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Is intraoperative mapping of music performance mandatory to preserve skills in professional musicians? Awake surgery for lower-grade glioma conducted from a meta-networking perspective.
Martín-Fernández, Jesús; Moritz-Gasser, Sylvie; Herbet, Guillaume; Duffau, Hugues.
Afiliación
  • Martín-Fernández J; 1Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
  • Moritz-Gasser S; 2Department of Neurosurgery, Our Lady of Candelaria University Hospital (HUNSC), Santa Cruz de Tenerife, Spain.
  • Herbet G; 3Institut Guttmann, University Institute of Neurorehabilitation attached to the UAB, Barcelona, Spain.
  • Duffau H; 4Department of Basic Medical Sciences, University of La Laguna, Santa Cruz de Tenerife, Spain.
Neurosurg Focus ; 56(2): E9, 2024 02.
Article en En | MEDLINE | ID: mdl-38301246
ABSTRACT

OBJECTIVE:

In surgery for lower-grade glioma (LGG) in professional musicians, for whom preserving music ability is essential, a critical question has emerged, namely, is it mandatory to include music performance during awake mapping, as proposed in several reports? In fact, music ability is subserved by a mosaic of interactive cognitive and emotional processes that rest on several networks. Therefore, from a meta-network perspective, the authors investigated whether an integrated multimodal monitoring of these cognitive and emotional functions during stimulation mapping could be efficient in maintaining musical skill. Indeed, it could be difficult for a patient to play a musical instrument in the surgical setting in addition to performing other tasks, such as movement and language.

METHODS:

An awake mapping-guided resection for LGG without intraoperative music performance was performed in 3 professional musicians. Intraoperative tests were tailored to each patient depending on the critical corticosubcortical circuits surrounding the tumor, including not only sensorimotor or language skills but also higher-order functions with a constant multitasking during the resection.

RESULTS:

Although music skills were not mapped during surgery, all patients resumed their professional activities, preserving the ability to play music and to perform concerts, to teach and to compose music, or to start learning a new instrument.

CONCLUSIONS:

A connectome-based resection without intraoperative music performance seems effective in achieving maximal glioma removal while preserving crucial networks subserving musical skills, creativity, and music learning. Neurosurgery should evolve toward a meta-networking approach to better understand higher-order functions mediating complex behavior, such as being a professional musician.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Glioma / Música Límite: Humans Idioma: En Revista: Neurosurg Focus Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Glioma / Música Límite: Humans Idioma: En Revista: Neurosurg Focus Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos