{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:16:40Z","timestamp":1790198200088,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Developing neurophysiological tools to predict WHO tumor grade can empower the treating teams for a better surgical decision-making process. A total of 38 patients with supratentorial diffuse gliomas underwent an asleep-awake-sedated craniotomies for tumor removal with intraoperative neuromonitoring. The resting motor threshold was calculated for different train stimulation paradigms during awake and asleep phases. Receiver operating characteristic analysis and Bayesian regression models were performed to analyze the prediction of tumor grading based on the resting motor threshold differences. Significant positive spearman correlations were observed between resting motor threshold excitability difference and WHO tumor grade for train stimulation paradigms of 5 (R\u2009=\u20090.54, P\u2009=\u20090.00063), 4 (R\u2009=\u20090.49, P\u2009=\u20090.002), 3 (R\u2009=\u20090.51, P\u2009=\u20090.001), and 2 pulses (R\u2009=\u20090.54, P\u2009=\u20090.0007). Kruskal\u2013Wallis analysis of the median revealed a positive significant difference between the median of excitability difference and WHO tumor grade in all paradigms. Receiver operating characteristic analysis showed 3\u00a0mA difference as the best predictor of high-grade glioma across different patterns of motor pathway stimulation. Bayesian regression found that an excitability difference above 3\u00a0mA would indicate a 75.8% probability of a glioma being high grade. Our results suggest that cortical motor excitability difference between the asleep and awake phases in glioma surgery could correlate with tumor grade.<\/jats:p>","DOI":"10.1093\/cercor\/bhad493","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T14:58:56Z","timestamp":1702997936000},"source":"Crossref","is-referenced-by-count":6,"title":["Cortical resting motor threshold difference in asleep-awake craniotomy for motor eloquent gliomas: WHO grading influences motor pathway excitability"],"prefix":"10.1093","volume":"34","author":[{"given":"Ana M","family":"Pescador","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital NHS Foundation Trust , Denmark Hill, London SE5 9RS , United Kingdom"},{"name":"Department of Clinical Neurophysiology, King\u2019s College Hospital NHS Foundation Trust , Denmark Hill, London SE5 9RS , United 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