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Silva RPDS, Monteiro LN, Dias LDS, Haddad JOD, Souza VBD, Oliveira VFLD, Fernandes AS, Olivera MFD, Rotta JM. Role of Neural Plasticity of Motor Cortex in Gliomas Evaluated by Brain Imaging and Mapping Techniques in Pre- and Postoperative Period: A Systematic Review. J Neurol Surg A Cent Eur Neurosurg 2024; 85:396-404. [PMID: 36808404 DOI: 10.1055/a-2037-5993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Resection of infiltrative neuroepithelial primary brain tumors, such as low-grade gliomas (LGGs) remains a neurosurgical challenge. Usual lack of clinical deficit despite LGGs growing in eloquent brain areas may be explained by reshaping and reorganization of functional networks. The development of modern diagnostic imaging techniques could disclose better understanding of the rearrangement of the brain cortex; however, mechanisms underlying such compensation and how it occurs in the motor cortex remain unclear. This systematic review aims to analyze the neuroplasticity of motor cortex in patients with LGGs, as determined by neuroimaging and functional techniques. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, medical subject headings (MeSH) and the following terms related to neuroimaging, LGGs and neuroplasticity were used with the Boolean operators AND and OR to synonymous terms in the PubMed database. Among the 118 results, 19 studies were included in the systematic review. RESULTS Motor function in patients with LGG was characterized by a compensation in the contralateral and supplementary motor areas and premotor functional networks. Furthermore, ipsilateral activation in these types of gliomas was rarely described. Moreover, some studies did not reveal statistical significance in association between functional reorganization and the postoperative period, which can be explained by the low number of patients. CONCLUSION Our findings suggest a high pattern of reorganization per different eloquent motor areas and gliomas diagnosis. Understanding this process is useful to guide safe surgical resection and to develop protocols that assess the plasticity, even though functional network rearrangement needs to be better characterized by more studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jose Marcus Rotta
- Neurosurgery Department, Hospital do Servidor Público Estadual de São Paulo, Brazil
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2
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Noorizadeh N, Varner JA, Birg L, Williard T, Rezaie R, Wheless J, Narayana S. Comparing the efficacy of awake and sedated MEG to TMS in mapping hand sensorimotor cortex in a clinical cohort. Neuroimage Clin 2024; 41:103562. [PMID: 38215622 PMCID: PMC10821581 DOI: 10.1016/j.nicl.2024.103562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/19/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024]
Abstract
Non-invasive methods such as Transcranial Magnetic Stimulation (TMS) and magnetoencephalography (MEG) aid in the pre-surgical evaluation of patients with epilepsy or brain tumor to identify sensorimotor cortices. MEG requires sedation in children or patients with developmental delay. However, TMS can be applied to awake patients of all ages with any cognitive abilities. In this study, we compared the efficacy of TMS with MEG (in awake and sedated states) in identifying the hand sensorimotor areas in patients with epilepsy or brain tumors. We identified 153 patients who underwent awake- (n = 98) or sedated-MEG (n = 55), along with awake TMS for hand sensorimotor mapping as part of their pre-surgical evaluation. TMS involved stimulating the precentral gyrus and recording electromyography responses, while MEG identified the somatosensory cortex during median nerve stimulation. Awake-MEG had a success rate of 92.35 % and TMS had 99.49 % (p-value = 0.5517). However, in the sedated-MEG cohort, TMS success rate of 95.61 % was significantly higher compared to MEG's 58.77 % (p-value = 0.0001). Factors affecting mapping success were analyzed. Logistic regression across the entire cohort identified patient sedation as the lone significant predictor, contrary to age, lesion, metal, and number of antiseizure medications (ASMs). A subsequent analysis replaced sedation with anesthetic drug dosage, revealing no significant predictors impacting somatosensory mapping success under sedation. This study yields insights into the utility of TMS and MEG in mapping hand sensorimotor cortices and underscores the importance of considering factors that influence eloquent cortex mapping limitations during sedation.
