Awake Surgery for functional analysis and preservation of attention in cingulum

2019 Fiscal Year Final Research Report

• Project/Area Number: 18K16551
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Chiba University
• Principal Investigator: HIRONO SEIICHIRO 千葉大学, 大学院医学研究院, 助教 (30554258)
• Project Period (FY): 2018-04-01 – 2020-03-31
• Keywords: 帯状束 / 注意障害 / 覚醒下手術 / グリオーマ

Outline of Final Research Achievements

The awake surgery for both the preservation of attention and the maximum tumor resection has not been developed. Here in this study, we focused on the cingulum and analysis the cingulum disconnection and postoperative impaired attention. Even without symptoms, around 30 to 50% of patients showed impaired attention preoperatively. When the right cingulum disconnected, no subjective impairment was found, but slightly worsening of the attentional function was observed in objective analysis. In addition, the left cingulum-disconnection induced severe long-lasting disattention in both subjective and objective analysis. Interestingly, there were some patients who didn't develop the impairment of attention even after cingulum disconnection.

Free Research Field

脳腫瘍外科

Academic Significance and Societal Importance of the Research Achievements

自覚症状がなくても一定の割合ですでに術前から注意障害を認める場合があることが判明した。また、左右の帯状束の切断によって生じる注意機能障害は、その程度や回復の可否に差があり、その障害が永続する可能性が示唆された。一方で、腫瘍の摘出に伴い帯状束を切断しても、術後の注意機能障害が一過性で回復する例も少数認められた。これらのことから、今後、帯状束の切断の結果生じる注意障害が一過性または永続性になる因子を明らかにすることで、さらなる注意機能の温存と最大限の腫瘍摘出の両立をはかることができ、脳腫瘍患者のQOLの改善に資する可能性が示唆された。