1
|
de Almeida CC, Neville IS, Hayashi CY, Gomes dos Santos A, Brunoni AR, Teixeira MJ, Paiva WS. Quantification of tumor induced motor cortical plasticity using navigated transcranial magnetic stimulation in patients with adult-type diffuse gliomas. Front Neurosci 2023; 17:1143072. [PMID: 37008212 PMCID: PMC10050360 DOI: 10.3389/fnins.2023.1143072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionThe evaluation of brain plasticity can provide relevant information for the surgical planning of patients with brain tumors, especially when it comes to intrinsic lesions such as gliomas. Neuronavigated transcranial magnetic stimulation (nTMS) is a non-invasive tool capable of providing information about the functional map of the cerebral cortex. Although nTMS presents a good correlation with invasive intraoperative techniques, the measurement of plasticity still needs standardization. The present study evaluated objective and graphic parameters in the quantification and qualification of brain plasticity in adult patients with gliomas in the vicinity of the motor area.MethodsThis is a prospective observational study that included 35 patients with a radiological diagnosis of glioma who underwent standard surgical treatment. nTMS was performed with a focus on the motor area of the upper limbs in both the affected and healthy cerebral hemispheres in all patients to obtain data on motor thresholds (MT) and graphical evaluation by three-dimensional reconstruction and mathematical analysis of parameters related to the location and displacement of the motor centers of gravity (ΔL), dispersion (SDpc) and variability (VCpc) of the points where there was a positive motor response. Data were compared according to the ratios between the hemispheres of each patient and stratified according to the final pathology diagnosis.ResultsThe final sample consisted of 14 patients with a radiological diagnosis of low-grade glioma (LGG), of which 11 were consistent with the final pathology diagnosis. The normalized interhemispheric ratios of ΔL, SDpc, VCpc, and MT were significantly relevant for the quantification of plasticity (p < 0.001). The graphic reconstruction allows the qualitative evaluation of this plasticity.ConclusionThe nTMS was able to quantitatively and qualitatively demonstrate the occurrence of brain plasticity induced by an intrinsic brain tumor. The graphic evaluation allowed the observation of useful characteristics for the operative planning, while the mathematical analysis made it possible to quantify the magnitude of the plasticity.
Collapse
Affiliation(s)
- Cesar Cimonari de Almeida
- Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Cesar Cimonari de Almeida,
| | - Iuri Santana Neville
- Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cintya Yukie Hayashi
- Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Alexandra Gomes dos Santos
- Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - André Russowsky Brunoni
- Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Valiengo L, Pinto BS, Marinho KAP, Santos LA, Tort LC, Benatti RG, Teixeira BB, Miranda CS, Cardeal HB, Suen PJC, Loureiro JC, Vaughan RAR, Dini Mattar RAMPF, Lessa M, Oliveira PS, Silva VA, Gattaz WF, Brunoni AR, Forlenza OV. Treatment of depression in the elderly with repetitive transcranial magnetic stimulation using theta-burst stimulation: Study protocol for a randomized, double-blind, controlled trial. Front Hum Neurosci 2022; 16:941981. [PMID: 36118977 PMCID: PMC9471379 DOI: 10.3389/fnhum.2022.941981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Transcranial magnetic stimulation (TMS) is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation (TBS) is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the efficacy of TBS in geriatric depression. Clinical trial registration [https://clinicaltrials.gov/ct2/], identifier [NCT04842929].
Collapse
Affiliation(s)
- Leandro Valiengo
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Programa de Fisiopatologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Leandro Valiengo,
| | - Bianca S. Pinto
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Kalian A. P. Marinho
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo A. Santos
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Luara C. Tort
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Rafael G. Benatti
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna B. Teixeira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Cristiane S. Miranda
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Henriette B. Cardeal
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo J. C. Suen
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Julia C. Loureiro
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Renata A. R. Vaughan
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Roberta A. M. P. F. Dini Mattar
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maíra Lessa
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Pedro S. Oliveira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Valquíria A. Silva
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Wagner Farid Gattaz
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - André R. Brunoni
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|