A Novel Intraoperative Brain Mapping Integrated Task-Presentation Platform

2021 ◽  
Author(s):  
N U Farrukh Hameed ◽  
Zehao Zhao ◽  
Jie Zhang ◽  
Linghao Bu ◽  
Yuyao Zhou ◽  
...  
Keyword(s):  
Lower Limit ◽  
Brain Mapping ◽  
Patient Comfort ◽  
Awake Surgery ◽  
Cognitive Tasks ◽  
Patient Response ◽  
Stimulus Response ◽  
Task Presentation ◽  
Stimulation System ◽  
The Brain

Abstract BACKGROUND To be efficient, intraoperative task-presentation systems must accurately present various language and cognitive tasks to patients undergoing awake surgery, and record behavioral data without compromising convenience of surgery. OBJECTIVE To present an integrated brain mapping task-presentation system we developed and evaluate its effectiveness in intraoperative task presentation. METHODS The Brain Mapping Interactive Stimulation System (Brain MISS) is a flexible task presentation system that adjusts for patient comfort, needs of the surgeon, and operating team, with multivideo recording for patients’ behavior. A total of 48 patients from 3 centers underwent intraoperative language task test during awake brain surgery with the Brain MISS. Each patient was assigned 5 questions each on picture naming, reading, and listening comprehension before and during awake surgeries. The accuracy of intraoperative stimulus-response (without electrical stimulation) was recorded. The Brain MISS was to be considered effective, if the lower limit of 95% CI of patients’ intraoperative response was ≥80% and also if the accuracy of intraoperative response of all patients was statistically higher than 80%. RESULTS All patients successfully underwent intraoperative assessment with the Brain MISS. The overall accuracy of stimulus response was 95.8% (95% CI 90.18%-100.00%), with the lower limit being higher than 80% and the response accuracy also significantly being higher than 80% in all patients (P = .006). CONCLUSION The Brain MISS is a portable and effective system for presenting and streamlining complicated language and cognitive tasks during awake surgery. It can also record standardized patient response data for neuroscientific research.

The difference between electrical microstimulation and direct electrical stimulation – towards new opportunities for innovative functional brain mapping?

2016 ◽  
Vol 27 (3) ◽  
pp. 231-258 ◽  
Author(s):  
Marion Vincent ◽  
Olivier Rossel ◽  
Mitsuhiro Hayashibe ◽  
Guillaume Herbet ◽  
Hugues Duffau ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Brain Mapping ◽  
Awake Surgery ◽  
Direct Electrical Stimulation ◽  
Functional Brain ◽  
Electrical Microstimulation ◽  
Functional Brain Mapping ◽  
Technical Developments ◽  
Stimulation Parameters ◽  
The Brain

AbstractBoth electrical microstimulation (EMS) and direct electrical stimulation (DES) of the brain are used to perform functional brain mapping. EMS is applied to animal fundamental neuroscience experiments, whereas DES is performed in the operating theatre on neurosurgery patients. The objective of the present review was to shed new light on electrical stimulation techniques in brain mapping by comparing EMS and DES. There is much controversy as to whether the use of DES during wide-awake surgery is the ‘gold standard’ for studying the brain function. As part of this debate, it is sometimes wrongly assumed that EMS and DES induce similar effects in the nervous tissues and have comparable behavioural consequences. In fact, the respective stimulation parameters in EMS and DES are clearly different. More surprisingly, there is no solid biophysical rationale for setting the stimulation parameters in EMS and DES; this may be due to historical, methodological and technical constraints that have limited the experimental protocols and prompted the use of empirical methods. In contrast, the gap between EMS and DES highlights the potential for new experimental paradigms in electrical stimulation for functional brain mapping. In view of this gap and recent technical developments in stimulator design, it may now be time to move towards alternative, innovative protocols based on the functional stimulation of peripheral nerves (for which a more solid theoretical grounding exists).

