Left or right temporal lesion might induce aggression or escape during awake surgery, respectively: role of the amygdala

Neural signatures of imaginary motivational states: desire for music, movement and social play

The literature has demonstrated the potential for detecting accurate electrical signals that correspond to the will or intention to move, as well as decoding the thoughts of individuals who imagine houses, faces or objects. This investigation examines the presence of precise neural markers of imagined motivational states through the combining of electrophysiological and neuroimaging methods. 20 participants were instructed to vividly imagine the desire to move, listen to music or engage in social activities. Their EEG was recorded from 128 scalp sites and analysed using individual standardized Low-Resolution Brain Electromagnetic Tomographies (LORETAs) in the N400 time window (400-600 ms). The activation of 1056 voxels was examined in relation to the 3 motivational states. The most active dipoles were grouped in eight regions of interest (ROI), including Occipital, Temporal, Fusiform, Premotor, Frontal, OBF/IF, Parietal, and Limbic areas. The statistical analysis revealed that all motivational imaginary states engaged the right hemisphere more than the left hemisphere. Distinct markers were identified for the three motivational states. Specifically, the right temporal area was more relevant for "Social Play", the orbitofrontal/inferior frontal cortex for listening to music, and the left premotor cortex for the "Movement" desire. This outcome is encouraging in terms of the potential use of neural indicators in the realm of brain-computer interface, for interpreting the thoughts and desires of individuals with locked-in syndrome.

Awake craniotomy for resection of supratentorial glioblastoma: a systematic review and meta-analysis

Background

The goal of glioblastoma (GBM) surgery is to maximize the extent of resection (EOR) while minimizing postoperative neurological complications. Awake craniotomy (AC) has been demonstrated to achieve this goal for low-grade gliomas in or near eloquent areas. However, the efficacy of AC for GBM resection has not been established. Therefore, we aimed to investigate the outcomes of AC for surgical resection of GBM using a systematic review and meta-analysis of published studies.

Methods

Systematic searches of Ovid MEDLINE, Embase, Cochrane Controlled Register of Controlled Trials, and PubMed were performed from database inception to September 14, 2019 for published studies reporting outcomes of AC for GBM resection. Outcome measures analyzed included EOR and the event rate of postoperative neurological deficits.

Results

A total of 1928 unique studies were identified. Fourteen studies reporting 278 patients were included in our meta-analysis. Mean age of patients was 46.9 years (95% confidence interval [CI]: 43.9–49.9). Early and late postoperative neurological deficits occurred in 34.5% (95% CI: 21.9–48.2) and 1.9% (95% CI: 0.0–9.2) of patients, respectively. Pooled percentage of gross total resection (GTR) was 74.7% (95% CI: 66.7–82.1), while the pooled percentage reduction in tumor volume was 95.3% (95% CI: 92.2–98.4).

Conclusions

Limited current evidence suggests that the use of AC for resection of supratentorial GBM is associated with a low rate of persistent neurological deficits while achieving an acceptable rate of GTR. Our findings demonstrate the potential viability of AC in GBM resection and highlight the need for further research on this topic.