Reorganization of language centers in patients with brain tumors located in eloquent speech areas – A pre- and postoperative preliminary fMRI study

Gębska-Kośla, Katarzyna; Bryszewski, Bartosz; Jaskólski, Dariusz J.; Fortuniak, Jan; Niewodniczy, Maciej; Stefańczyk, Ludomir; Majos, Agata

doi:10.1016/j.pjnns.2017.07.010

Cited by 25 publications

(25 citation statements)

References 33 publications

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“…The total number of patients that were studied was 170. The sample size ranged from 10 [52] to 42 participants [50]. Patients' mean age ranged from 30.9 ± 7.4 years [50] to 53.1 ± 13.1 years [46].…”

Section: Resultsmentioning

confidence: 99%

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Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review

et al. 2019

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Cerebral plasticity is the ability of the central nervous system to reorganize itself in response to different injuries. The reshaping of functional areas is a crucial mechanism to compensate for damaged function. It is acknowledged that functional remodeling of cortical areas may occur also in glioma patients. Principal limits of previous investigations on cortical plasticity of motor and language functions included scarce reports of longitudinal evaluations and limited sample sizes. This systematic review is aimed at elucidating cortical brain plasticity for motor and language functions, in adult glioma patients, by means of preoperative and intraoperative mapping techniques. We systematically reviewed the literature for prospective studies, assessing cortical plasticity of motor and language functions in low-grade and high-grade gliomas. Eight longitudinal studies investigated cortical plasticity, evaluated by motor and language task-based functional MRI (fMRI), motor navigated transcranial magnetic stimulation (n-TMS), and intraoperative mapping with cortical direct electrocortical stimulation (DES) of language and motor function. Motor function reorganization appeared relatively limited and mostly characterized by intrahemispheric functional changes, including secondary motor cortices. On the other hand, a high level of functional reshaping was found for language function in DES studies. Occurrence of cortical functional reorganization of language function was described focusing on the intrahemispheric recruitment of perilesional areas. However, the association between these functional patterns and recovery of motor and language deficits still remains partially clear. A number of relevant methodological issues possibly affecting the finding generalization emerged, such as the complexity of plasticity outcome measures and the lack of large longitudinal studies. Future studies are required to further confirm these evidences on cortical plasticity in larger samples, combining both functional imaging and intraoperative mapping techniques in longitudinally evaluations.

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Section: Resultsmentioning

confidence: 99%

“…Tumor size was specified in five studies (5/8) [45, 46, 50–52], one reported only resected volume [47]. The extent of resection was included in six investigations (6/8) [45, 46, 48–51].…”

Section: Resultsmentioning

confidence: 99%

Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review

et al. 2019

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“…Conversely, inter-hemispheric activations in the homologous language areas were evidenced, with an activation of the right “Broca’s area” in five frontal LGG patients without language disorders, and with an activation of the right “Wernicke’s area” in five temporal gliomas, both before and after surgery [ 113 ]. In a patient with resection for a left LGG near the “Broca’s area”, without language impairment, fMRI achieved before surgery and 3, 32, and 41 months after resection demonstrated a progressive right-sided activation of Broca’s and Wernicke’s areas [ 114 ].…”

Section: Functional Compensation After Lgg Surgery: Postoperative mentioning

confidence: 99%

Functional Mapping before and after Low-Grade Glioma Surgery: A New Way to Decipher Various Spatiotemporal Patterns of Individual Neuroplastic Potential in Brain Tumor Patients

Duffau

2020

Cancers

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Intraoperative direct electrostimulation mapping (DEM) is currently the gold-standard for glioma surgery, since functional-based resection allows an optimization of the onco-functional balance (increased resection with preserved quality of life). Besides intrasurgical awake mapping of conation, cognition, and behavior, preoperative mapping by means of functional neuroimaging (FNI) and transcranial magnetic stimulation (TMS) has increasingly been utilized for surgical selection and planning. However, because these techniques suffer from several limitations, particularly for direct functional mapping of subcortical white matter pathways, DEM remains crucial to map neural connectivity. On the other hand, non-invasive FNI and TMS can be repeated before and after surgical resection(s), enabling longitudinal investigation of brain reorganization, especially in slow-growing tumors like low-grade gliomas. Indeed, these neoplasms generate neuroplastic phenomena in patients with usually no or only slight neurological deficits at diagnosis, despite gliomas involving the so-called “eloquent” structures. Here, data gained from perioperative FNI/TMS mapping methods are reviewed, in order to decipher mechanisms underpinning functional cerebral reshaping induced by the tumor and its possible relapse, (re)operation(s), and postoperative rehabilitation. Heterogeneous spatiotemporal patterns of rearrangement across patients and in a single patient over time have been evidenced, with structural changes as well as modifications of intra-hemispheric (in the ipsi-lesional and/or contra-lesional hemisphere) and inter-hemispheric functional connectivity. Such various fingerprints of neural reconfiguration were correlated to different levels of cognitive compensation. Serial multimodal studies exploring neuroplasticity might lead to new management strategies based upon multistage therapeutic approaches adapted to the individual profile of functional reallocation.

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“…Concerning language, reorganization in the affected hemisphere was observed for left Wernicke’s area (e.g., Gębska-Kośla et al, 2017 ) and the left mesial temporal cortex (e.g., Kamada et al, 2004 ). Gębska-Kośla et al (2017) observed that tumor resection in either Broca’s or Wernicke’s area restored the primary activation of the ipsilesional ( vs . contralesional) hemisphere in some of the patients (the others presented with unchanged patterns).…”

Section: Postoperative Plasticitymentioning

confidence: 99%

What do we know about pre- and postoperative plasticity in patients with glioma? A review of neuroimaging and intraoperative mapping studies

Cargnelutti

Ius

Škrap

et al. 2020

NeuroImage: Clinical

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Highlights Brain reorganization can take place before and after surgery of low- and high-grade gliomas. Plasticity is observed for low-grade but also for high-grade gliomas. The contralesional hemisphere can be vital for successful compensation. There is evidence of plasticity for both the language system and the sensorimotor system. Partial compensation can also occur at the white-matter level. Subcortical connectivity is crucial for brain reorganization.

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Reorganization of language centers in patients with brain tumors located in eloquent speech areas – A pre- and postoperative preliminary fMRI study

Abstract: In the cases of tumors localized near the left Broca's area, a transfer of the function to the healthy hemisphere seems to take place. Resection of tumors located near Broca's or Wernicke's areas may lead to relocation of the brain language centers.

Cited by 25 publications

References 33 publications

Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review

Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review

Functional Mapping before and after Low-Grade Glioma Surgery: A New Way to Decipher Various Spatiotemporal Patterns of Individual Neuroplastic Potential in Brain Tumor Patients

What do we know about pre- and postoperative plasticity in patients with glioma? A review of neuroimaging and intraoperative mapping studies

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