Testing Executive Functioning during Intraoperative Monitoring with the Stroop paradigm in 152 glioma patients

Intraoperative monitoring in awake surgery is performed in patients with both high-grade and low-grade glioma infiltrating functional brain areas to preserve cognitive functioning. Executive functioning is highly important to maintain autonomy in daily live and quality of life. A paradigm to preserve executive functioning is urgently needed. We studied the feasibility of an adapted Stroop paradigm in a sample of 256 consecutive included glioma patients within clinical care-as-usual. We compared characteristics of patients in whom the paradigm was versus was not used. In 152 (60%) of the patients the Stroop was used intraoperative. No differences in age [range 15-82], education, side (L vs. R: 72.8 vs 27.2%) or grade (low vs high: 31 vs 69%) of the tumor was found between procedures with and without the use of the Stroop paradigm (all p>0.05). No differences were discerned between site of the tumor (frontal/temporal/parietal/insular) : (47.9/18.1/17.1/6.4%). Pre-operative neuropsychological data underlines the heterogeneity and the wide applicability of this task. We conclude that our adapted stroop paradigm is a feasible promising tool to preserve executive functioning in both high and low-grade glioma patients.