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

2020 ◽  
Author(s):  
Silvio Sarubbo ◽  
Luciano Annicchiarico ◽  
Francesco Corsini ◽  
Luca Zigiotto ◽  
Guillaume Herbet ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Functional Information ◽  
Subcortical Structures ◽  
Functional Responses ◽  
Functional Sites ◽  
Probabilistic Atlas ◽  
Cortical Level ◽  
Brain Extraction ◽  
Correct Alignment ◽  
Automated Alignment

Abstract BACKGROUND Functional preoperative planning for resection of intrinsic brain tumors in eloquent areas is still a challenge. Predicting subcortical functional framework is especially difficult. Direct electrical stimulation (DES) is the recommended technique for resection of these lesions. A reliable probabilistic atlas of the critical cortical epicenters and subcortical framework based on DES data was recently published. OBJECTIVE To propose a pipeline for the automated alignment of the corticosubcortical maps of this atlas with T1-weighted MRI. METHODS To test the alignment, we selected 10 patients who underwent resection of brain lesions by using DES. We aligned different cortical and subcortical functional maps to preoperative volumetric T1 MRIs (with/without gadolinium). For each patient we quantified the quality of the alignment, and we calculated the match between the location of the functional sites found at DES and the functional maps of the atlas. RESULTS We found an accurate brain extraction and alignment of the functional maps with both the T1 MRIs of each patient. The matching analysis between functional maps and functional responses collected during surgeries was 88% at cortical and, importantly, 100% at subcortical level, providing a further proof of the correct alignment. CONCLUSION We demonstrated quantitatively and qualitatively the reliability of this tool that may be used for presurgical planning, providing further functional information at the cortical level and a unique probabilistic prevision of distribution of the critical subcortical structures. Finally, this tool offers the chance for multimodal planning through integrating this functional information with other neuroradiological and neurophysiological techniques.

scholarly journals Monocular Advantage for Face Perception Implicates Subcortical Mechanisms in Adult Humans

2014 ◽  
Vol 26 (5) ◽  
pp. 927-937 ◽  
Author(s):  
Shai Gabay ◽  
Adrian Nestor ◽  
Eva Dundas ◽  
Marlene Behrmann
Keyword(s):  
Face Recognition ◽  
Face Perception ◽  
Sex Differentiation ◽  
Neural Correlates ◽  
Subcortical Structures ◽  
Adaptive Process ◽  
Cortical Level ◽  
Adult Humans ◽  
Human Adults ◽  
Robust Evidence

The ability to recognize faces accurately and rapidly is an evolutionarily adaptive process. Most studies examining the neural correlates of face perception in adult humans have focused on a distributed cortical network of face-selective regions. There is, however, robust evidence from phylogenetic and ontogenetic studies that implicates subcortical structures, and recently, some investigations in adult humans indicate subcortical correlates of face perception as well. The questions addressed here are whether low-level subcortical mechanisms for face perception (in the absence of changes in expression) are conserved in human adults, and if so, what is the nature of these subcortical representations. In a series of four experiments, we presented pairs of images to the same or different eyes. Participants' performance demonstrated that subcortical mechanisms, indexed by monocular portions of the visual system, play a functional role in face perception. These mechanisms are sensitive to face-like configurations and afford a coarse representation of a face, comprised of primarily low spatial frequency information, which suffices for matching faces but not for more complex aspects of face perception such as sex differentiation. Importantly, these subcortical mechanisms are not implicated in the perception of other visual stimuli, such as cars or letter strings. These findings suggest a conservation of phylogenetically and ontogenetically lower-order systems in adult human face perception. The involvement of subcortical structures in face recognition provokes a reconsideration of current theories of face perception, which are reliant on cortical level processing, inasmuch as it bolsters the cross-species continuity of the biological system for face recognition.

