Awake surgery: skills of neurosurgeon matter but those of patient too. How to optimize functional brain mapping by improving per-operatory testing?

It is now possible to perform resections of slowgrowing tumors in awake patients. Using direct electrical stimulation (DES), real-time functional mapping of the brain can be used to prevent the resection of essential areas near the tumor. For now, simple clinical tests are performed on conscious patients and combined with DES in order to discriminate functional and non-functional areas invaded by the tumors. In this work we try to develop a simple device based on a simple technology to better quantify the performances of the patients during the surgery itself and give a real-time feedback to the neurosurgeon that will help to further guide the surgery by improving the sensibility of the functional mapping. This procedure should also allow building a strong database that should serve retrospectively to improve the surgical procedure and reinforce the neurosurgeons’ experience as well as to monitor the patients’ performances all along their life