TY - JOUR T1 - Potential differences between monolingual and bilingual patients in approach and outcome after awake brain surgery. JF - J Neurooncol Y1 - 2020 A1 - ReFaey, Karim A1 - Tripathi, Shashwat A1 - Bhargav, Adip G A1 - Grewal, Sanjeet S A1 - Middlebrooks, Erik H A1 - Sabsevitz, David S A1 - Jentoft, Mark A1 - Peter Brunner A1 - Wu, Adela A1 - Tatum, William O A1 - Ritaccio, Anthony A1 - Chaichana, Kaisorn L A1 - Quinones-Hinojosa, Alfredo KW - Brain Mapping KW - Brain Neoplasms KW - Craniotomy KW - Female KW - Follow-Up Studies KW - Glioma KW - Humans KW - Incidence KW - Language KW - Male KW - Middle Aged KW - Monitoring, Intraoperative KW - Prognosis KW - Retrospective Studies KW - Seizures KW - United States KW - Wakefulness AB -

INTRODUCTION: 20.8% of the United States population and 67% of the European population speak two or more languages. Intraoperative different languages, mapping, and localization are crucial. This investigation aims to address three questions between BL and ML patients: (1) Are there differences in complications (i.e. seizures) and DECS techniques during intra-operative brain mapping? (2) Is EOR different? and (3) Are there differences in the recovery pattern post-surgery?

METHODS: Data from 56 patients that underwent left-sided awake craniotomy for tumors infiltrating possible dominant hemisphere language areas from September 2016 to June 2019 were identified and analyzed in this study; 14 BL and 42 ML control patients. Patient demographics, education level, and the age of language acquisition were documented and evaluated. fMRI was performed on all participants.

RESULTS: 0 (0%) BL and 3 (7%) ML experienced intraoperative seizures (P = 0.73). BL patients received a higher direct DECS current in comparison to the ML patients (average = 4.7, 3.8, respectively, P = 0.03). The extent of resection was higher in ML patients in comparison to the BL patients (80.9 vs. 64.8, respectively, P = 0.04). The post-operative KPS scores were higher in BL patients in comparison to ML patients (84.3, 77.4, respectively, P = 0.03). BL showed lower drop in post-operative KPS in comparison to ML patients (- 4.3, - 8.7, respectively, P = 0.03).

CONCLUSION: We show that BL patients have a lower incidence of intra-operative seizures, lower EOR, higher post-operative KPS and tolerate higher DECS current, in comparison to ML patients.

VL - 148 IS - 3 ER -