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Manual reaction times and brain dynamics after 'awake surgery' of slow-growing tumours invading the parietal area. A case report

机译:缓慢增长的肿瘤侵入顶区的“清醒手术”后的手动反应时间和脑动力学。病例报告

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Primary objectives: Awake surgeries of slow-growing tumours invading the brain and guided by direct electrical stimulation induce major brain reorganizations accompanied with slight impairments post-operatively. In most cases, these deficits are so slight after a few days that they are often not detectable on classical neuropsychological evaluations. Consequently, this study investigated whether simple visuo-manual reaction time paradigms would sign some level of functional asymmetries between both hemispheres. Importantly, the visual stimulus was located in the saggital plane in order to limit attentional biases and to focus mainly on the inter-hemispheric asymmetry. Methods and procedures: Three patients (aged 41, 59 and 59 years) after resections in parietal regions and a control group (age=44, SD=6.9) were compared during simple uni- and bimanual reaction times (RTs). Main outcomes and results: Longer RTs were observed for the contralesional compared to the ipsilesional hand in the unimanual condition. This asymmetry was reversed for the bimanual condition despite longer RTs. Conclusion and clinical implications: Reaction time paradigms are useful in these patients to monitor more precisely their functional deficits, especially their level of functional asymmetry, and to understand brain (re)organization following slow-growing lesions.
机译:主要目标:慢速生长的肿瘤侵入大脑并在直接电刺激的引导下进行清醒手术,会引起大脑的重大重组,并伴有术后轻微损伤。在大多数情况下,几天后这些缺陷非常轻微,以致于在经典的神经心理学评估中通常无法检测到。因此,本研究调查了简单的视觉-手动反应时间范式是否会在两个半球之间标志某种程度的功能不对称。重要的是,视觉刺激位于矢状面内,以限制注意力偏差并主要集中于半球间不对称性。方法和程序:在单纯的单手和双手反应时间(RTs)中比较了3例顶叶切除术后的患者(分别为41、59和59岁)和对照组(年龄= 44,SD = 6.9)。主要结果和结果:在单手情况下,与同侧手相比,对侧手的RT更长。尽管RT较长,但这种不对称性在双向条件下仍可逆转。结论和临床意义:反应时间范式可用于这些患者,以更精确地监测其功能缺陷,尤其是其功能不对称的水平,并了解病变缓慢生长后的大脑(重新)组织。

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