The sensory-motor profile awake-A new tool for pre-, intra-, and postoperative assessment of sensory-motor function.
OBJECTIVE
Awake craniotomy is a well-established procedure in surgery of intracranial tumors in eloquent areas. However, sufficiently standardized instruments for the assessment of sensory-motor function before, during and after the operation are currently lacking, despite their importance for evaluation of operative outcome.


METHODS
To address this issue, we designed a standardized assessment tool (the "sensory-motor profile awake scale"; SMP-a). The final scale consists of three motor sections (face, arm and leg) assessing both gross and fine motor skills and one sensory section. It differentiates between six grades of impairment and its tasks are applicable for intraoperative continuous monitoring of sensory-motor functions and supporting processes. We analyzed the data of 17 patients with intracranial tumors eligible for awake craniotomy who were preoperatively assessed with the SMP-a. In addition, we present an exemplary case.


RESULTS
Our data support the assumption that the SMP-a is feasible in patients eligible for awake craniotomy, even in patients with symptoms of mild aphasia or more severe sensory-motor deficits caused by tumor recurrence. The exemplary case demonstrates the feasibility of repeated measures with the SMP-a in a tumor patient, including the adaption of tasks to the individual requirements of an intraoperative setting.


CONCLUSIONS
This exploratory study suggests that the SMP-a might be a feasible rating scale in patients with intracranial tumors. The flexibility of the scale enables individual adaption, but preserves the standardized scoring system to allow comparison between assessment dates, patients and, hopefully in the future, institutions. However, future studies are mandatory to provide data on the instrument's diagnostic properties with respect to feasibility, objectivity, validity and reliability.
Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany. Electronic address: Juliane.becker@uksh.de.
Juliane
J
Becker
Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria. Electronic address: margit.jehna@medunigraz.at.
Margit
M
Jehna
Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany. Electronic address: Elisabeth.steinmann@uksh.de.
Elisabeth
E
Steinmann
Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany. Electronic address: Maximilian.Mehdorn@uksh.de.
Hubertus M
HM
Mehdorn
Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany. Electronic address: Michael.Synowtiz@uksh.de.
Michael
M
Synowitz
Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. Electronic address: hartwigsen@cbs.mpg.de.
Gesa
G
Hartwigsen
D000328:Adult; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods; D064926:Neurophysiological Monitoring / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D059035:Perioperative Period; D014851:Wakefulness
Awake craniotomy; Brain tumor; Direct cortical stimulation; Neuropsychological monitoring; Non-language mapping; Sensory-motor function