We developed a junior-real-time neuropsychological testing (j-RTNT) and used it during surgery of a right fronto-insular dysembryoplastic neuroepithelial tumor causing seizures in a 16 years old female. The j-RTNT included tasks from the battery NEPSY-II. Pre-surgery evaluation detected a below average performance in visuo-spatial planning, inhibition, visual attention, planning and borderline performance in speeded naming. The j-RTNT allows detecting sudden decreases that could be caused by resection. During surgery, ECoG was characterized by slow sharp activity and spikes on the electrodes exploring the right fronto-polar region. After the resection, spikes were not detected anymore. Immediate post-surgery performance resulted within the normal range, remained below average in visuo-spatial planning, and improved in inhibition, switching and in speeded naming. Follow-up revealed cognitive recovery. Neurological assessment was unremarkable and the patient was seizure free. No epileptic activity could be observed on follow-up EEG. fMRI data showed that in the follow-up vs. pre-surgery there was a higher recruitment of the right superior frontal gyrus, a region involved in the cognitive execution and cognitive control networks. The j-RTNT is feasible with young patients, goes beyond the testing of limited functions, assessing multiple times during resection several different functions to better monitoring the effects of resection.

中文翻译：

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初级实时神经心理测试（j-RTNT），用于接受清醒开颅手术的年轻患者。

我们开发了一种初级实时神经心理学测试（j-RTNT），并在手术中导致了一名16岁女性癫痫发作的右额窦-非胚性发育不良神经上皮肿瘤的治疗中使用了它。j-RTNT包含来自电池NEPSY-II的任务。术前评估发现在视觉空间规划，抑制，视觉注意力，规划和快速命名方面的边界表现均低于平均水平。j-RTNT可以检测可能由于切除而引起的突然下降。在手术期间，ECoG的特征是缓慢的剧烈活动和探查右额极区域的电极上的尖峰。切除后，不再检测到尖峰。手术后即刻表现在正常范围内，视觉空间规划仍低于平均水平，抑制效果有所改善，切换并加快命名速度。随访显示认知恢复。神经学评估无异常，患者无癫痫发作。随访脑电图未见癫痫活动。fMRI数据显示，在随访与术前对比中，右上额叶回的招募率更高，该区域涉及认知执行和认知控制网络。j-RTNT在年轻患者中是可行的，它不仅限于功能受限的测试，还包括在切除过程中多次评估几种不同功能以更好地监测切除效果。术前，右上额叶回的招募程度更高，该区域涉及认知执行和认知控制网络。j-RTNT在年轻患者中是可行的，它不仅限于功能受限的测试，还包括在切除过程中多次评估几种不同功能以更好地监测切除效果。术前，右上额叶回的招募程度更高，该区域涉及认知执行和认知控制网络。j-RTNT在年轻患者中是可行的，它不仅限于功能受限的测试，还包括在切除过程中多次评估几种不同功能以更好地监测切除效果。