awake surgery

Cross-modality imaging of the neural systems that support executive functions

Executive functions refer to a collection of mental processes such as attention, planning and problem solving, supported by a frontoparietal distributed brain network. These functions are essential for everyday life. Specifically in the context of patients with brain tumours there is a need to preserve them in order to enable good quality of life for patients. During surgeries for the removal of a brain tumour, the aim is to remove as much as possible of the tumour and at the same time prevent damage to the areas around it to preserve function and enable good quality of life for patients. In many cases, functional mapping is conducted during an awake surgery in order to identify areas critical for certain functions and avoid their surgical resection. While mapping is routinely done for functions such as movement and language, mapping executive functions is more challenging. Despite growing recognition in the importance of these functions for patient well-being in recent years, only a handful of studies addressed their intraoperative mapping. In the talk, I will present our new approach for mapping executive function areas using electrocorticography during awake brain surgery. These results will be complemented by neuroimaging data from healthy volunteers, directed at reliably localizing executive function regions in individuals using fMRI. I will also discuss more broadly challenges ofß using neuroimaging for neurosurgical applications. We aim to advance cross-modality neuroimaging of cognitive function which is pivotal to patient-tailored surgical interventions, and will ultimately lead to improved clinical outcomes.