Awake intraoperative brain mapping is a neurosurgical technique utilized to identify functional areas of the brain and to avoid causing damage to these critical regions. The procedure involves temporarily awakening the patient during surgery and testing their brain function while directly applying electrical stimulation to specific areas of the brain. In the context of infiltrative brain tumors such as gliomas, there is robust evidence suggesting that awake brain mapping not only improves the extent of their resection, but is also safer with a lower risk of procedure-related complications. Clinical psychologists play a vital role in awake intraoperative brain mapping by profiling the patient's psychological status before and after the procedure, providing emotional support, and evaluating neuropsychological function during surgery.
Before an awake craniotomy, clinical psychologists assesses a patient's language, cognitive and emotional status as well as provide psychoeducation to alleviate anxieties related to the procedure. Preoperative mapping paradigms are also tested and rehearsed with the patient. Intraoperatively, during the awake phase of the procedure clinical psychologists often become the primary point of contact for the patient. They are tasked with delivering mapping tests and continually ensuring the patient’s comfort whilst working with the rest of the treating team.
Postoperatively, clinical psychologists are required to regularly evaluate the patient's cognitive, emotional, and behavioral functioning to determine the extent of potential changes resulting from surgery. Information garnered from this exercise can help guide postoperative care and rehabilitation. Finally, clinical psychologists may also provide counselling to patients and their families to help them cope with the emotional and psychological impact of the neuro-oncological diagnosis.
In conclusion, clinical psychologists play a critical role in awake intraoperative brain mapping by assessing the patient's psychological status before and after the surgery, providing emotional support, and assisting with the assessment of cognitive function during the surgery. By collaborating with neurosurgeons and other members of the treating team, clinical psychologists can help optimize patient outcomes and ensure the best possible surgical outcomes.