Subcortical surgical anatomy of the lateral frontal region: human white matter dissection and correlations with functional insights provided by intraoperative direct brain stimulation

2012 ◽  
Vol 117 (6) ◽  
pp. 1053-1069 ◽  
Author(s):  
Alessandro De Benedictis ◽  
Silvio Sarubbo ◽  
Hugues Duffau
Keyword(s):  
White Matter ◽  
Frontal Lobe ◽  
Inferior Frontal Gyrus ◽  
Postoperative Outcome ◽  
Surgical Anatomy ◽  
Frontal Region ◽  
Surgical Approaches ◽  
Subcortical Structures ◽  
Functional Responses ◽  
Frontal Horn

Object Recent neuroimaging and surgical results support the crucial role of white matter in mediating motor and higher-level processing within the frontal lobe, while suggesting the limited compensatory capacity after damage to subcortical structures. Consequently, an accurate knowledge of the anatomofunctional organization of the pathways running within this region is mandatory for planning safe and effective surgical approaches to different diseases. The aim of this dissection study was to improve the neurosurgeon's awareness of the subcortical anatomofunctional architecture for a lateral approach to the frontal region, to optimize both resection and postoperative outcome. Methods Ten human hemispheres (5 left, 5 right) were dissected according to the Klingler technique. Proceeding lateromedially, the main association and projection tracts as well as the deeper basal structures were identified. The authors describe the anatomy and the relationships among the exposed structures in both a systematic and topographical surgical perspective. Structural results were also correlated to the functional responses obtained during resections of infiltrative frontal tumors guided by direct cortico-subcortical electrostimulation with patients in the awake condition. Results The eloquent boundaries crucial for a safe frontal lobectomy or an extensive lesionectomy are as follows: 1) the motor cortex; 2) the pyramidal tract and premotor fibers in the posterior and posteromedial part of the surgical field; 3) the inferior frontooccipital fascicle and the superior longitudinal fascicle posterolaterally; and 4) underneath the inferior frontal gyrus, the head of the caudate nucleus, and the tip of the frontal horn of the lateral ventricle in the depth. Conclusions Optimization of results following brain surgery, especially within the frontal lobe, requires a perfect knowledge of functional anatomy, not only at the cortical level but also with regard to subcortical white matter connectivity.

Right parietal cortex and calculation processing: intraoperative functional mapping of multiplication and addition in patients affected by a brain tumor

2013 ◽  
Vol 119 (5) ◽  
pp. 1107-1111 ◽  
Author(s):  
Alessandro Della Puppa ◽  
Serena De Pellegrin ◽  
Elena d'Avella ◽  
Giorgio Gioffrè ◽  
Marina Munari ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Parietal Cortex ◽  
Parietal Lobe ◽  
Tumor Resection ◽  
Functional Mapping ◽  
Awake Surgery ◽  
Intraparietal Sulcus ◽  
Functional Sites ◽  
Parietal Area ◽  
The Right

Object The role of parietal areas in number processing is well known. The significance of intraoperative functional mapping of these areas has been only partially explored, however, and only a few discordant data are available in the surgical literature with regard to the right parietal lobe. The purpose of this study was to evaluate the clinical impact of simple calculation in cortical electrostimulation of right-handed patients affected by a right parietal brain tumor. Methods Calculation mapping in awake surgery was performed in 3 right-handed patients affected by high-grade gliomas located in the right parietal lobe. Preoperatively, none of the patients presented with calculation deficits. In all 3 cases, after sensorimotor and language mapping, cortical and intraparietal sulcus areas involved in single-digit multiplication and addition calculations were mapped using bipolar electrostimulation. Results In all patients, different sites of the right parietal cortex, mainly in the inferior lobule, were detected as being specifically related to calculation (multiplication or addition). In 2 patients the intraparietal sulcus was functionally specific for multiplication. No functional sites for language were detected. All sites functional for calculation were spared during tumor resection, which was complete in all cases without postoperative neurological deficits. Conclusions These findings provide intraoperative data in support of an anatomofunctional organization for multiplication and addition within the right parietal area. Furthermore, the study shows the potential clinical relevance of intraoperative mapping of calculation in patients undergoing surgery in the right parietal area. Further and larger studies are needed to confirm these data and assess whether mapped areas are effectively essential for function.

scholarly journals What Can Glioma Patients Teach Us about Language (Re)Organization in the Bilingual Brain: Evidence from fMRI and MEG

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2593
Author(s):  
Ileana Quiñones ◽  
Lucia Amoruso ◽  
Iñigo Cristobal Pomposo Gastelu ◽  
Santiago Gil-Robles ◽  
Manuel Carreiras
Keyword(s):  
Right Hemisphere ◽  
Brain Plasticity ◽  
Tumor Resection ◽  
Cognitive Resources ◽  
Low Grade ◽  
Subcortical Structures ◽  
Language Mapping ◽  
Complementary Role ◽  
Before And After ◽  
Longitudinal Effects

