Preservation of artistic activities in 19 semiprofessional or professional artists who underwent awake connectome-based resection for a WHO grade 2 glioma.

Abstract

Objective: In low-grade glioma (LGG), although awake surgery (AS) with intraoperative functional mapping helps to minimize neurological and cognitive deficits, its impact on artistic abilities has received less attention. This study is the first to assess the capacity of professional or semiprofessional artists to resume various art activities following AS for LGG.

Methods: Artists who underwent AS for an IDH-mutated WHO grade 2 glioma with connectome-based resection using cortico-subcortical electrostimulation were consecutively selected. Real-time, tailored multitasking was performed throughout the resection, but no additional tasks related to artistic abilities were introduced.

Results: Nineteen patients were included, consisting of 15 professional artists (5 architects, 2 comedians, 2 musicians, 2 dancers, 1 sculptor, 1 plastic artist, 1 writer, and 1 art professor) and 4 semiprofessional artists-2 musicians (1 professor of chemistry, 1 informatician), 1 poet (theater administrator), and 1 painter (social worker). This consecutive cohort included 10 men (52.6%) and 9 women (47.4%) who underwent AS for LGG. Of the 19 patients, 16 were right-handed, the mean age was 36.8 ± 9.7 years, and the mean Karnofsky Performance Scale score was 94.7 ± 6.9. There were 11 left-sided and 8 right-sided tumors distributed across the 5 lobes (mean preoperative volume 52.8 ± 39.4 cm3). All patients were fully active before surgery, except for 1 architect with intractable epilepsy. Postoperatively, no permanent deficits were observed, except 1 case of voluntary induced hemianopia (5.3%). The mean Karnofsky Performance Scale score was 95.7 ± 5 at 3 months after surgery. All patients returned to their artistic practice at the semiprofessional or professional level, and none reported a subjective loss of creativity. The mean extent of resection was 91.2% ± 8.6% (mean residual tumoral volume 5 ± 5.8 cm3). There were 12 astrocytomas and 7 oligodendrogliomas. Only 1 patient received immediate adjuvant therapy. Five patients (26.3%) underwent subsequent AS. The mean follow-up duration was 7.6 ± 3.1 years since the initial AS. All patients except 3 (84.2%) were still alive at the last follow-up (1 died from an unrelated cause). There were no significant differences between professional and semiprofessional artists, except for a higher rate of reoperation in the latter subgroup (p = 0.037).

Conclusions: These original data show that AS with intraoperative continuous multitasking enabled semiprofessional and professional artists with LGG to resume their artistic work following surgery. This suggests that, although artistic creativity should be more systematically considered in surgical neuro-oncology, even for nonprofessional artists, there is nonetheless no need to introduce specific tests during surgery.