How to operate on a brain tumor so that the patient can continue playing chess

Catalan researchers have described for the first time how to operate on a brain tumor while preserving a patient’s chess-playing ability. The research and operation come from the Cognition and Brain Plasticity Group of the University of Barcelona and the Bellvitge Biomedical Research Institute (IDIBELL), the Bellvitge University Hospital and the Computer Vision Center. The results have been published in the journal Cortex.

The patient is an amateur chess player who underwent surgery to remove a brain tumor in the left parietal lobe. The previous study allowed the passage through the operating room to be carried out by minimizing the risk of the operation on his performance in chess, reports the Agència Catalana de Notícies (ACN).

Before the operation, the researchers combined electrical stimulation mapping to the awake patient with functional MRI to evaluate different cognitive processes involved in the game of chess, such as visual search (locating a piece on the board), rule retrieval (determining whether a move is legal or not) and the ability to predict checkmate.

Following previous work, they identified a point in the left supramarginal gyrus of the brain that is key to retaining the ability to play chess well. Before the intervention, the patient (who had an ELO score of 1.950) expressed his desire to preserve his performance as a chess player.

Thanks to the work to detect the brain region related to chess and the efforts not to affect this region during the operation, the patient was able to maintain both his chess performance and ELO score after the intervention.

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The study has demonstrated the feasibility of this type of protocols to preserve higher cognitive abilities after brain tumor resection. In addition to the usefulness it has had in this specific case, the study opens the door to using similar protocols to promote the preservation of complex skills in future patients.

With more than 300,000 brain tumors diagnosed annually worldwide, brain cancer represents a major global health problem. The usual treatment is removal of the tumor through neurosurgery.

This intervention is often performed with the patient awake when the lesion is located in the so-called eloquent areas of the brain, which are those related to functions such as speech, movement of the extremities or facial expressions, functions that are especially sensitive to preserving during surgery.

To maximize this preservation, specialists carry out the procedure called electrical stimulation mapping (ESM). This procedure involves stimulating the brain with an electrode while the patient performs a certain task to identify functional regions critical for movement, senses or language.

In the case of the chess player patient, electrical stimulation mapping was complemented by a brain study using functional magnetic resonance imaging (fMRI). While fMRI showed brain activity in the vicinity of the tumor, ESM revealed the existence of the functional point during the chess rule recovery effort.

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