The clinical and neurocognitive functional changes with awake brain mapping for gliomas invading eloquent areas: Institutional experience and the utility of The Montreal Cognitive Assessment DOI Creative Commons
Yuan Wang,

Shaochun Guo,

Na Wang

et al.

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 13

Published: Feb. 22, 2023

Awake craniotomy with intraoperative brain functional mapping effectively reduces the potential risk of neurological deficits in patients glioma invading eloquent areas. However, frequently present impaired neurocognitive function. The study aimed to investigate and outcomes after awake assess experience a tertiary neurosurgical center China over eight years. This retrospective included 80 who underwent for gliomas cortex between January 2013 December 2021. Clinical surgical factors, such as extent resection (EOR), perioperative Karnofsky Performance Score (KPS), progression-free survival (PFS), overall (OS), were evaluated. We also used Montreal Cognitive Assessment (MoCA) status changes. most observed location was frontal lobe (33/80, 41.25%), whereas tumor primarily invaded language-related (36/80, 45%). Most had supratotal (11/80, 13.75%) total (45/80, 56.25%). median PFS 43.2 months, OS 48.9 months our cohort. transient (less than seven days) deficit rate 17.5%, persistent (lasting three months) 15%. At follow-up, (72/80, 90%) KPS scores > 80. Meanwhile, compared preoperative baseline tests, changes MoCA presented significant improvements at discharge follow-up tests. is feasible safe method treating cortex, benefit minimizing deficits, increasing EOR, extending time. results test indicated that plays critical role preserving function during resection.

Language: Английский

The Case for Neurosurgical Intervention in Cancer Neuroscience DOI
Joshua D. Bernstock, Jakob V. E. Gerstl, Jason Chen

et al.

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

Published: June 21, 2024

The emerging field of cancer neuroscience reshapes our understanding the intricate relationship between nervous system and biology; this new paradigm is likely to fundamentally change advance neuro-oncological care. profound interplay cancers reciprocal: Cancer growth can be induced regulated by system; conversely, tumors themselves alter system. Such crosstalk cells evident in both peripheral central systems. Recent advances have uncovered numerous direct neuron-cancer interactions at glioma-neuronal synapses, paracrine mechanisms within tumor microenvironment, indirect neuroimmune interactions. Neurosurgeons historically played a role care, as becoming increasingly established, neurosurgical intervention clearer. Examples include denervation procedures, delineation neuron-glioma networks, development neuroprostheses, neuromodulatory advanced local delivery present review seeks highlight key with implications outline future neuroscience.

Language: Английский

Citations

1
Functional and oncological outcomes following more than three consecutive surgical resections for multiple relapses of initially grade 2 IDH-mutated gliomas DOI

Anissa Nassihi,

Hugues Duffau

Acta Neurochirurgica, Journal Year: 2024, Volume and Issue: 166(1)

Published: Oct. 28, 2024

Language: Английский

Citations

1
Updated perspectives on awake neurosurgery with cognitive and emotional assessment for patients with low-grade gliomas DOI
Hugues Duffau

Expert Review of Neurotherapeutics, Journal Year: 2021, Volume and Issue: 21(4), P. 463 - 473

Published: March 16, 2021

Introduction: Thanks to early extensive surgical resection combined with medical oncological therapies, life expectancy dramatically increased in low-grade glioma (LGG), an overall survival currently over 15 years. Therefore, patients should be able maintain valuable family and socio-professional activities.Areas covered: For many decades, cognitive emotional aspects were neglected by neurooncologists. The goal of surgery was avoid hemiplegia and/or aphasia, no considerations regarding behavior. However, because LGG live longer, they must cognitively affectively make long-term projects. Preservation higher-order functions considered systematically means awake cognitive/emotional mapping monitoring.Expert opinion: aim is incorporate recent advances neurosciences, which proposed revisited models cerebral processing relying on a meta-network perspective, into the pre-, intra- postoperative procedure. In this connectomal approach, brain result from complex interactions within between neural networks. This improved understanding constant instability system allows better assessment before after each treatment years, order preserve personality adaptive behavior for patient, based his/her own definition quality life. It time create neurosciences.

Language: Английский

Citations

9
A Personalized Longitudinal Strategy in Low-Grade Glioma Patients: Predicting Oncological and Neural Interindividual Variability and Its Changes over Years to Think One Step Ahead DOI Open Access
Hugues Duffau

Journal of Personalized Medicine, Journal Year: 2022, Volume and Issue: 12(10), P. 1621 - 1621

Published: Oct. 1, 2022

Diffuse low-grade glioma (LGG) is a rare cerebral cancer, mostly involving young adults with an active life at diagnosis. If left untreated, LGG widely invades the brain and becomes malignant, generating neurological worsening ultimately death. Early repeat treatments for this incurable tumor, including maximal connectome-based surgical resection(s) in awake patients, enable postponement of malignant transformation while preserving quality owing to constant neural network reconfiguration. Due considerable interindividual variability terms course consecutive reorganization, multistage longitudinal strategy should be tailored accordingly each patient. It crucial predict how will progress (changes growth rate pattern migration, genetic mutation, etc.) adapt patterns spatiotemporal redistribution, possible functional consequences such as epilepsy or cognitive decline, etc.). The goal anticipate therapeutic management, remaining one step ahead order select optimal (re-)treatment(s) (some them possibly kept reserve), appropriate time(s) evolution chronic disease, before malignization clinical worsening. Here, predictive tumoral non-tumoral factors, their ever-changing interactions, are reviewed guide individual decisions advance based on patient-specific markers, treatment LGG.

Language: Английский

Citations

6
The clinical and neurocognitive functional changes with awake brain mapping for gliomas invading eloquent areas: Institutional experience and the utility of The Montreal Cognitive Assessment DOI Creative Commons
Yuan Wang,

Shaochun Guo,

Na Wang

et al.

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 13

Published: Feb. 22, 2023

Awake craniotomy with intraoperative brain functional mapping effectively reduces the potential risk of neurological deficits in patients glioma invading eloquent areas. However, frequently present impaired neurocognitive function. The study aimed to investigate and outcomes after awake assess experience a tertiary neurosurgical center China over eight years. This retrospective included 80 who underwent for gliomas cortex between January 2013 December 2021. Clinical surgical factors, such as extent resection (EOR), perioperative Karnofsky Performance Score (KPS), progression-free survival (PFS), overall (OS), were evaluated. We also used Montreal Cognitive Assessment (MoCA) status changes. most observed location was frontal lobe (33/80, 41.25%), whereas tumor primarily invaded language-related (36/80, 45%). Most had supratotal (11/80, 13.75%) total (45/80, 56.25%). median PFS 43.2 months, OS 48.9 months our cohort. transient (less than seven days) deficit rate 17.5%, persistent (lasting three months) 15%. At follow-up, (72/80, 90%) KPS scores > 80. Meanwhile, compared preoperative baseline tests, changes MoCA presented significant improvements at discharge follow-up tests. is feasible safe method treating cortex, benefit minimizing deficits, increasing EOR, extending time. results test indicated that plays critical role preserving function during resection.

Language: Английский

Citations

3