Abstract
BackgroundIn awake craniotomy, it is possible to temporarily inactivate regions of the brain using direct electrical stimulation, while the patient performs neuropsychological tasks. If the patient shows decreased performance in a given task, the neurosurgeon will not remove these regions, so as to maintain all brain functions.ObjectiveThe objective of our study was to describe our experience of using a virtual reality (VR) social network during awake craniotomy and discuss its future applications for perioperative mapping of nonverbal language, empathy, and theory of mind.MethodsThis was a single-center, prospective, unblinded trial. During wound closure, different VR experiences with a VR headset were proposed to the patient. This project sought to explore interactions with the neuropsychologist’s avatar in virtual locations using a VR social network as an available experience.ResultsThree patients experienced VR. Despite some limitations due to patient positioning during the operation and the limitation of nonverbal cues inherent to the app, the neuropsychologist, as an avatar, could communicate with the patient and explore gesture communication while wearing a VR headset.ConclusionsWith some improvements, VR social networks can be used in the near future to map social cognition during awake craniotomy.Trial RegistrationClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943 (Archived at WebCite at http://www.webcitation.org/70CYDil0P)
Highlights
IntroductionSocial cognition includes all complex cognitive processes involved in social interaction such as nonverbal language (facial and bodily nonverbal cues as affective prosody), empathy, and theory of mind (ToM)
Social cognition includes all complex cognitive processes involved in social interaction such as nonverbal language, empathy, and theory of mind (ToM)
With some improvements, virtual reality (VR) social networks can be used in the near future to map social cognition during awake craniotomy
Summary
Social cognition includes all complex cognitive processes involved in social interaction such as nonverbal language (facial and bodily nonverbal cues as affective prosody), empathy, and theory of mind (ToM). Patients often experience difficulties with understanding humor and as well as conceptualizing and understanding thoughts and beliefs, emotions, feelings and desires, behaviors, actions, and intentions of other people. In recent times, these sequelae were largely misunderstood by neurosurgeons and compared with postsurgical impairment of language or executive functions, with few evaluations concerning social cognition having been published [1,2,3,4,5,6]. It is possible to temporarily inactivate regions of the brain using direct electrical stimulation, while the patient performs neuropsychological tasks. If the patient shows decreased performance in a given task, the neurosurgeon will not remove these regions, so as to maintain all brain functions
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