"iST" is a useful tool to protect the function of non-advantaged frontal glioma patients

Ref: Puglisi G, et alJNeurosurg2018 Sep 28:1-7doi: 10.3171/2018.4.JNS18393The goal of theglioma surgery is to protect the integrity of the patient's brain function while maximizing the removal of the tumorCurrently, the risk of impairment of patient function (executive functions, EFs) and quality of life is still high during prefrontal tumor excision, but most of them can achieve surgical goalsGuglielmo Puglisi, of the University of Milan's Neurosurgery Oncology Division, and others using the midoperative version of the Streup task (intrainiversion of the stroop task, iST) detectEF-related brain regions during surgery, protecting advanced brain functionThe findings were published online in J Neurosurg in September 201845 patients with non-advantaged prefrontal glioma were operated on to determine the exact removal boundary through the brain positioning systemOf these, 18 patients in the control group received subcortical levels of brain function in surgery, including language, exercise and motor function in addition to executive functionThe remaining 27 patients were in the Stroop task group, which, in addition to receiving language, exercise, and motor function positioning, were positioned for their function at the cortical-cortical level of iST (Figure 1)The performing function status of both groups of patients was assessed before surgery, 7 days after surgery and 3 monthsThe iST positioning pattern diagram is applied in the techniqueThe patient is required to say the color of the letters on the monitorWhen the ribbon is stimulated (red lightning in figure), it can interfere with the patient's color recognition and reading speedinstudies, iST was successfully applied in all patients in the Stroop task groupBy precisely stimulating the white matter in the lower part of the forehead, the front of the island leaf, and above the shell core, the patient's results in terms of color recognition speed and reading of the meaning are disturbed, and the functional limits of the patient after surgery can be judgedThe researchers found that the use of iST in surgery in the control group and the Stroop task group significantly reduced the incidence of performing dysfunction during follow-up 3 months after surgery (Figure 2)Figure 2Trends in the occurrence of functional defectsfinally, the authors point out that the use of iST for brain function positioning can identify and protect the frontal lobe structure associated with autonomic reaction during surgery, reducing the incidence of postoperative performing function deficiencyTherefore, iST recognition can protect the neural function network, prevent the occurrence of advanced cognitive dysfunction in patients after large-scale excision of non-advantaged frontal lobe tumors, and improve the quality of life after surgery.