[Awake surgery for preservation of higher brain functions].

Awake surgery for gliomas has become a widely accepted neurosurgical method worldwide. However, it is applied mainly to restore speech and simple motor functions, and intraoperative applications to restore higher brain functions have not been established yet. Preserving these functions is crucial to restoring the normal social lives of patients postoperatively. In this review article, we focused on preserving spatial attention and higher motor functions, and discussed their neural basis, as well as, the application of awake surgery practices using effective tasks. For spatial attention, the line bisection task is the most popular and reliable; however, other tasks, such as exploratory tasks, can be used, depending on the location of the brain. For higher motor functions, we developed two tasks: 1) the PEG & COIN task, which evaluates grasping and approaching skills, and 2) the sponge-control task, which assesses somatosensory-dependent movement. Although scientific knowledge and evidence are still limited in this field of neurosurgery, we believe that expanding our knowledge about higher brain functions and developing specific and efficient intraoperative tasks to evaluate them will eventually preserve patients'quality of life.