Neurosurgeons Advance Brain Tumor Removal with Awake Mapping

New research uncovers subtle patient behavior changes that can improve personalized brain surgery outcomes.

Published on Feb. 26, 2026

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A new study details how neurosurgeons can use "awake brain mapping" to safely remove as much cancerous brain tissue as possible while minimizing harm to a patient's speech, movement, and quality of life. The research found that measuring small changes in a patient's responses during the procedure can provide more personalized guidance for surgery and lead to better outcomes.

Why it matters

Improving awake brain mapping techniques is crucial for brain cancer patients, as it allows surgeons to remove more of the cancerous tissue while preserving the patient's critical functions. This research points to a future where brain surgeries are tailored even more precisely to protect each patient's unique neurological profile.

The details

During awake brain mapping, surgeons stimulate the brain with small electrical impulses while the patient performs tasks like naming pictures or reading words. If the patient responds correctly, the surgeon knows that part of the brain can be safely removed. But the new study found that measuring subtle changes in the patient's speed and accuracy, even when they don't make errors, can provide more nuanced insights into the brain's language organization. This allows surgeons to better balance tumor removal with preserving the patient's quality of life.

  • The new study is soon to be published in the journal Science Advances.
  • MindTrace, a startup spun out of the research, has been used in over a dozen awake brain surgeries since its release this year.

The players

Bradford Mahon

A cognitive neuroscientist at Carnegie Mellon University's Neuroscience Institute and Department of Psychology, and senior author of the study.

Raouf Belkhir

The lead author of the study and a psycholinguist completing the University of Pittsburgh-Carnegie Mellon University Medical Scientist Training Program.

Tyler Schmidt

A neurosurgeon at the University of Rochester who has used the MindTrace platform in over a dozen awake brain surgeries.

MindTrace

A startup company spun out of Mahon's research laboratory at Carnegie Mellon University, building an integrated software platform to support neurocognitive testing before, during and after brain surgery.

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What they’re saying

“We found that if you measure both the types of errors that patients make, as well as how fast they respond even when they do not make errors, more granular inferences can be drawn about language organization from an awake brain mapping procedure.”

— Bradford Mahon, Cognitive neuroscientist (Mirage News)

“Stimulation has traditionally been treated as a binary test — either it causes an error, or it doesn't. But in reality, these effects are often more continuous than binary.”

— Raouf Belkhir, Psycholinguist (Mirage News)

“Awake brain surgery is an incredibly brave thing to do as a patient. Making sure we have a well-planned roadmap both before and during surgery to obtain the needed information about their brain organization is a top priority.”

— Tyler Schmidt, Neurosurgeon (Mirage News)

What’s next

The researchers don't yet know the exact combination of parameters to maximize the effect of direct electrical stimulation mapping, but they plan to continue studying the subtle signals hidden in the data to develop even more personalized approaches to brain surgery.

The takeaway

This research shows that by measuring previously overlooked aspects of patient performance during awake brain mapping, surgeons can develop better predictive models to personalize surgical approaches and optimize outcomes for each brain cancer patient, preserving critical functions like speech and movement while removing as much cancerous tissue as possible.