Preserving a Patient’s Cognitive Function: Surgeons Identify and Protect Key Brain Region
A groundbreaking study published in the journal Cortex sheds light on the innovative approach taken by surgeons to preserve a patient’s cognitive function during a complex brain surgery. The patient, identified as “AB,” faced the daunting task of having a glioblastoma removed from his brain, knowing that the procedure could potentially impact his ability to play chess—a cherished hobby he had cultivated for 25 years. With a specific request to safeguard his chess skills, AB’s surgeon, Dr. Andreu Gabarrós, and his team at Bellvitge University Hospital in Spain embarked on a mission to map AB’s brain and identify key areas crucial for his cognitive abilities.
The Chess-Preserving Surgical Protocol
Dr. Gabarrós collaborated with neuroscientist colleagues at the University of Barcelona to develop a chess-preserving surgical protocol for AB’s procedure. The team utilized functional magnetic resonance imaging (fMRI) to isolate the regions of AB’s brain linked to his chess performance. By combing through existing scientific literature and conducting brain scans, they were able to pinpoint the supramarginal gyrus (SMG) as a critical area responsible for various cognitive tasks, including chess play.
During the surgery, surgeons employed electrical stimulation mapping (ESM) to identify and avoid areas of the brain essential for AB’s chess abilities. By stimulating different spots on the cerebral cortex while AB was awake, the surgeons could assess his cognitive responses and pinpoint the precise location of the SMG. This meticulous process allowed the team to spare the crucial brain tissue needed for AB to continue playing chess post-surgery.
Post-Surgery Evaluation and Results
Following the surgery, AB experienced complications that temporarily affected his language and motor skills. However, four months later, when his cognitive abilities were assessed, AB demonstrated a slight decline in response times for complex chess-related tasks. Despite this minor setback, AB was able to maintain his coveted Elo rating, indicating that his chess skills had been preserved.
While the study focused on a single patient, its implications are significant for the field of neurosurgery. The innovative approach taken by Dr. Gabarrós and his team highlights the importance of preserving cognitive functions while removing tumor tissue. By identifying and protecting key brain regions associated with specific tasks like chess play, surgeons can tailor their procedures to meet the individual needs of each patient.
The success of AB’s surgery has paved the way for further research in this area, with the team at the University of Barcelona exploring similar protocols for other cognitive skills, such as computer programming. By integrating cognitive tasks into surgical planning, surgeons can enhance the precision and effectiveness of their procedures, ultimately improving patient outcomes.
In conclusion, the study exemplifies the intersection of science and medicine in preserving cognitive function during complex brain surgeries. Through collaboration and innovation, surgeons can now tailor their procedures to protect essential brain regions while addressing the specific needs and abilities of each patient. The chess-preserving surgical protocol developed for AB’s surgery serves as a blueprint for future advancements in neurosurgery, offering hope for patients facing similar challenges in preserving their cognitive skills.