{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:29Z","timestamp":1786969589278,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Intraoperative neurophysiological monitoring (IONM) is widely used during brainstem surgery to reduce the risk of neurological injury, although its prognostic value in adult brainstem glioma (BSG) surgery remains unclear. We retrospectively analyzed 22 consecutive adults who underwent surgery for BSGs with multimodal IONM between 2010 and 2023. Monitoring included somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), brainstem auditory evoked potentials (BAEPs), corticobulbar MEPs (CoMEPs), and cranial nerves electromyography. The primary endpoint was the association between intraoperative neurophysiological changes and postoperative neurological functional status at hospital discharge, assessed with the modified McCormick Scale (mMCS). Secondary endpoints included postoperative complications and length of hospital stay. SSEP warning criteria were met in 10 patients (45.5%), while 10 patients (45.5%) experienced a \u226550% reduction in MEP amplitude in at least one monitored muscle. Despite these findings, neither SSEP nor MEP amplitude changes were significantly associated with postoperative neurological status. Transcranial MEP stimulation thresholds increased significantly during surgery (p = 0.007), and threshold elevation was associated with postoperative complications (Kendall\u2019s \u03c4 = 0.498, p = 0.007). BAEP recordings remained stable throughout all procedures. Conventional amplitude-based IONM changes were not associated with early neurological outcome after adult BSG resection. In contrast, increases in MEP stimulation threshold may represent a sensitive indicator of postoperative complications. Further prospective studies are warranted.<\/jats:p>","DOI":"10.3390\/curroncol33080481","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:00:05Z","timestamp":1786964405000},"page":"481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Neurophysiological Monitoring During Adult Brainstem Glioma Resection: Association Between Electrophysiological Changes and Early Neurological Outcome"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-6640","authenticated-orcid":false,"given":"Giada","family":"Pauletto","sequence":"first","affiliation":[{"name":"Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Skrap","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-2984","authenticated-orcid":false,"given":"Barbara","family":"Tomasino","sequence":"additional","affiliation":[{"name":"Scientific Institute, IRCCS E. Medea, 33037 Pasian di Prato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8140-6277","authenticated-orcid":false,"given":"Christian","family":"Lettieri","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Ecoretti","sequence":"additional","affiliation":[{"name":"Neurophysiology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miran","family":"Skrap","sequence":"additional","affiliation":[{"name":"Independent Researcher, 34151 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7185-7779","authenticated-orcid":false,"given":"Andrea","family":"Landi","sequence":"additional","affiliation":[{"name":"Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-6149","authenticated-orcid":false,"given":"Luca","family":"Denaro","sequence":"additional","affiliation":[{"name":"Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vindigni","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Robiony","sequence":"additional","affiliation":[{"name":"Clinical Unit of Maxillofacial Surgery, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Valente","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"},{"name":"Department of Medicine (DMED), University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Ius","sequence":"additional","affiliation":[{"name":"Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5301-8621","authenticated-orcid":false,"given":"Lorenzo","family":"Verriello","sequence":"additional","affiliation":[{"name":"Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/s11910-013-0346-3","article-title":"Brainstem glioma: A review","volume":"13","author":"Grimm","year":"2013","journal-title":"Curr. 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