Brain surgery is a delicate balancing act in which the team of doctors must remove life-threatening tumors while not damaging areas of the brain that control essential functions, such as language, sensation and body movement. A mistake could permanently impair a patient’s speech or ability to see.

To safeguard against damage, neuropsychologists use cognitive tests while a patient is sedated but awake. By asking a patient to do simple tasks like counting or reading, the surgical team can map out a patient’s brain and determine which areas the surgical team must avoid during tumor removal.

The Problem

While working at the Medical College of Wisconsin, neuropsychologist Dr. David Sabsevitz recognized that the testing methodologies available were limited and severely antiquated. He set out to improve the efficiency of the tests and make them more sophisticated. He also wanted to standardize testing methods and recognized that automating the data collection process would benefit individual patient cases as well as larger research projects.

The Solution

Testing Efficiencies

The NeuroMapper App is an interoperative digital testing suite used during tumor removal and other extra-operative cases. Researchers can use the app’s standardized testing strategy on patients but also have the flexibility to adapt to patient needs by introducing new, web-hosted testing stimuli with just a few clicks.

Improve Testing Sophistication

Two iPad’s running the NeuroMapper App interact via Bluetooth. A doctor uses one iPad to administer the tests, while the patient uses the second iPad to view the test stimuli. The patient’s iPad uses the onboard camera and microphone to record the patient’s visual and verbal responses. The other iPad allows the medical team to adjust the sequence of test stimuli based on the surgeon’s needs. If the tumor is in a language part of the brain but nearing the visual area, tests specifically for the visual area of the brain can be quickly called up and administered.

Automate Data Collection

Researchers can conduct pre-operative baseline tests for any patient and log the responses using the hardware available on the iPad. During surgery, researchers are able to collect response times from the patient and compare them to the pre-operative baseline values. By comparing pre-operative and interoperative results, the surgical team can easily identify any deficiencies the patient may be experiencing.

The NeuroMapper App is in full operation at over 20 medical research sites, including Mayo Clinic, Froedtert & the Medical College of Wisconsin, the University of Texas MD Anderson Cancer Center, and UC San Diego Health, and has assisted medical teams in thousands of interoperative awake brain surgeries.

About the Medical College of Wisconsin

With a history dating back to 1893, the Medical College of Wisconsin is dedicated to leadership and excellence in education, patient care, research and community engagement. More than 1,400 students are enrolled in MCW’s medical school and graduate school programs in Milwaukee, Green Bay, and Central Wisconsin. MCW’s School of Pharmacy opened in 2017. A major national research center, MCW is the largest research institution in the Milwaukee metro area and second largest in Wisconsin. In the last ten years, faculty received more than $1.5 billion in external support for research, teaching, training and related purposes. This total includes highly competitive research and training awards from the National Institutes of Health (NIH). Annually, MCW faculty direct or collaborate on more than 3,100 research studies, including clinical trials. Additionally, more than 1,600 physicians provide care in virtually every specialty of medicine for more than 2.8 million patients annually.