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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Development of an educational method to rethink and learn oncological brain surgery in an “a la carte” connectome-based perspective

Acta Neurochirurgica, Journal Year: 2023, Volume and Issue: 165(9), P. 2489 - 2500

Published: May 18, 2023

Language: Английский

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Cortical mapping in multilinguals undergoing awake brain surgery for brain tumors: Illustrative cases and systematic review

Neuropsychologia, Journal Year: 2022, Volume and Issue: 179, P. 108450 - 108450

Published: Dec. 16, 2022

Language: Английский

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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

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

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Nuancing the Limitations of Axonal Plasticity in World Health Organization Grade II Gliomas: White Matter Tracts Compensation Is Driven by Cortical Remodeling

Neurosurgery, Journal Year: 2023, Volume and Issue: 93(4), P. e85 - e91

Published: April 19, 2023

Diffuse World Health Organization grade II glioma (GIIG) is a slow-growing brain cancer that migrates along the white matter (WM) tracts. Neuroplastic changes were described in reaction to GIIG progression, opening window extensive cerebral surgical resection patients able resume an active life with no functional consequences. However, atlases of cortico-subcortical neural plasticity emphasized limited potential axonal reorganization. Yet, removal WM involved by can be possible, at least some extent, without generating permanent neurological disturbances. Here, aim was discuss mechanisms underlying compensation which make feasible subcortical component and propose new model adaptative reconfiguration level connectivity. In this model, 2 parts tracts are considered: (1) stem bundle represents actual limitation plastic potential, as supported reproducible behavioral disorders elicited intraoperative electrostimulation mapping (ESM) (2) terminations/origins may longer critical case reallocation cortex to/from these fibers run-thus inducing troubles during direct ESM. Understanding certain degree specific portions driven cortical remodeling enable rethink concept refine preoperative estimation extent for GIIG. Identifying eloquent ESM, especially their convergence depth, essential achieve individualized connectome-based resection.

Language: Английский

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Case report: when art is faced with brain surgery: acute change in creative style in a painter after glioma resection

Frontiers in Oncology, Journal Year: 2024, Volume and Issue: 14

Published: March 28, 2024

Background Strong interactions between art and health are well-known. While advances in brain surgery resulted an improved preservation of sensorimotor, visuospatial, language cognitive functions, creative abilities received less attention. However, creativity may represent a critical issue to resume optimal quality life, especially artists. Here, unique case sudden change style painter who underwent glioma resection is described. This prompts explore further thinking its clinical implications routine practice. Methods A 36-year-old right-handed woman experienced inaugural seizures, allowing the discovery right frontal lesion. The patient was professional did not complain about any decline her creativity. preoperative neurological examination normal. Results Surgery achieved with maximal tumor through lobectomy. WHO grade II oligodendroglioma diagnosed. regular surveillance performed without adjuvant oncological treatment. exhibit postoperative functional deterioration she returned normal activities including painting during 15 years. Remarkably, even though activity judged by herself be rich satisfying, drastically changed from surrealism mysticism cubism whereas able explain why. Conclusion first report acute modification following lobectomy for low-grade glioma, supporting that resective impact neglected many decades, this complex human ability should evaluated more regularly neurosurgical practice, particularly

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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Awake brain surgery: toward optimal cognitive explorations

Frontiers in Human Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: March 27, 2024

OPINION article Front. Hum. Neurosci., 27 March 2024Sec. Cognitive Neuroscience Volume 18 - 2024 | https://doi.org/10.3389/fnhum.2024.1369462

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Vers un modèle en méta-réseau du fonctionnement cérébral : contribution de la chirurgie éveillée des gliomes de bas grade et implications thérapeutiques

Bulletin de l Académie Nationale de Médecine, Journal Year: 2024, Volume and Issue: 208(6), P. 824 - 831

Published: April 26, 2024

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In Reply: Planning Brain Tumor Resection Using a Probabilistic Atlas of Cortical and Subcortical Structures Critical for Functional Processing: A Proof of Concept

Operative Neurosurgery, Journal Year: 2023, Volume and Issue: 24(3), P. e246 - e247

Published: Jan. 11, 2023

To the Editor: We read comments by Shalom et al1 to our work2 published in Operative Neurosurgery as proof of concept for implementation neurosurgical planning with knowledge coming from most extensive data set functional and probabilistic cortical subcortical evidences obtained brain mapping cognitive monitoring.3-5 This letter is a chance comment highlight some interesting evolution field clinical surgical neurosciences. As al,1 we also appreciate report experience Andrews al2 about so-called "Broca Aphasia." all agree that resection Broca area does not necessarily generate aphasia. phenomenon has extensively described explained ourselves past 15 years.6-10 Our work definition main hubs streams processing language (and nonlanguage) functions only resulted reappraisal anatomy but broke classic localizationist view processing.8,11,12 In particular, recently released atlas speech articulatory network, an unprecedented resting-state whole-brain seed-based analysis direct electrical stimulation (DES) sites during awake surgery.13 other words, have demonstrated using intrasurgical DES dogmatic static organization now overpassed, therefore, should evolve toward meta-networking model based on dynamic interactions within between neural circuits.14 this new framework, provided more evidence role white matter tracts distributed epicenters,15 leading considerable interindividual variability because pathological physiological processes.16,17 Of course, personalized cerebral reconfiguration be taken into account safe modern tumor resections.18 Just light, group proposed highest amount patients glioma goal, one hand, clarify mechanisms crucial pathways and, provide overview possible distribution such complex, multimodal, bihemispherical networks. Indeed, it seems important remind investigated underpinning neuroplasticity almost 2 decades, especially event glioma, both intraoperative perioperative neuroimaging.19-23 consequence, are first claim monitoring gold standard surgery, at level, improving complex biological system perspective, is, individual level.24 reliable causal hands neurosurgeons. It sole tool providing inferences workflow information practice allowed development "connectome-based" concept.25 On basis, value mainly related improvement younger neurosurgeons their mental spatial 3-dimensional imagery networks critical utmost importance insist fact MRI, regularly used preoperative many teams worldwide, able differentiate essential compensable structures tractography indirect mirror functions.26 exclude use techniques reported automatic extraction network level.27 Concluding, unique atlas, computed basis real anatomo truth observed mapping, axonal levels, didactic which aims giving opportunity young surgeons better plan according limitations reported, ie, mostly represented connectivity.11,21,28 Because map, will never replace combined online throughout resection, could helpful anticipate relationships select appropriately tasks performed patient operating theater.29 results integrative multimodal approach, capable insights connectomal cortices tracts, may improve awareness neurosurgeon functions30,31 reinforce link fundamental neurosciences implications.

Language: Английский

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