Recent evidence suggests that the presence of brain tumors (e.g., low-grade gliomas) triggers language reorganization. Neuroplasticity mechanisms called into play can transfer linguistic functions from damaged to healthy areas unaffected by the tumor. This phenomenon has been reported in monolingual patients, but much less is known about the neuroplasticity of language in the bilingual brain. A central question is whether processing a first or second language involves the same or different cortical territories and whether damage results in diverse recovery patterns depending on the language involved. This question becomes critical for preserving language areas in bilingual brain-tumor patients to prevent involuntary pathological symptoms following resection. While most studies have focused on intraoperative mapping, here, we go further, reporting clinical cases for five bilingual patients tested before and after tumor resection, using a novel multimethod approach merging neuroimaging information from fMRI and MEG to map the longitudinal reshaping of the language system. Here, we present four main findings. First, all patients preserved linguistic function in both languages after surgery, suggesting that the surgical intervention with intraoperative language mapping was successful in preserving cortical and subcortical structures necessary for brain plasticity at the functional level. Second, we found reorganization of the language network after tumor resection in both languages, mainly reflected by a shift of activity to right hemisphere nodes and the recruitment of ipsilesional left nodes. Third, we found that this reorganization varied according to the language involved, indicating that L1 and L2 follow different reshaping patterns after surgery. Fourth, oscillatory longitudinal effects were correlated with BOLD laterality changes in superior parietal and middle frontal areas. These findings may reflect that neuroplasticity impacts on the compensatory involvement of executive control regions, supporting the allocation of cognitive resources as a consequence of increased attentional demands. Furthermore, these results hint at the complementary role of this neuroimaging approach in language mapping, with fMRI offering excellent spatial localization and MEG providing optimal spectrotemporal resolution.

Cognitive Functions of the Fetus

2018 ◽  
Vol 39 (02) ◽  
pp. 181-189 ◽  
Author(s):  
Aida Kadic ◽  
Asim Kurjak
Keyword(s):  
Cognitive Functions ◽  
Neurodevelopmental Outcome ◽  
Action Planning ◽  
Prenatal Development ◽  
Postnatal Period ◽  
Subcortical Structures ◽  
Sensory Stimuli ◽  
Cortical Level ◽  
Gestational Week ◽  
And Behavior

AbstractThe human brain is intricately designed to execute cognitive functions, such as perception, attention, action, memory and learning. The complete nervous system is active during prenatal development and the aim of this review is to present data on fetal cognitive functions. The fetus processes sensory stimuli at a cortical level, including painful stimulus, from about 25 weeks of gestation onwards. At gestational week 34, the fetus is able not only to perceive complex acoustic external sounds but also to discriminate between different sounds. Fetal action planning is established by 22 weeks and investigations using four-dimensional ultrasound reveal that complexity of fetal motor action and behavior increases as pregnancy progresses. The capacity of the fetus to learn and memory are prodigious. At term, subcortical structures of the brain are well developed. There is high activity in primary cortical areas and low activity in association areas. Clinically relevant data on cognitive functions of the fetus could be important for the management of fetal pain and treatment of preterm infants as well as for improved neurodevelopmental outcome of fetuses from high-risk pregnancies. Finally, the brain’s developmental journey, including development of cognitive functions, continues with the same intensity in the postnatal period.

scholarly journals Subcortical mapping of calculation processing in the right parietal lobe

2015 ◽  
Vol 122 (5) ◽  
pp. 1038-1041 ◽  
Author(s):  
Alessandro Della Puppa ◽  
Serena De Pellegrin ◽  
Anna Lazzarini ◽  
Giorgio Gioffrè ◽  
Oriela Rustemi ◽  
...  
Keyword(s):  
Parietal Lobe ◽  
Current Knowledge ◽  
Tumor Resection ◽  
Preoperative Assessment ◽  
Cortical Mapping ◽  
Functional Sites ◽  
Postoperative Mri ◽  
The Right ◽  
Subcortical Mapping ◽  
Calculation Processing