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Affiliation(s)
- Negar Noorizadeh
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Jackie Austin Varner
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Liliya Birg
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Theresa Williard
- Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Roozbeh Rezaie
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - James Wheless
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States
| | - Shalini Narayana
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, United States.
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3
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Lai MH, Xu HC, Huang MC, Lu Y, Yang K, Jiang LM, Yu XM. Transcranial direct current stimulation combined with bodyweight support-tai chi footwork for motor function of stroke survivors: a study protocol of randomised controlled trial. BMJ Open 2023; 13:e065338. [PMID: 36882241 PMCID: PMC10008177 DOI: 10.1136/bmjopen-2022-065338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Our previous studies have proposed the bodyweight support-t'ai chi (BWS-TC) footwork training for stroke survivors with severe motor dysfunction and fear of falling, and have proven its positive effects for motor function. Transcranial direct current stimulation (tDCS) provides a non-invasive and safe way to modulate neuronal activity and provoke neuroplastic changes and to improve the motor function of stroke survivors. However, it is unclear whether the integration of BWS-TC and tDCS has synergistic effects on improving motor function of the stroke survivors. METHODS AND ANALYSIS This study will be an assessor-blinded randomised controlled trial involving 12-week intervention and 6-month follow-up. One hundred and thirty-five individuals with stroke will be randomly divided in a ratio of 1:1:1 into three groups. Control group A, control group B and intervention group C will receive tDCS and conventional rehabilitation programmes (CRPs), BWS-TC and CRP, tDCS-BWS-TC and CRP for 12 weeks, respectively. The primary outcome measures will include the efficacy (Fugl-Meyer Assessment), acceptability and safety of these interventions. The secondary outcome measures will include balance ability (ie, limits of stability and modified clinical test of sensory integration), walking function, brain structure and function, risk of falling, Barthel Index and 36-Item Short Form Survey. All outcomes will be assessed at baseline, 6 and 12 weeks during intervention, and 1, 3 and 6 months during the follow-up period. Two-way analysis of variance with repeated measures will be applied to examine the main effects of the group and the time factor and group-time interaction effects for all outcome measures. ETHICS AND DISSEMINATION Ethics approval was obtained from the ethics committee of the Shanghai Seventh People's Hospital (2021-7th-HIRB-017). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences. TRIAL REGISTRATION NUMBER ChiCTR2200059329.
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Affiliation(s)
- Ming-Hui Lai
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hai-Chen Xu
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Meng-Cui Huang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Lu
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kun Yang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li-Ming Jiang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Ming Yu
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Pre-Operative Functional Mapping in Patients with Brain Tumors by fMRI and MEG: Advantages and Disadvantages in the Use of One Technique over the Other. Life (Basel) 2023; 13:life13030609. [PMID: 36983765 PMCID: PMC10051860 DOI: 10.3390/life13030609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Pre-operative mapping of brain functions is crucial to plan neurosurgery and investigate potential plasticity processes. Due to its availability, functional magnetic resonance imaging (fMRI) is widely used for this purpose; on the other hand, the demanding cost and maintenance limit the use of magnetoencephalography (MEG), despite several studies reporting its accuracy in localizing brain functions of interest in patient populations. In this review paper, we discuss the strengths and weaknesses of both techniques, from a methodological perspective first; then, we scrutinized and commented on the findings from 16 studies, identified by a database search, that made pre-operative assessments using both techniques in patients with brain tumors. We commented on the results by accounting for study limitations associated with small sample sizes and variability in the used tasks. Overall, we found that, although some studies reported the superiority for MEG, the majority of them underlined the complementary use of these techniques and suggested assessment using both. Indeed, both fMRI and MEG present some disadvantages, although the development of novel devices and processing procedures has enabled ever more accurate assessments. In particular, the development of new, more feasible MEG devices will allow widespread availability of this technique and its routinely combined use with fMRI.
