The death of localizationism: The concepts of functional connectome and neuroplasticity deciphered by awake mapping, and their implications for best care of brain-damaged patients

Revue Neurologique, Journal Year: 2021, Volume and Issue: 177(9), P. 1093 - 1103

Published: Sept. 23, 2021

Language: Английский

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Untapped Neuroimaging Tools for Neuro-Oncology: Connectomics and Spatial Transcriptomics

Cancers, Journal Year: 2022, Volume and Issue: 14(3), P. 464 - 464

Published: Jan. 18, 2022

Neuro-oncology research is broad and includes several branches, one of which neuroimaging. Magnetic resonance imaging (MRI) instrumental for the diagnosis treatment monitoring patients with brain tumors. Most commonly, structural perfusion MRI sequences are acquired to characterize tumors understand their behaviors. Thanks technological advances, can now be transformed into a so-called average accounting individual morphological differences, enables retrospective group analysis. These normative analyses uncommonly used in neuro-oncology research. Once data have been normalized, voxel-wise spatial mapping performed. Additionally, investigations underlying connectomics performed using functional templates. recently available template transcriptomics has enabled assessment associated gene expression. The few published shown relationships between tumor characteristics localization, as well insights circuitry epileptogenic depression after cingulate resection. wide breadth possibilities remain largely unexplored, specifically terms transcriptomics. We provide framework performing oncology while also highlighting limitations. Normative an opportunity address questions from different perspective.

Language: Английский

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Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Frontiers in Oncology, Journal Year: 2022, Volume and Issue: 12

Published: July 5, 2022

Early maximal surgical resection is the first treatment in diffuse low-grade glioma (DLGG), because reduction of tumor volume delays malignant transformation and extends survival. Awake surgery with intraoperative mapping behavioral monitoring enables to preserve quality life (QoL). However, infiltrative nature DLGG, relapse unavoidable, even after (supra)total resection. Therefore, besides chemotherapy radiotherapy, question reoperation(s) increasingly raised, especially patients DLGG usually enjoy a normal long-lasting projects. Here, purpose review literature emerging field iterative surgeries DLGG. First, long-term follow-up results showed that who underwent multiple had an increased survival (above 17 years) preservation QoL. Second, criteria guiding decision reoperate defining optimal timing are discussed, mainly based on dynamic intercommunication between (including its kinetics pattern regrowth) reactional cerebral reorganization—i.e., mechanisms underpinning reconfiguration within across neural networks enable functional compensation. Third, how adapt medico-surgical strategy this individual spatiotemporal brain interplay detailed, by considering perpetual changes connectome. These data support early reoperation recurrent before onset symptoms transformation. Repeat awake resection(s) should be integrated global management including (neo)adjuvant medical treatments, enhance oncological outcomes. The prediction potential limitation neuroplasticity at each step disease must improved anticipate personalized multistage therapeutic attitudes.

Language: Английский

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Awake Surgery for Left Posterior Insular Low-Grade Glioma Through the Parietorolandic Operculum: The Need to Preserve the Functional Connectivity. A Case Series

Frontiers in Surgery, Journal Year: 2022, Volume and Issue: 8

Published: Jan. 13, 2022

Objective: Surgical approach to low-grade glioma (LGG) involving the posterior insula is challenging, especially in left hemisphere, with a high risk of sensorimotor, language, or visual deterioration. In this study, case series 5 right-handed patients harboring insular LGG reported, by detailing transcorticosubcortical approach. Method: The five surgeries were achieved awake using cortical and axonal electrostimulation mapping. was removed through rolandic and/or parietal opercula, preservation subcortical connectivity. Results: mapping positive patients, enabling selection an optimal transcortical approach, via anterolateral supramarginal gyrus four lateral retrocentral three cases (plus superior temporal one case). Moreover, white matter tracts identified all cases, i.e., part longitudinal fasciculus (five cases), arcuate (four thalamocortical somatosensory pathways motor pathway (one case), semantic (three optic tract Complete resection two near-total patients. There no postoperative permanent deficits. Conclusion: A parietorolandic operculum represents safe effective access LGG. Detection functional connectivity direct bundles are needed cross-road brain region prevent otherwise predictable postsurgical impairments.

