Abstract
The laser speckle imaging is based on the analysis of speckle patterns produced by the reflection of a laser light on a surface. In a previous study, Klijn et al. used speckle laser imaging to monitor changes in motor cortex blood flow during motor tasks performed in awake patients by surgery, finding an activation pattern similar blood-oxygen-level dependent studied in functional MRI (fMRI). We report in this clinical case the study and detection of activation in brain areas involved in language by laser speckle imaging in a patient 30 years during awake. Mr J. was hospitalized in the Department of Neurosurgery of the University Hospital of Angers for a posterior temporal glial tumor. Brain areas involved in language were identified preoperatively using fMRI and during the surgery with cortical stimulation mapping. We studied during surgery the changes in cortical blood flow using a laser speckle Pericam PSI (Perimed) when the patient was performing naming tasks in a block paradigm, identical to that used during fMRI sequences. The acquired images were then realigned to remove motion artifacts. During surgery, stimulation of the posterior part of the supramarginal gyrus resulted in a reproducible suspension of language, corresponding to an identified langage area in fMRI. The laser speckle study showed a cyclic variation of the local blood flow of the previously identified area, increasing during the naming tests and returning to baseline levels during the sessions of rest. This case emphasizes the importance of laser speckle in the intraoperative analysis of changes in cortical blood flow. A study is ongoing in our service to validate the relevance of laser speckle as a means of identifying functional brain areas during awake surgery.
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