Real-Time Neuropsychological Testing (RTNT) and Music Listening during Glioblastoma Excision in Awake Surgery: A Case Report

SIMPLE SUMMARY: In a case study, real-time neuropsychological testing (RTNT) and music listening were applied for resections in the left temporal–parietal lobe during awake surgery (AS). The preoperative, intraoperative, and postoperative neuropsychological evaluation of patients with brain tumors and those treated neurosurgically has become part of clinical protocols. It allows for the evaluation of the presence of any neuropsychological deficits and their severity, provides reliable indications regarding the patients’ tolerability of an intervention in AS, and examines the cognitive and emotional motivational status of patients in the postoperative phase, thereby providing indications of the rehabilitation treatment and quality-of-life level. Moreover, we demonstrated that before/during AS and after music listening, the patient reported a decrease in depression and anxiety, in addition to an improvement in all the collected cognitive parameters. In conclusion, RTNT (also integrated with music listening) maximizes the surgical resection of lesions and minimizes the risks of post-operative neuropsychological and neurological sequelae through improving the quality of life of patients. ABSTRACT: In this case report, real-time neuropsychological testing (RTNT) and music listening were applied for resections in the left temporal–parietal lobe during awake surgery (AS). The case is based on a 66-year-old with glioblastoma and alterations in expressive language and memory deficit. Neuropsychological assessment was run at baseline (2–3 days before surgery), discharge from hospital (2–3 days after surgery), and follow-up (1 month and 3 months). RTNT was started before beginning the anesthetic approach (T0) and during tumor excision (T1 and T2). At T0, T1, and T2 (before performing neuropsychological tests), music listening was applied. Before AS and after music listening, the patient reported a decrease in depression and anxiety. During AS, an improvement was shown in all cognitive parameters collected at T0, T1, and T2. After the excision and music listening, the patient reported a further decrease in depression and anxiety. Three days post surgery, and at follow-ups of one month and three months, the patient reported a further improvement in cognitive aspects, the absence of depression, and a reduction in anxiety symptoms. In conclusion, RTNT has been useful in detecting cognitive function levels during tumor excision. Music listening during AS decreased the patient’s anxiety and depression symptoms.