Artists playing music while undergoing brain surgery. A look into the scientific evidence and the social media perspective

Recently, social media showed musicians performing pieces during awake surgery for brain diseases, such as tumors or dystonia. They tend to emphasize the use of intraoperative performance. Our aim is to review the literature on intraoperative performance in awake surgery for musicians, in order to understand if it is appropriate for all kind of procedures reported. We performed a comprehensive review of the literature with chosen keywords. We selected all papers regarding musicians who underwent awake surgery. The data extracted were analyzed. Literature search retrieved a total of 12 studies: among these, 5 studies reported musicians performing pieces during surgery. Google search returned a total of 11 cases. The ability to play an instrument involves multiple higher cognitive functions that remain not fully understood. During tumor resection or surgical treatment for epilepsies involving eloquent areas in musicians, an intraoperative musical performance could allow a more accurate monitoring of complex function, rather than the simple finger exercises and movements. On the other hand, treatment of dystonia follows standardized stereotactic procedures (DBS), the target is preset and determined by imaging and neurophysiology. The patient indeed, is awake mainly for side effects monitoring. However, in most cases, playing music did not improve or modify surgery. Intraoperative performances certainly generate amazement and interest, especially in the media and in non-experts. During tumor or brain lesion resection, intraoperative musical performances can avoid subsequent neurological al disturbances. However, in several procedures (DBS), playing music did not improve or modify surgery.