B F W van der Kallen’s research while affiliated with Hamad Medical Corporation and other places

BACKGROUND In glioma surgery, awake craniotomy with Direct Electrical Stimulation (DES) is increasingly becoming the gold standard treatment to preserve language, cognition and motor function and to optimize extent of resection. Computer programming is historically seen as an integration of cognition, language, and mathematics but an intraoperative task to monitor computer programming does not exist yet. In this study we describe a new task for intraoperative monitoring, using visual Boolean Logic Puzzles. MATERIAL AND METHODS We describe a computer programmer who underwent awake craniotomy to resect an anaplastic astrocytoma in the left superior frontal gyrus. At the request of the patient we tested programming language. We developed a new task and set of logic puzzle visual stimuli to monitor underlying cognitive function used for programming language. This test was used during preoperative functional MRI (fMRI), direct electrical stimulation (DES) and ongoing monitoring during resection. RESULTS In fMRI this task showed bilateral activation in Brodmann area 6 and 8 and for left hemisphere in Brodmann area 10. These areas are below and lateral of the tumor. Monitoring of language, motor skills and Boolean mapping was performed during DES and while resection was performed. No deficits in programming ability could be identified intra- and postoperatively. CONCLUSION Boolean Logic Puzzles may be a useful intraoperative task to preserve programming skills.