neurosurgery; D019635:Neurosurgical Procedures; D014851:Wakefulness