The perspectives of mapping and monitoring of the sense of self in neurosurgical patients

Article Article scientifique Revue de la littérature The perspectives of mapping and monitoring of the sense of self in neurosurgical patients eng 2021-03-08 2021-05 author Schaller Karl Lothard 658606 author Iannotti Giannina Rita 791431 author Orepic Pavo 965457 author Betka Sophie 935330 author Haemmerli Julien 0000-0001-7446-3815 659636 author Boex Colette 0000-0002-9374-4791 28086 author Alcoba Banqueri Sixto Luis 948177 author Garin Dorian Fernand Alfred 0000-0002-3872-3496 851502 author Herbelin Bruno author Park Junhyeong 941828 author Michel Christoph 0000-0003-3426-5739 91629 author Blanke Olaf 107390 1213-1226 10.1007/s00701-021-04778-3 33686522 0001-6268 PMC8053654 Surgical treatment of tumors, epileptic foci or of vascular origin, requires a detailed individual pre-surgical workup and intra-operative surveillance of brain functions to minimize the risk of post-surgical neurological deficits and decline of quality of life. Most attention is attributed to language, motor functions, and perception. However, higher cognitive functions such as social cognition, personality, and the sense of self may be affected by brain surgery. To date, the precise localization and the network patterns of brain regions involved in such functions are not yet fully understood, making the assessment of risks of related post-surgical deficits difficult. It is in the interest of neurosurgeons to understand with which neural systems related to selfhood and personality they are interfering during surgery. Recent neuroscience research using virtual reality and clinical observations suggest that the insular cortex, medial prefrontal cortex, and temporo-parietal junction are important components of a neural system dedicated to self-consciousness based on multisensory bodily processing, including exteroceptive and interoceptive cues (bodily self-consciousness (BSC)). Here, we argue that combined extra- and intra-operative approaches using targeted cognitive testing, functional imaging and EEG, virtual reality, combined with multisensory stimulations, may contribute to the assessment of the BSC and related cognitive aspects. Although the usefulness of particular biomarkers, such as cardiac and respiratory signals linked to virtual reality, and of heartbeat evoked potentials as a surrogate marker for intactness of multisensory integration for intra-operative monitoring has to be proved, systemic and automatized testing of BSC in neurosurgical patients will improve future surgical outcome. Bodily self Brain surgery Consciousness Neuropsychology Self Social Body Image Brain Mapping Cognition Evoked Potentials / physiology Heart Rate / physiology Humans Neurosurgical Procedures Self Concept Dewey 616.8 61 Département des neurosciences cliniques 226 53 Département de neurosciences fondamentales 21A false 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 118 Organisation et plasticité des réseaux neuronaux cérébraux 148 Acta neurochirurgica 163 5 4a52c71b-116c-45f5-89c3-6825dc073b2b Article (Published version) Public Article-scientifique-from-europePmc.pdf 1149203 application/pdf CC BY-4.0 openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine fondamentale / Département de neurosciences fondamentales

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Garin, Dorian Fernand Alfred

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