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Erschienen in:

14.12.2023 | Review

Preoperative assessment of eloquence in neurosurgery: a systematic review

verfasst von: Emma Rammeloo, Joost Willem Schouten, Keghart Krikour, Eelke Marijn Bos, Mitchel Stuart Berger, Brian Vala Nahed, Arnaud Jean Pierre Edouard Vincent, Jasper Kees Wim Gerritsen

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2023

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Abstract

Background and objectives

Tumor location and eloquence are two crucial preoperative factors when deciding on the optimal treatment choice in glioma management. Consensus is currently lacking regarding the preoperative assessment and definition of eloquent areas. This systematic review aims to evaluate the existing definitions and assessment methods of eloquent areas that are used in current clinical practice.

Methods

A computer-aided search of Embase, Medline (OvidSP), and Google Scholar was performed to identify relevant studies. This review includes articles describing preoperative definitions of eloquence in the study’s Methods section. These definitions were compared and categorized by anatomical structure. Additionally, various techniques to preoperatively assess tumor eloquence were extracted, along with their benefits, drawbacks and ease of use.

Results

This review covers 98 articles including 12,714 participants. Evaluation of these studies indicated considerable variability in defining eloquence. Categorization of these definitions yielded a list of 32 brain regions that were considered eloquent. The most commonly used methods to preoperatively determine tumor eloquence were anatomical classification systems and structural MRI, followed by DTI-FT, functional MRI and nTMS.

Conclusions

There were major differences in the definitions and assessment methods of eloquence, and none of them proved to be satisfactory to express eloquence as an objective, quantifiable, preoperative factor to use in glioma decision making. Therefore, we propose the development of a novel, objective, reliable, preoperative classification system to assess eloquence. This should in the future aid neurosurgeons in their preoperative decision making to facilitate personalized treatment paradigms and to improve surgical outcomes.

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Titel: Preoperative assessment of eloquence in neurosurgery: a systematic review
verfasst von: Emma Rammeloo
Joost Willem Schouten
Keghart Krikour
Eelke Marijn Bos
Mitchel Stuart Berger
Brian Vala Nahed
Arnaud Jean Pierre Edouard Vincent
Jasper Kees Wim Gerritsen
Publikationsdatum: 14.12.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04509-x

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