Language: Английский

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Alternations and Applications of the Structural and Functional Connectome in Gliomas: A Mini-Review

Frontiers in Neuroscience, Journal Year: 2022, Volume and Issue: 16

Published: April 11, 2022

In the central nervous system, gliomas are most common, but complex primary tumors. Genome-based molecular and clinical studies have revealed different classifications subtypes of gliomas. Neuroradiological approaches non-invasively provided a macroscopic view for surgical resection therapeutic effects. The connectome is structural map physical object, brain, which raises issues spatial scale definition, it calculated through diffusion magnetic resonance imaging (MRI) functional MRI. this study, we reviewed basic principles attributes connectome, followed by alternations connectomes their influences on glioma. To extend applications demonstrated that series multi-center projects still need to be conducted systemically investigate structural-functional coupling Additionally, brain-computer interface based accurate could provide more precise data, significant surgery postoperative recovery. Besides, integrating data from sources, including other omics information, processing with artificial intelligence, together validated biological findings will development personalized strategy.

Language: Английский

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Oncological and functional neurosurgery: Perspectives for the decade regarding diffuse gliomas

Revue Neurologique, Journal Year: 2023, Volume and Issue: 179(5), P. 437 - 448

Published: March 10, 2023

Language: Английский

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Intraoperative neurophysiology in pediatric neurosurgery: a historical perspective

Child s Nervous System, Journal Year: 2023, Volume and Issue: 39(10), P. 2929 - 2941

Published: Sept. 30, 2023

Abstract Introduction Intraoperative neurophysiology (ION) has been established over the past three decades as a valuable discipline to improve safety of neurosurgical procedures with main goal reducing neurological morbidity. Neurosurgeons have substantially contributed development this field not only by implementing use and refinement ION in operating room but also introducing novel techniques for both mapping monitoring neural pathways. Methods This review provides personal perspective on evolution variety pediatric procedures: from brain tumor brainstem surgery, spinal cord tethered surgery. Results discussion The contribution neurosurgeons is highlighted showing how our played crucial role promoting at turn century. Finally, view their potential implications neurosurgery will provide insights into future ION, further supporting functional, rather than merely anatomical, approach neurosurgery.

Language: Английский

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Connectome-Based Neurosurgery in Primary Intra-Axial Neoplasms: Beyond the Traditional Modular Conception of Brain Architecture for the Preservation of Major Neurological Domains and Higher-Order Cognitive Functions

Life, Journal Year: 2024, Volume and Issue: 14(1), P. 136 - 136

Published: Jan. 18, 2024

Despite the therapeutical advancements in surgical treatment of primary intra-axial neoplasms, which determined both a significative improvement OS and QoL reduction incidence surgery-induced major neurological deficits, nowadays patients continue to manifest subtle post-operative neurocognitive impairments, preventing them from full reintegration back into social life workforce. The birth connectomics paved way for profound reappraisal traditional conception brain architecture, favour model based on large-scale structural functional interactions complex mosaic cortical areas organized fluid network interconnected by subcortical bundles. Thanks these advancements, neurosurgery is facing new era connectome-based resections, core principle still represented achievement an ideal onco-functional balance, but with closer eye whole-brain circuitry, constitutes foundations functions, be intended as motricity; language visuospatial function; higher-order cognitive functions such cognition, conation, emotion adaptive behaviour. Indeed, balance between radicality tumoral resection preservation, far possible, integrity local global networks stands mandatory goal fulfilled allow resume their previous make tailored gentler individual needs.

Language: Английский

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Challenges and Opportunities in Awake Craniotomy for Brain Tumor Surgery in Low- and Lower-Middle-Income Countries: A Narrative Review and Perspective

World Neurosurgery, Journal Year: 2024, Volume and Issue: 189, P. 118 - 126

Published: June 9, 2024

Language: Английский

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Commentary: Resting State Functional Networks in Gliomas: Validation With Direct Electrical Stimulation Using a New Tool for Planning Brain Resections

Neurosurgery, Journal Year: 2024, Volume and Issue: unknown

Published: June 13, 2024

Language: Английский

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