Neurocognitive and functional outcomes in patients with diffuse frontal lower-grade gliomas undergoing intraoperative awake brain mapping

2020 ◽  
Vol 132 (6) ◽  
pp. 1683-1691 ◽  
Author(s):  
Kazuya Motomura ◽  
Lushun Chalise ◽  
Fumiharu Ohka ◽  
Kosuke Aoki ◽  
Kuniaki Tanahashi ◽  
...  
Keyword(s):  
Working Memory ◽  
Brain Mapping ◽  
Functional Outcomes ◽  
Digit Span ◽  
Awake Surgery ◽  
Motor Deficit ◽  
Lower Grade ◽  
Superior Frontal Gyrus ◽  
Neurocognitive Functions ◽  
Motor Disturbances

OBJECTIVELower-grade gliomas (LGGs) are often observed within eloquent regions, which indicates that tumor resection in these areas carries a potential risk for neurological disturbances, such as motor deficit, language disorder, and/or neurocognitive impairments. Some patients with frontal tumors exhibit severe impairments of neurocognitive function, including working memory and spatial awareness, after tumor removal. The aim of this study was to investigate neurocognitive and functional outcomes of frontal LGGs in both the dominant and nondominant hemispheres after awake brain mapping.METHODSData from 50 consecutive patients with diffuse frontal LGGs in the dominant and nondominant hemispheres who underwent awake brain surgery between December 2012 and September 2018 were retrospectively analyzed. The goal was to map neurocognitive functions such as working memory by using working memory tasks, including digit span testing and N-back tasks.RESULTSDue to awake language mapping, the frontal aslant tract was frequently identified as a functional boundary in patients with left superior frontal gyrus tumors (76.5%). Furthermore, functional boundaries were identified while evaluating verbal and spatial working memory function by stimulating the dorsolateral prefrontal cortex using the digit span and visual N-back tasks in patients with right superior frontal gyrus tumors (7.1%). Comparing the preoperative and postoperative neuropsychological assessments from the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) and Wechsler Memory Scale–Revised (WMS-R), significant improvement following awake surgery was observed in mean Perceptual Organization (Z = −2.09, p = 0.04) in WAIS-III scores. Postoperative mean WMS-R scores for Visual Memory (Z = −2.12, p = 0.03) and Delayed Recall (Z = −1.98, p = 0.04) were significantly improved compared with preoperative values for every test after awake surgery. No significant deterioration was noted with regard to neurocognitive functions in a comprehensive neuropsychological test battery. In the postoperative course, early transient speech and motor disturbances were observed in 30.0% and 28.0% of patients, respectively. In contrast, late permanent speech and motor disturbances were observed in 0% and 4.0%, respectively.CONCLUSIONSIt is noteworthy that no significant postoperative deterioration was identified compared with preoperative status in a comprehensive neuropsychological assessment. The results demonstrated that awake functional mapping enabled favorable neurocognitive and functional outcomes after surgery in patients with diffuse frontal LGGs.

Neuro-Clinical Signatures of Language Impairments: A Theoretical Framework for Function-to-structure Mapping in Clinics

2020 ◽  
Vol 20 (9) ◽  
pp. 800-811 ◽  
Author(s):  
Ferath Kherif ◽  
Sandrine Muller
Keyword(s):  
Brain Mapping ◽  
Theoretical Framework ◽  
Brain Regions ◽  
Language Impairments ◽  
Structure Mapping ◽  
Language Functions ◽  
The Past ◽  
Language Recovery ◽  
The Brain ◽  
Bow Tie

In the past decades, neuroscientists and clinicians have collected a considerable amount of data and drastically increased our knowledge about the mapping of language in the brain. The emerging picture from the accumulated knowledge is that there are complex and combinatorial relationships between language functions and anatomical brain regions. Understanding the underlying principles of this complex mapping is of paramount importance for the identification of the brain signature of language and Neuro-Clinical signatures that explain language impairments and predict language recovery after stroke. We review recent attempts to addresses this question of language-brain mapping. We introduce the different concepts of mapping (from diffeomorphic one-to-one mapping to many-to-many mapping). We build those different forms of mapping to derive a theoretical framework where the current principles of brain architectures including redundancy, degeneracy, pluri-potentiality and bow-tie network are described.