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Li Y, Zhu H, Chen Q, Yang L, Chen F, Ma H, Xu H, Chen K, Bu J, Zhang R. Immediate Effects of Vagal Nerve Stimulation in Drug-Resistant Epilepsy Revealed by Magnetoencephalographic Recordings. Brain Connect 2023; 13:51-59. [PMID: 35974665 DOI: 10.1089/brain.2022.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Vagus nerve stimulation (VNS) has been a neuromodulatory option for treating drug-resistant epilepsy (DRE), but its mechanism remains unclear. To obtain insight into the mechanism by which VNS reduces epileptic seizures, the immediate effects of VNS in brain networks of DRE patients were investigated when the patients' vagal nerve stimulators were turned on. Methods: The brain network properties of 14 DRE patients with a vagal nerve stimulator and 14 healthy controls were evaluated using magnetoencephalography recordings for 6 main frequency bands. Results: Compared with healthy controls, DRE patients exhibited significant increases in functional connectivity in the theta, alpha, beta, and gamma bands and significant reductions in the small-world measure in the theta and beta bands. During periods when patients' vagal nerve stimulators were turned on, DRE patients showed significant reductions in functional connectivity in the theta and alpha bands and a significant increase in the small-world measure in the theta band when compared with periods when patients' vagal nerve stimulators were turned off. Conclusions: Our results indicate that the brain networks of DRE patients were pathologically hypersynchronous and instantaneous VNS can decrease the synchronization of brain networks of epileptic patients, which might play a key role in the mechanism by which VNS reduces epileptic seizures. In the theta band, instantaneous VNS can increase the network efficiency of DRE patients, and the increment in network efficiency may be helpful for improving brain cognitive function in epileptic patients. Impact statement For the first time, we investigated the immediate effects of vagus nerve stimulation (VNS) in the brain networks of drug-resistant epilepsy patients using magnetoencephalography. Our results show that instantaneous VNS can decrease the hypersynchronization of epileptic networks and increase the network efficiency of epileptic patients. Our results are helpful in understanding the mechanism of action by which VNS reduces epileptic seizures and improves the cognitive function in epileptic patients and the brain network reorganization caused by long-term VNS.
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Affiliation(s)
- Yuejun Li
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,Department of Magnetoencephalography, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Haitao Zhu
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Qiqi Chen
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,Department of Magnetoencephalography, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lu Yang
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Fangqing Chen
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Haiyan Ma
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Honghao Xu
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Kefan Chen
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jinxin Bu
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Rui Zhang
- Department of Functional Neurosurgery and Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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Hemispheric Asymmetry of the Hand Motor Representations in Patients with Highly Malignant Brain Tumors: Implications for Surgery and Clinical Practice. Brain Sci 2022; 12:brainsci12101274. [PMID: 36291208 PMCID: PMC9599694 DOI: 10.3390/brainsci12101274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/02/2022] Open
Abstract
We addressed both brain pre-surgical functional and neurophysiological aspects of the hand representation in 18 right-handed patients harboring a highly malignant brain tumor in the sensorimotor (SM) cortex (10 in the left hemisphere, LH, and 8 in the right hemisphere, RH) and 10 healthy controls, who performed an fMRI hand-clenching task with both hands alternatively. We extracted the main ROI in the SM cortex and compared ROI values and volumes between hemispheres and groups, in addition to their motor neurophysiological measures. Hemispheric asymmetry in the fMRI signal was observed for healthy controls, namely higher signal for the left-hand movements, but not for either patients’ groups. ROI values, although altered in patients vs. controls, did not differ significantly between groups. ROI volumes associated with right-hand movement were lower for both patients’ groups vs. controls, and those associated with left-hand movement were lower in the RH group vs. all groups. These results are relevant to interpret potential preoperative plasticity and make inferences about postoperative plasticity and can be integrated in the surgical planning to increase surgery success and postoperative prognosis and quality of life.
