Awake Mapping Research Could Clarify Treatment Choices

The research program of neurosurgeon Shawn Hervey-Jumper, MD, is deeply influenced by his patients’ struggles to understand how treatment will affect their quality of life. This is especially important, he says, given that we now know molecular markers that indicate a brain tumor patient’s likely prognosis, and 70 percent of surviving patients experience cognitive dysfunction that leads to reduced quality of life.

Hervey-Jumper’s research, therefore, aims to understand the mechanisms by which gliomas disturb functional language and cognitive networks. A 2017 Robert Wood Johnson Foundation Harold Amos Scholar and recipient of a UCSF Brain SPORE Career Development award, Hervey-Jumper says that better understanding of why a significant percentage of gliomas remain functionally relevant could have an important impact on decisions about what to remove during surgery, as well as patients’ subsequent treatment. To that end, Hervey-Jumper tests patients’ language and cognitive function prior to surgery. Then, during awake surgeries, he uses magnetoencephalography (MEG) or electrocorticography (ECoG) to more closely measure areas of functional connectivity within patient gliomas. He grows glioma cells for experiments in his laboratory to better understand how functionally connected glioma cells grow. And post surgery, Hervey-Jumper follows participating patients regularly by testing their cognition and language abilities. His initial work has indicated more synaptogenic activity in areas of high connectivity.

“As we develop this, I am hoping we can better explain to patients the risks of their operations and make more informed choices about the options we pursue and when these options should be considered,” he says.