Stereotactic Brain Biopsy in Eloquent Areas Assisted by Navigated Transcranial Magnetic Stimulation: a Technical Case Report

2018 ◽  
Vol 17 (3) ◽  
pp. E124-E129 ◽  
Author(s):  
Jiri Bartek ◽  
Gerald Cooray ◽  
Mominul Islam ◽  
Margret Jensdottir
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Awake Surgery ◽  
Histopathological Diagnosis ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Stereotactic Brain Biopsy ◽  
Eloquent Areas ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE Stereotactic brain biopsy (SB) is an important part of the neurosurgical armamentarium, with the possibility of achieving histopathological diagnosis in otherwise inaccessible lesions of the brain. Nevertheless, the procedure is not without the risk of morbidity, which is especially true for lesions in eloquent parts of the brain, where even a minor adverse event can result in significant deficits. Navigated transcranial magnetic stimulation (nTMS) is widely used to chart lesions in eloquent areas, successfully guiding maximal safe resection, while its potential role in aiding with the planning of a stereotactic biopsy is so far unexplored. CLINICAL PRESENTATION Magnetic resonance imaging of a 67-yr-old woman presenting with dysphasia revealed a noncontrast enhancing left-sided lesion in the frontal and parietal pars opercularis. Due to the location of the lesion, nTMS was used to chart both primary motor and language cortex, utilizing this information to plan a safe SB trajectory and sampling area according to the initial work-up recommendations from the multidisciplinary neuro-oncology board. The SB was uneventful, with histology revealing a ganglioglioma, WHO I. The patient was discharged the following day, having declined to proceed with tumor resection (awake surgery) due to the non-negligible risk of morbidity. Upon 1- and 3-mo follow-up, she showed no signs of any procedure-related deficits. CONCLUSION nTMS can be implemented to aid with the planning of a stereotactic biopsy procedure in eloquent areas of the brain, and should be considered part of the neurosurgical armamentarium.

scholarly journals Action video gaming and the brain: fMRI effects without behavioral effects in visual and verbal cognitive tasks

2017 ◽  
Vol 8 (1) ◽  
pp. e00877 ◽  
Author(s):  
Fabio Richlan ◽  
Juliane Schubert ◽  
Rebecca Mayer ◽  
Florian Hutzler ◽  
Martin Kronbichler
Keyword(s):  
Behavioral Effects ◽  
Cognitive Tasks ◽  
Video Gaming ◽  
Brain Fmri ◽  
The Brain

scholarly journals Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1075
Author(s):  
Ladina Greuter ◽  
Raphael Guzman ◽  
Jehuda Soleman
Keyword(s):  
Primary Treatment ◽  
The Other ◽  
Awake Surgery ◽  
Low Grade ◽  
Total Excision ◽  
Cerebrospinal Fluid Flow ◽  
Pilocytic Astrocytomas ◽  
The Brain ◽  
Initial Results ◽  
Infratentorial Tumors

Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG.

scholarly journals Intraoperative brain mapping during awake surgery in symptomatic supratentorial cavernomas

Neurocirugía ◽  
2020 ◽  
Author(s):  
Ricardo Prat-Acín ◽  
Inma Galeano-Senabre ◽  
Pilar López-Ruiz ◽  
Daniel García-Sánchez ◽  
Angel Ayuso-Sacido ◽  
...  
Keyword(s):  
Brain Mapping ◽  
Awake Surgery

scholarly journals Preserved representations and decodability of diverse cognitive functions across the cortex, cerebellum, and subcortex

2021 ◽  
Author(s):  
Tomoya Nakai ◽  
Shinji Nishimoto
Keyword(s):  
Cognitive Functions ◽  
Principal Component ◽  
Cognitive Tasks ◽  
Sufficient Information ◽  
The Novel ◽  
Imaging Data ◽  
Functional Representations ◽  
Model Training ◽  
Task Representations ◽  
The Brain