Preservation of calculation processing in brain surgery is crucial for patients' quality of life. Over the last decade, surgical electrostimulation was used to identify and preserve the cortical areas involved in such processing. Conversely, subcortical connectivity among different areas implicated in this function remains unclear, and the role of surgery in this domain has not been explored so far. The authors present the first 2 cases in which the subcortical functional sites involved in calculation were identified during right parietal lobe surgery. Two patients affected by a glioma located in the right parietal lobe underwent surgery with the aid of MRI neuronavigation. No calculation deficits were detected during preoperative assessment. Cortical and subcortical mapping were performed using a bipolar stimulator. The current intensity was determined by progressively increasing the amplitude by 0.5-mA increments (from a baseline of 1 mA) until a sensorimotor response was elicited. Then, addition and multiplication calculation tasks were administered. Corticectomy was performed according to both the MRI neuronavigation data and the functional findings obtained through cortical mapping. Direct subcortical electrostimulation was repeatedly performed during tumor resection. Subcortical functional sites for multiplication and addition were detected in both patients. Electrostimulation interfered with calculation processing during cortical mapping as well. Functional sites were spared during tumor removal. The postoperative course was uneventful, and calculation processing was preserved. Postoperative MRI showed complete resection of the tumor. The present preliminary study shows for the first time how functional mapping can be a promising method to intraoperatively identify the subcortical functional sites involved in calculation processing. This report therefore supports direct electrical stimulation as a promising tool to improve the current knowledge on calculation processing connectivity.

PET study of voluntary saccadic eye movements in humans: basal ganglia-thalamocortical system and cingulate cortex involvement

1993 ◽  
Vol 69 (4) ◽  
pp. 1009-1017 ◽  
Author(s):  
L. Petit ◽  
C. Orssaud ◽  
N. Tzourio ◽  
G. Salamon ◽  
B. Mazoyer ◽  
...  
Keyword(s):  
Eye Movements ◽  
Basal Ganglia ◽  
Saccadic Eye Movements ◽  
Precentral Gyrus ◽  
Subcortical Structures ◽  
Intravenous Injections ◽  
Cortical Level ◽  
Positron Emission ◽  
Lenticular Nuclei ◽  
Cortical Regions

1. The purpose of this work was to explore the cortical and subcortical mechanisms underlying the execution of voluntary saccadic eye movements in humans. 2. Normalized regional cerebral blood flow (NrCBF) was measured using positron emission tomography (PET) and H2(15O) bolus intravenous injections in four right-handed healthy volunteers at rest and while performing self-paced voluntary horizontal saccadic eye movements in total darkness. 3. Magnetic resonance imaging of each subject's brain was matched to PET images, allowing the detection of activation in individually defined anatomic regions of interest. Cortical regions were drawn according to gyri limits; subcortical structures were also defined. 4. Self-paced saccadic eye movements elicited bilateral NrCBF increases in the lenticular nuclei, including putamen and globus pallidus, and in the thalamus. At the cortical level, we found bilateral NrCBF increases in the precentral gyrus, the superior part of the median frontal gyrus that corresponds to the supplementary motor area. There was also a significant NrCBF increase in the cerebellar vermis. 5. Right fusiform and lingual gyri, right insula, and left cingulate gyrus were also activated during the execution of saccades. 6. These results indicate that the classical basal ganglia-thalamocortical motor loop previously described for skeletal movements may also be involved in simple saccadic eye movements in humans.

mRNA localization by Electron microscopic in situ hybridization

1991 ◽  
Vol 49 ◽  
pp. 430-431
Author(s):  
J. A. Pollock ◽  
M. Martone ◽  
T. Deerinck ◽  
M. H. Ellisman
Keyword(s):  
Electron Microscopy ◽  
High Resolution ◽  
Nucleic Acids ◽  
Recombinant Dna ◽  
Light And Electron Microscopy ◽  
Electron Microscopic ◽  
High Voltage Electron Microscopy ◽  
Functional Sites ◽  
Voltage Electron

Localization of specific proteins in cells by both light and electron microscopy has been facilitate by the availability of antibodies that recognize unique features of these proteins. High resolution localization studies conducted over the last 25 years have allowed biologists to study the synthesis, translocation and ultimate functional sites for many important classes of proteins. Recently, recombinant DNA techniques in molecular biology have allowed the production of specific probes for localization of nucleic acids by “in situ” hybridization. The availability of these probes potentially opens a new set of questions to experimental investigation regarding the subcellular distribution of specific DNA's and RNA's. Nucleic acids have a much lower “copy number” per cell than a typical protein, ranging from one copy to perhaps several thousand. Therefore, sensitive, high resolution techniques are required. There are several reasons why Intermediate Voltage Electron Microscopy (IVEM) and High Voltage Electron Microscopy (HVEM) are most useful for localization of nucleic acids in situ.

Sign in / Sign up

Export Citation Format

Share Document