A novel tablet computer platform for advanced language mapping during awake craniotomy procedures

Melanie A. Morrison*, Fred Tam, Marco M. Garavaglia, Laleh Golestanirad, Gregory M.T. Hare, Michael D. Cusimano, Tom A. Schweizer, Sunit Das, Simon J. Graham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

A computerized platform has been developed to enhance behavioral testing during intraoperative language mapping in awake craniotomy procedures. The system is uniquely compatible with the environmental demands of both the operating room and preoperative functional MRI (fMRI), thus providing standardized testing toward improving spatial agreement between the 2 brain mapping techniques. Details of the platform architecture, its advantages over traditional testing methods, and its use for language mapping are described. Four illustrative cases demonstrate the efficacy of using the testing platform to administer sophisticated language paradigms, and the spatial agreement between intraoperative mapping and preoperative fMRI results. The testing platform substantially improved the ability of the surgeon to detect and characterize language deficits. Use of a written word generation task to assess language production helped confirm areas of speech apraxia and speech arrest that were inadequately characterized or missed with the use of traditional paradigms, respectively. Preoperative fMRI of the analogous writing task was also assistive, displaying excellent spatial agreement with intraoperative mapping in all 4 cases. Sole use of traditional testing paradigms can be limiting during awake craniotomy procedures. Comprehensive assessment of language function will require additional use of more sophisticated and ecologically valid testing paradigms. The platform presented here provides a means to do so.

Original languageEnglish (US)
Pages (from-to)938-944
Number of pages7
JournalJournal of neurosurgery
Volume124
Issue number4
DOIs
StatePublished - Apr 2016

Keywords

  • Brain mapping
  • Brain tumor
  • Functional neurosurgery
  • Glioma
  • Language
  • Surgery
  • Surgical technique
  • Tablet computing

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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