Functional Ultrasound (fUS) During Awake Brain Surgery: The Clinical Potential of Intra-Operative Functional and Vascular Brain Mapping

BACKGROUND Preserving major cognitive functions, such as visuo-spatial and social cognition in the surgical management of brain tumors could be decisive for the postoperative quality of life. Using virtual reality during awake brain surgery appears to be interesting for preserving complex cognitive functions. Developing neuropsychological tasks appropriate for use during awake brain surgery using virtual reality technology is challenging. OBJECTIVE In this paper, we describe our preliminary experience of extending progressively complex cognitive paradigms via dynamic VR environments during 68 peri-operative brain mapping. METHODS This is a single center, retrospective longitudinal study, concerning two cohorts. RESULTS A total of 65 patients (30 women, mean age 49.7, range 23-75) operated with VR-assisted Brain mapping were included. At least one VR task (VR-DO 80, VR Estermann or VR-TANGO task) during DES were done for all the patients. The mean duration of surgery was 4 h 30 min, the mean duration of the awake phase was 2 h 15 min. The mean intensity used for DES was 3 mA (Intensity from 0,5 to 8 mA). Mean total duration of VRH use per patient at 16 min (from 10 to 37 min). VR task allowed to preserve language, visual field, visuospatial and social cognition in our serie. CONCLUSIONS We show through illustrative cases how VR opens new possibilities for the mapping of complex cognitive functions within the operating theater. CLINICALTRIAL ClinicalTrials.gov NCT03010943Virtual reality; awake neurosurgery; visual field; social cognition; visuospatial cognition; unilateral spatial neglect. INTERNATIONAL REGISTERED REPORT RR2-10.2196/10332.

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JMRI special issue: Clinical potential of brain mapping using MRI

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.20588 ◽

2006 ◽

Vol 23 (6) ◽

pp. 785-786 ◽

Cited By ~ 2

Author(s):

C. Leon Partain

Keyword(s):

Brain Mapping ◽

Special Issue ◽

Clinical Potential

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Clinical Applications of Functional Neuroimaging

10.1093/oxfordhb/9780199764228.013.004 ◽

2014 ◽

Author(s):

Andrew C. Papanicolaou ◽

Roozbeh Rezaie ◽

Shalini Narayana ◽

Asim F. Choudhri ◽

James W. Wheless ◽

...

Keyword(s):

Brain Mapping ◽

Surgical Planning ◽

Functional Neuroimaging ◽

Clinical Applications ◽

Hemispheric Dominance ◽

Brain Surgery ◽

Noninvasive Methods ◽

Language Functions ◽

Cortical Regions ◽

Gold Standards

The main clinical application of functional neuroimaging is mapping cortical regions containing part of the circuitry necessary for somatosensory, motor, and language functions and assessing hemispheric dominance for both language and encoding operations of memory prior to several types of brain surgery. Presently, it is used in conjunction with the classical invasive methods of brain mapping. This chapter presents the case for replacing invasive methods with noninvasive ones given the limitations of the invasive methods that render them unjustifiable as “gold standards.” Evidence is presented that the efficacy of the two types of methods in reducing morbidity, facilitating surgical planning, and enhancing surgical outcome is comparable. Additional advantages of noninvasive presurgical brain mapping are also discussed. The chapter concludes that there are no compelling reasons for invasive mapping in most patients whenever noninvasive methods are available.

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Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study (Preprint)

10.2196/preprints.24373 ◽

2020 ◽

Author(s):

Morgane Casanova ◽

Anne Clavreul ◽

Gwénaëlle Soulard ◽

Matthieu Delion ◽

Ghislaine Aubin ◽

...

Keyword(s):

Virtual Reality ◽

Eye Tracking ◽

Brain Mapping ◽

Eye Gaze ◽

Standard Procedure ◽

Naming Task ◽

Evaluation Study ◽

Awake Surgery ◽

Brain Surgery ◽

Language Mapping

BACKGROUND Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. OBJECTIVE This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. METHODS We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. RESULTS None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. CONCLUSIONS We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. CLINICALTRIAL ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

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Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Journal of Medical Internet Research ◽

10.2196/24373 ◽

2021 ◽

Vol 23 (3) ◽

pp. e24373

Author(s):

Morgane Casanova ◽

Anne Clavreul ◽

Gwénaëlle Soulard ◽

Matthieu Delion ◽

Ghislaine Aubin ◽

...

Keyword(s):

Virtual Reality ◽

Eye Tracking ◽

Brain Mapping ◽

Eye Gaze ◽

Standard Procedure ◽

Naming Task ◽

Evaluation Study ◽

Awake Surgery ◽

Brain Surgery ◽

Language Mapping

Background Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. Objective This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. Methods We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. Results None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. Conclusions We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. Trial Registration ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

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Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00322 ◽

2020 ◽

Vol 63 (5) ◽

pp. 1618-1635

Author(s):

Céline Richard ◽

Mary Lauren Neel ◽

Arnaud Jeanvoine ◽

Sharon Mc Connell ◽

Alison Gehred ◽

...

Keyword(s):

Systematic Review ◽

Cochrane Library ◽

Neurodevelopmental Outcomes ◽

Frequency Following Response ◽

Ovid Medline ◽

Published Evidence ◽

Mesh Terms ◽

Potential Applicability ◽

Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

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