Cited by 312Glioma Diagnosis and TreatmentAdvanced Neuroimaging Techniques and ApplicationsIntraoperative Neuromonitoring and Anesthetic Effects

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INTRAOPERATIVE SUBCORTICAL LANGUAGETRACT MAPPING GUIDES SURGICAL REMOVALOF GLIOMAS INVOLVING SPEECH AREAS

Bello, Lorenzo, Gallucci, Marcello, Fava, Marica, Carrabba, Giorgio, Giussani, Carlo, Acerbi, Francesco, Baratta, Pietro, Songa, Valeria, Conte, Valeria, Branca, Vincenzo, Stocchetti, Nino, Papagno, Costanza, Gaini, Sergio Maria·2007·Neurosurgery

DOI 10.1227/01.neu.0000249206.58601.de

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Abstract

OBJECTIVE: Subcortical stimulation can be used to identify functional language tracts during resection of gliomas located close to or within language areas or pathways. The objective of the present study was to investigate the feasibility of the routine use of subcortical stimulation for identification of language tracts in a large series of patients with gliomas and to determine the influence that subcortical language tract identification exerted on the extent of surgery and on the appearance of immediate and definitive postoperative deficits. METHODS: Subcortical stimulation for language tract identification was systematically used during surgical removal of 88 gliomas (44 high-grade and 44 low-grade gliomas) involving language pathways. Procedures were performed during asleep/awake craniotomy. Subcortical stimulation was continuously alternated with surgical resection in a back-and-forth fashion. Language performances were tested by neuropsychological language evaluation preoperatively and at 3, 30, and 90 days after surgery. RESULTS: Language tracts were identified in 59% of patients, with differences according to tumor location but not according to histological grade. Language tract identification influenced the ability to reach a complete tumor removal in low-grade gliomas, in which tracts were documented inside the peripheral mass of the tumor. Identification of language tracts was associated with a higher occurrence of transient postoperative deficits (67.3% of cases), but a low occurrence of definitive morbidity (2.3% of cases). A pattern of typical language disturbances related to the phonological and semantic system can be identified according to tumor location, with preservation being important for the maintenance of language integrity. CONCLUSION: Our study supports the routine use of subcortical stimulation for language tract identification as a reliable tool for guiding surgical removal of gliomas in or in close proximity to language areas or pathways.

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Authors: Bello, L., Gallucci, M., Fava, M., Carrabba, G., Giussani, C., Acerbi, F., Baratta, P., Songa, V., Conte, V., Branca, V., Stocchetti, N., Papagno, C., & Gaini, S. M.
Affiliations: University of Milan (IT)
ORCID: Gallucci, Marcello
Giussani, Carlo
Venue: Neurosurgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-01
Volume: 60
Issue: 1
Pages: 67-82
ISSN: 0148-396X (ISSN-L)
DOI: 10.1227/01.neu.0000249206.58601.de
OpenAlex: W1158397885
Cited by: 312
References: 32
Citations by year: 2026: 9 · 2025: 14 · 2024: 13 · 2023: 21 · 2022: 25 · 2021: 23 · 2020: 16 · 2019: 13 · 2018: 13 · 2017: 17 · 2016: 17 · 2015: 15 · 2014: 14 · 2013: 24 · 2012: 21
FWCI: 6.38
Type: journal article
Language: en
Open access: closed
Locations: Neurosurgery (publishedVersion)
PubMed (publishedVersion)
CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
BOA (University of Milano-Bicocca) (submittedVersion)
Institutional Research Information System (Università degli Studi di Trento) (submittedVersion)
Neuro-Oncology
Topics: Health Sciences › Medicine › Oncology › Glioma Diagnosis and Treatment
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
Health Sciences › Medicine › Surgery › Intraoperative Neuromonitoring and Anesthetic Effects
Keywords: glioma resection, awake craniotomy, language pathways, postoperative language deficits, extent of resection, tumor location
MeSH terms: Adult, Aged, Brain Mapping, Brain Neoplasms, Cerebral Cortex, Electric Stimulation, Female, Glioma, Humans, Language Tests, Male, Middle Aged, Speech, Monitoring, Intraoperative

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INTRAOPERATIVE SUBCORTICAL LANGUAGETRACT MAPPING GUIDES SURGICAL REMOVALOF GLIOMAS INVOLVING SPEECH AREAS

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