Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection

Dziedzic, Tomasz; Bala, Aleksandra; Marchel, Andrzej

doi:10.1007/s10143-021-01602-5

Cited by 18 publications

(11 citation statements)

References 56 publications

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“…The insula, surrounded by cortical gyrus, white matter, and basal ganglia structures ( Dziedzic et al, 2022 ), is a center of integration for emotional, visceromotor, autonomic, and interoceptive information. Its diverse functional roles may be due to its strong connections to a broad network of cortical and subcortical regions ( Wang R. et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…Functional brain imaging studies revealed significant changes in the FC in the cerebellum-neocortex and cerebellum-basal ganglia circuits in patients with MDD ( Dai et al, 2022 ). Additionally, an increased long-range positive FC (lpFC) in the left inferior parietal lobule was found to distinguish HCs and patients with MDD ( Dziedzic et al, 2022 ). Given that the architecture of the connectome affects the effectiveness and velocity of information transport, including regions such as anterior and middle cingulate cortex, medial occipital areas, superior frontal areas, post- and precentral gyrus, parahippocampal gyrus, and precuneus, the balance of intra-hemispheric and inter-hemispheric connectivity plays a crucial role in brain function ( Krupnik et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Disrupted interhemispheric coordination of sensory-motor networks and insula in major depressive disorder

Zhang

Jing²,

Yan³

et al. 2023

Front. Neurosci.

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ObjectivePrior researches have identified distinct differences in neuroimaging characteristics between healthy controls (HCs) and patients with major depressive disorder (MDD). However, the correlations between homotopic connectivity and clinical characteristics in patients with MDD have yet to be fully understood. The present study aimed to investigate common and unique patterns of homotopic connectivity and their relationships with clinical characteristics in patients with MDD.MethodsWe recruited 42 patients diagnosed with MDD and 42 HCs. We collected a range of clinical variables, as well as exploratory eye movement (EEM), event-related potentials (ERPs) and resting-state functional magnetic resonance imaging (rs-fMRI) data. The data were analyzed using correlation analysis, support vector machine (SVM), and voxel-mirrored homotopic connectivity (VMHC).ResultsCompared with HCs, patients with MDD showed decreased VMHC in the insula, and increased VMHC in the cerebellum 8/vermis 8/vermis 9 and superior/middle occipital gyrus. SVM analysis using VMHC values in the cerebellum 8/vermis 8/vermis 9 and insula, or VMHC values in the superior/middle occipital gyrus and insula as inputs can distinguish HCs and patients with MDD with high accuracy, sensitivity, and specificity.ConclusionThe study demonstrated that decreased VMHC in the insula and increased VMHC values in the sensory-motor networks may be a distinctive neurobiological feature for patients with MDD, which could potentially serve as imaging markers to discriminate HCs and patients with MDD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disrupted interhemispheric coordination of sensory-motor networks and insula in major depressive disorder

Zhang

Jing²,

Yan³

et al. 2023

Front. Neurosci.

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“…Intracranial abscesses are treated with surgical drainage followed by long-term antibiotic treatment. [ 9 , 10 ] Surgical drainage is preferably accomplished by stereotactic needle aspiration. [ 9 - 12 ] If needle aspiration fails to decompress the abscess or if the abscess recurs, surgical excision of the abscess may be required.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of an abscess of the insula

Leavitt

Baohan

Heller

et al. 2022

Surgical Neurology International

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Background: Mass lesions within the insular are diagnostically and surgically challenging due to the numerous critical cortical, subcortical, and vascular structures surrounding the region. Two main surgical techniques – the transsylvian approach and the transcortical approach – provide access to the insular cortex. Of the range of pathologies encountered, abscesses in the insula are surprisingly rare. Case Description: A 34-year-old patient was admitted for surgical resection of a suspected high-grade glioma in the insula of the dominant hemisphere. A rapid clinical decline prompted emergent neurosurgical intervention using a transsylvian approach. Surprisingly, abundant purulent material was encountered on entering the insular fossa. Pathological analysis confirmed an insular abscess, although a source of infection could not be identified. The patient required a second evacuation for reaccumulation of the abscess and adjuvant corticosteroids for extensive cerebral edema. Conclusion: An abscess located in the insular cortex is an incredibly rare occurrence. Surgical management using the transsylvian approach is one option to approach this region. Familiarity with this approach is thus extremely beneficial in situations requiring emergent access to the dominant insula when awake mapping is not feasible. In addition, treatment of abscesses with adjuvant corticosteroids is indicated when extensive, life-threatening cerebral edema is present.

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“…For this type of procedure, the AF constitutes the deep, superior, and posterior functional limit of resection (Dziedzic et al, 2022).…”

Section: Af Topographical Anatomy and Surgical Implicationsmentioning

confidence: 99%

The arcuate fasciculus: Combining structure and function into surgical considerations

et al. 2023

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BackgroundTwo Centuries from today, Karl Friedrich Burdach attributed the nomenclature “arcuate fasciculus” to a white matter (WM) pathway connecting the frontal to the temporal cortices by arching around the Sylvian fissure. Although this label remained essentially unvaried, the concepts related to it and the characterization of the structural properties of this bundle evolved along with the methodological progress of the past years. Concurrently, the functional relevance of the arcuate fasciculus (AF) classically restricted to the linguistic domain has extended to further cognitive abilities. These features make it a relevant structure to consider in a large variety of neurosurgical procedures.ObjectiveHerein, we build on our previous review uncovering the connectivity provided by the Superior Longitudinal System, including the AF, and provide a handy representation of the structural organization of the AF by considering the frequency of defined reports in the literature. By adopting the same approach, we implement an account of which functions are mediated by this WM bundle. We highlight how this information can be transferred to the neurosurgical field by presenting four surgical cases of glioma resection requiring the evaluation of the relationship between the AF and the nearby structures, and the safest approaches to adopt.ConclusionsOur cumulative overview reports the most common wiring patterns and functional implications to be expected when approaching the study of the AF, while still considering seldom descriptions as an account of interindividual variability. Given its extension and the variety of cortical territories it reaches, the AF is a pivotal structure for different cognitive functions, and thorough understanding of its structural wiring and the functions it mediates is necessary for preserving the patient's cognitive abilities during glioma resection.

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Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection

Cited by 18 publications

References 56 publications

Disrupted interhemispheric coordination of sensory-motor networks and insula in major depressive disorder

Disrupted interhemispheric coordination of sensory-motor networks and insula in major depressive disorder

Surgical management of an abscess of the insula

The arcuate fasciculus: Combining structure and function into surgical considerations

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