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Action comprehension assessment during intraoperative mapping in patients with right hemisphere gliomas.
Poster E115 in Poster Session E, Thursday, October 26, 10:15 am - 12:00 pm CEST, Espace Vieux-Port
Laura de Frutos Sagastuy1, Ileana Quiñones1, Santiago Gil-Robles2,3, Iñigo Pomposo4, Garazi Bermúdez4, Manuel Carreiras1,2, Lucia Amoruso1,2,5; 1Basque center on Cognition, Brain and Language, 2Ikerbasque, Basque Foundation for Science, Bilbao, Spain, 3Hospital Quirón, Madrid, Spain, 4BioCruces Research Institute, Bilbao, Spain, 5Cognitive Neuroscience Center (CNC), University of San Andres, Argentina
The Action Observation Network (AON) plays a critical role in our ability to understand the “why” of other people's actions, allowing us to interact with our conspecifics in a flexible and appropriate fashion. At the neuroanatomical level, the AON involves fronto-parietal regions subcortically interconnected through the superior longitudinal fasciculus (SLF), which has recently been identified as the main association tract in this network. Damage to this system can result in maladaptive social behavior, highlighting the need for its preservation during intraoperative mapping for glioma resection. However, no team has yet developed a cognitive task that allows mapping the AON during awake brain surgery. Here, we used fMRI to validate an action observation task requiring participants to watch incomplete ongoing actions performed by others and infer the underlying motor intention. In healthy individuals, the task accurately mapped bilateral AON regions dorsally (z-score ~ 7). We further applied this task to patients with gliomas in frontal and parietal regions prior to surgery, and observed significant activation in the AON and regions surrounding the tumor, proving valuable for presurgical planning. During the surgical procedure, the direct electrical stimulation (DES) technique was employed to map the hubs of the AON enabling real-time structure-function causal evidence and shedding light in the involvement of white matter tracts in this cognitive process. The combination of this task with DES, successfully identified positive sites at cortical (e.g., IFG) and subcortical levels (e.g., SLF). Overall, our findings demonstrate that this task is highly sensitive and specific for detecting AON activity in both neurotypical individuals and patients diagnosed with right glioma tumors. They also show that, although challenging, developing tools to map social cognition in the right hemisphere can enhance the precision of awake brain surgery, potentially reducing postoperative deficits in social comprehension abilities.
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