Which part of the brain contributes to our complex cognitive processes? Studies have revealed contributions of the cerebellum and subcortex to higher-order cognitive functions; however it is unclear whether such functional representations are preserved across the cortex, cerebellum, and subcortex. In this study, we used functional magnetic resonance imaging data with 103 cognitive tasks and constructed three voxel-wise encoding and decoding models independently using cortical, cerebellar, and subcortical voxels. Representational similarity analysis revealed that the structure of task representations is preserved across the three brain parts. Principal component analysis visualized distinct organizations of abstract cognitive functions in each part of the cerebellum and subcortex. More than 90% of the cognitive tasks were decodable from the cerebellum and subcortical activities, even for the novel tasks not included in model training. Furthermore, we discovered that the cerebellum and subcortex have sufficient information to reconstruct activity in the cerebral cortex.

scholarly journals Cortical state transitions and stimulus response evolve along stiff and sloppy parameter dimensions, respectively

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Adrian Ponce-Alvarez ◽  
Gabriela Mochol ◽  
Ainhoa Hermoso-Mendizabal ◽  
Jaime de la Rocha ◽  
Gustavo Deco
Keyword(s):  
Collective Behavior ◽  
Neural Population ◽  
State Transitions ◽  
Population Activity ◽  
Sensory Inputs ◽  
Stimulus Response ◽  
Spontaneous Neuronal Activity ◽  
The Brain ◽  
Shed Light ◽  
Neural Population Activity

Previous research showed that spontaneous neuronal activity presents sloppiness: the collective behavior is strongly determined by a small number of parameter combinations, defined as ‘stiff’ dimensions, while it is insensitive to many others (‘sloppy’ dimensions). Here, we analyzed neural population activity from the auditory cortex of anesthetized rats while the brain spontaneously transited through different synchronized and desynchronized states and intermittently received sensory inputs. We showed that cortical state transitions were determined by changes in stiff parameters associated with the activity of a core of neurons with low responses to stimuli and high centrality within the observed network. In contrast, stimulus-evoked responses evolved along sloppy dimensions associated with the activity of neurons with low centrality and displaying large ongoing and stimulus-evoked fluctuations without affecting the integrity of the network. Our results shed light on the interplay among stability, flexibility, and responsiveness of neuronal collective dynamics during intrinsic and induced activity.

scholarly journals Cortical state transitions and stimulus response evolve along stiff and sloppy parameter dimensions, respectively

2019 ◽  
Author(s):  
Adrián Ponce-Alvarez ◽  
Gabriela Mochol ◽  
Ainhoa Hermoso-Mendizabal ◽  
Jaime de la Rocha ◽  
Gustavo Deco
Keyword(s):  
Collective Behavior ◽  
Neural Population ◽  
State Transitions ◽  
Population Activity ◽  
Sensory Inputs ◽  
Stimulus Response ◽  
Spontaneous Neuronal Activity ◽  
The Brain ◽  
Shed Light ◽  
Neural Population Activity

SummaryPrevious research showed that spontaneous neuronal activity presents sloppiness: the collective behavior is strongly determined by a small number of parameter combinations, defined as “stiff” dimensions, while it is insensitive to many others (“sloppy” dimensions). Here, we analyzed neural population activity from the auditory cortex of anesthetized rats while the brain spontaneously transited through different synchronized and desynchronized states and intermittently received sensory inputs. We showed that cortical state transitions were determined by changes in stiff parameters associated with the activity of a core of neurons with low responses to stimuli and high centrality within the observed network. In contrast, stimulus-evoked responses evolved along sloppy dimensions associated with the activity of neurons with low centrality and displaying large ongoing and stimulus-evoked fluctuations without affecting the integrity of the network. Our results shed light on the interplay among stability, flexibility, and responsiveness of neuronal collective dynamics during intrinsic and induced activity.

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