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

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.

%B J Neurooncol %V 148 %P 587-598 %8 07/2020 %G eng %N 3 %R 10.1007/s11060-020-03554-0