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Fang S, Li L, Weng S, Guo Y, Zhong Z, Fan X, Jiang T, Wang Y. Contralesional Sensorimotor Network Participates in Motor Functional Compensation in Glioma Patients. Front Oncol 2022; 12:882313. [PMID: 35530325 PMCID: PMC9072743 DOI: 10.3389/fonc.2022.882313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Some gliomas in sensorimotor areas induce motor deficits, while some do not. Cortical destruction and reorganization contribute to this phenomenon, but detailed reasons remain unclear. This study investigated the differences of the functional connectivity and topological properties in the contralesional sensorimotor network (cSMN) between patients with motor deficit and those with normal motor function. Methods We retrospectively reviewed 65 patients (32 men) between 2017 and 2020. The patients were divided into four groups based on tumor laterality and preoperative motor status (deficit or non-deficit). Thirty-three healthy controls (18 men) were enrolled after matching for sex, age, and educational status. Graph theoretical measurement was applied to reveal alterations of the topological properties of the cSMN by analyzing resting-state functional MRI. Results The results for patients with different hemispheric gliomas were similar. The clustering coefficient, local efficiency, transitivity, and vulnerability of the cSMN significantly increased in the non-deficit group and decreased in the deficit group compared to the healthy group (p < 0.05). Moreover, the nodes of the motor-related thalamus showed a significantly increased nodal efficiency and nodal local efficiency in the non-deficit group and decreased in the deficit group compared with the healthy group (p < 0.05). Conclusions We posited the existence of two stages of alterations of the preoperative motor status. In the compensatory stage, the cSMN sacrificed stability to acquire high efficiency and to compensate for impaired motor function. With the glioma growing and the motor function being totally damaged, the cSMN returned to a stable state and maintained healthy hemispheric motor function, but with low efficiency.
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Affiliation(s)
- Shengyu Fang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Lianwang Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shimeng Weng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yuhao Guo
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhang Zhong
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
| | - Tao Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Research Unit of Accurate Diagnosis, Treatment and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
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Stadlbauer A, Kinfe TM, Zimmermann M, Eyüpoglu I, Brandner N, Buchfelder M, Zaiss M, Dörfler A, Brandner S. Association between tissue hypoxia, perfusion restrictions, and microvascular architecture alterations with lesion-induced impairment of neurovascular coupling. J Cereb Blood Flow Metab 2022; 42:526-539. [PMID: 32787542 PMCID: PMC8985434 DOI: 10.1177/0271678x20947546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Functional magnetic resonance imaging (fMRI) has been mainly utilized for the preoperative localization of eloquent cortical areas. However, lesion-induced impairment of neurovascular coupling (NVC) in the lesion border zone may lead to false-negative fMRI results. The purpose of this study was to determine physiological factors impacting the NVC. Twenty patients suffering from brain lesions were preoperatively examined using multimodal neuroimaging including fMRI, magnetoencephalography (MEG) during language or sensorimotor tasks (depending on lesion location), and a novel physiologic MRI approach for the combined quantification of oxygen metabolism, perfusion state, and microvascular architecture. Congruence of brain activity patterns between fMRI and MEG were found in 13 patients. In contrast, we observed missing fMRI activity in perilesional cortex that demonstrated MEG activity in seven patients, which was interpreted as lesion-induced impairment of NVC. In these brain regions with impaired NVC, physiologic MRI revealed significant brain tissue hypoxia, as well as significantly decreased macro- and microvascular perfusion and microvascular architecture. We demonstrated that perilesional hypoxia with reduced vascular perfusion and architecture is associated with lesion-induced impairment of NVC. Our physiologic MRI approach is a clinically applicable method for preoperative risk assessment for the presence of false-negative fMRI results and may prevent severe postoperative functional deficits.
