Where are higher-order cognitive functions? The paradox of non-locality in awake cognitive mapping using a complex dynamic system framework

Frontiers in Psychology, Journal Year: 2025, Volume and Issue: 16

Published: March 3, 2025

This study addresses the challenge in identifying and preserving higher-order cognitive functions within a complex dynamic systems framework during neurosurgery. Traditionally, neurosurgical practice has prioritized avoiding language motor deficits, while functions-such as social cognition executive processes-remain underexplored. These arise from large-scale networks operating an optimal balance between synchronization metastability rather than isolated localized cortical regions. complexity highlights paradox of non-locality awake mapping: no single area "contains" function, but certain "critical points" can transiently disrupt network dynamics when stimulated intraoperatively. Direct electrical stimulation provides unique real-time insights by inducing brief dyssynchronizations that elicit observable behavioral changes, allowing neurosurgeons neuropsychologists to pinpoint crucial subcortical "connectome-stop minimize damage. Preserving deep white-matter tracts is essential, given their limited neuroplasticity profound, often irreversible impact tract lesions on cognition. To address these challenges, we propose three-step mapping approach: (1) localizing critical points via DES-driven impairment, (2) constant monitoring multiple domains tumor resection progresses, (3) halting at connectome-stop prevent deficits. An illustrative case involving right parietal glioma demonstrates how this methodology integrates computational neuroscience, theory, clinical achieve functional preservation maintain patient's quality life.

Language: Английский

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Main clinical findings and their frequency in cortical-subcortical areas tested in awake brain mapping for diffuse low-grade glioma

Journal of Clinical Neuroscience, Journal Year: 2025, Volume and Issue: 136, P. 111290 - 111290

Published: May 2, 2025

Language: Английский

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The Safety and Usefulness of Awake Surgery as a Treatment Modality for Glioblastoma: A Retrospective Cohort Study and Literature Review

Cancers, Journal Year: 2024, Volume and Issue: 16(15), P. 2632 - 2632

Published: July 24, 2024

Awake surgery contributes to the maximal safe removal of gliomas by localizing brain function. However, efficacy and safety thereof as a treatment modality for glioblastomas (GBMs) have not yet been established. In this study, we analyzed outcomes awake GBMs, response mapping, factors correlated with mapping failure. Patients GBMs who had undergone at our hospital between March 2010 February 2023 were included in study. Those recurrence excluded from The clinical characteristics, extent resection (EOR), postoperative complications, progression-free survival (PFS), overall (OS), failure retrospectively analyzed. Of 32 participants median age was 57 years old; 17 (53%) male. successfully completed 28 (88%). A positive limited observed 13 (41%), respectively. EOR gross total, subtotal, partial resections biopsies 19 (59%), 8 (25%), 3 (9%), 2 cases (6%), Eight (25%) three (9%) presented neurological deterioration acute period months postoperatively, PFS OS 15.7 36.9 months, time anesthetic induction extubation statistically significantly longer cohort than that success cohort. Functional areas could be detected during GBMs. Thus, influences intraoperative discernment, preservation function, improves outcomes.

Language: Английский

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A historical perspective on the neurobiology of speech and language: from the 19th century to the present

Frontiers in Psychology, Journal Year: 2024, Volume and Issue: 15

Published: Sept. 18, 2024

In this essay, we review 19th century conceptions on the neurobiology of speech and language, including pioneer work Franz Gall, Jean-Baptiste Bouillaud, Simon Alexandre Ernest Aubertin, Marc Dax, Paul Broca, Carl Wernicke. We examine how these early investigations, anchored in study neurological disorders, have broadened their scope via neuropsychological psycholinguistic theories models. Then, discuss major technological advances led to an important paradigm shift, through which brain slowly detached from disease become individuals all ages, with or without pathology language disorders. The profusion neuroimaging studies that were conducted past four decades, inquiring into various aspects complemented—and often challenged—classical views production. Our understanding “motor center,” for instance, has been entirely transformed. notion cerebral dominance also revisited. end paper by discussing challenges controversies 21st as well modern neural architecture supporting functions.

Language: Английский

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Awake Surgery for Right Frontal Lobe Glioma: Preserving Emotional Recognition and Facilitating Early Return to Work

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: July 29, 2024

Background Many glioma patients struggle to return work after surgery because of higher brain dysfunction. Although the right frontal lobe has historically been considered functionally silent, reports performing awake evaluate functions in with tumors this area have increased. We present two who underwent for malignant preserve emotional recognition and facilitate an early work. Case Presentation: 1 was a 48-year-old right-handed woman employed as nursery school teacher case 2 21-year-old man sales. Both had contrast-enhancing exhibiting high signal intensity on fluid attenuated inversion recovery imaging surgery. During operation, cortical mapping performed using Reading Mind Eyes, calculation, motor tasks. Resection sites involved avoided. In 1, all regions were completely resected; 2, enhancement resected. discharged home without neurological deficits returned within 21 days Conclusion It may be important focus not only overall survival progression free patients, but also factors associated life satisfaction, such time until becomes difficult. Awake aimed at preserving is useful improve satisfaction.

Language: Английский

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Lung cancer metastasis-induced distal esophageal segmental spasm confirmed by individualized peroral endoscopic myotomy: A case report

World Journal of Gastrointestinal Surgery, Journal Year: 2024, Volume and Issue: 16(10), P. 3321 - 3327

Published: Sept. 27, 2024

BACKGROUND Peroral endoscopic myotomy (POEM) has been widely performed as a standard treatment for achalasia; however, its efficacy and safety treating distal esophageal segmental spasms induced by cancer metastasis remain unknown. CASE SUMMARY A 72-year-old male was referred to our hospital complained of progressive dysphagia two years. Endoscopy revealed 2 cm long segment stenosis with intact mucosa normal cardia. Computed tomography showed right upper lung mass, pathology the pleural effusion confirmed diagnosis adenocarcinoma multiple rib mediastinal lymph node metastases malignant effusion. Individualized POEM first alleviate dysphagia, final changed muscle arising from adenocarcinoma. After treatment, patient could eat soft solid food received rounds pembrolizumab-combination chemotherapy. The patient’s progression-free survival approximately 16 months. Long stable disease obtained during 24-month follow-up. CONCLUSION incidence muscular is extremely low. can effectively improve nutritional status before subsequent chemotherapy be combined immune checkpoint inhibitors.

Language: Английский

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Comparative efficacy of awake and asleep motor mapping in glioma surgery: A meta-analysis of 3011 patients

Neurosurgical Review, Journal Year: 2024, Volume and Issue: 47(1)

Published: Nov. 19, 2024

Language: Английский

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