The Effect of Intraoperative Cortical Stimulation on Hand Strength and Function During Awake Craniotomies
The neurosurgical standard of care for treating a patient with a tumor invading hand primary motor cortex (M1) includes performing a craniotomy with intraoperative direct electrical stimulation (DES) mapping and to resect as much tumor as possible without a resultant permanent neurological deficit. However, the subjective nature of current intraoperative hand motor assessments do not offer a comprehensive understanding of how hand strength and function may be impacted by resection. Additionally, there is a paucity of data to inform how altering DES parameters may effect motor mapping. Here, the investigators seek to demonstrate a feasible, standardized protocol to quantitatively assess hand strength and function and systematically assess several stimulation parameters to improve intraoperative measurements and better understand how cortical stimulation interacts with underlying neural function.
• Age 18 - 75
• Ability to understand a written informed consent document, and the willingness to sign it
• Radiographic evidence of tumor on MRI (i.e. non-enhancing) invading primary motor cortex in the non-dominant hemisphere.
• Karnofsky performance status (KPS) ≥ 70
• Normal or near normal motor strength (i.e., at least 3/5 in relevant areas)
• Normal or near normal speech (Can consistently name at least 4/5 cards)
• Free of other illness, in the judgment of the investigator, that may shorten life expectancy
• Willing and able to participate in all aspects of the study