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Affiliation(s)
- Andreas Stadlbauer
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Thomas M Kinfe
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Max Zimmermann
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | - Ilker Eyüpoglu
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Nadja Brandner
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Moritz Zaiss
- Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Arnd Dörfler
- Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
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Jaatela J, Aydogan DB, Nurmi T, Vallinoja J, Piitulainen H. Identification of Proprioceptive Thalamocortical Tracts in Children: Comparison of fMRI, MEG, and Manual Seeding of Probabilistic Tractography. Cereb Cortex 2022; 32:3736-3751. [PMID: 35040948 PMCID: PMC9433422 DOI: 10.1093/cercor/bhab444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022] Open
Abstract
Studying white matter connections with tractography is a promising approach to understand the development of different brain processes, such as proprioception. An emerging method is to use functional brain imaging to select the cortical seed points for tractography, which is considered to improve the functional relevance and validity of the studied connections. However, it is unknown whether different functional seeding methods affect the spatial and microstructural properties of the given white matter connection. Here, we compared functional magnetic resonance imaging, magnetoencephalography, and manual seeding of thalamocortical proprioceptive tracts for finger and ankle joints separately. We showed that all three seeding approaches resulted in robust thalamocortical tracts, even though there were significant differences in localization of the respective proprioceptive seed areas in the sensorimotor cortex, and in the microstructural properties of the obtained tracts. Our study shows that the selected functional or manual seeding approach might cause systematic biases to the studied thalamocortical tracts. This result may indicate that the obtained tracts represent different portions and features of the somatosensory system. Our findings highlight the challenges of studying proprioception in the developing brain and illustrate the need for using multimodal imaging to obtain a comprehensive view of the studied brain process.
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Affiliation(s)
- Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo FI-02150, Finland
| | - Dogu Baran Aydogan
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo FI-02150, Finland
- Department of Psychiatry, Helsinki University Hospital, Helsinki FI-00029, Finland
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio FI-70211, Finland
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo FI-02150, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä FI-40014, Finland
| | - Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo FI-02150, Finland
| | - Harri Piitulainen
- Address correspondence to Harri Piitulainen, associate professor, Harri Piitulainen, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. BOX 35, FI-40014, Finland.
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Yamamoto AK, Sanjuán A, Pope R, Parker Jones O, Hope TMH, Prejawa S, Oberhuber M, Mancini L, Ekert JO, Garjardo-Vidal A, Creasey M, Yousry TA, Green DW, Price CJ. The Effect of Right Temporal Lobe Gliomas on Left and Right Hemisphere Neural Processing During Speech Perception and Production Tasks. Front Hum Neurosci 2022; 16:803163. [PMID: 35652007 PMCID: PMC9148966 DOI: 10.3389/fnhum.2022.803163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
Using fMRI, we investigated how right temporal lobe gliomas affecting the posterior superior temporal sulcus alter neural processing observed during speech perception and production tasks. Behavioural language testing showed that three pre-operative neurosurgical patients with grade 2, grade 3 or grade 4 tumours had the same pattern of mild language impairment in the domains of object naming and written word comprehension. When matching heard words for semantic relatedness (a speech perception task), these patients showed under-activation in the tumour infiltrated right superior temporal lobe compared to 61 neurotypical participants and 16 patients with tumours that preserved the right postero-superior temporal lobe, with enhanced activation within the (tumour-free) contralateral left superior temporal lobe. In contrast, when correctly naming objects (a speech production task), the patients with right postero-superior temporal lobe tumours showed higher activation than both control groups in the same right postero-superior temporal lobe region that was under-activated during auditory semantic matching. The task dependent pattern of under-activation during the auditory speech task and over-activation during object naming was also observed in eight stroke patients with right hemisphere infarcts that affected the right postero-superior temporal lobe compared to eight stroke patients with right hemisphere infarcts that spared it. These task-specific and site-specific cross-pathology effects highlight the importance of the right temporal lobe for language processing and motivate further study of how right temporal lobe tumours affect language performance and neural reorganisation. These findings may have important implications for surgical management of these patients, as knowledge of the regions showing functional reorganisation may help to avoid their inadvertent damage during neurosurgery.
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Affiliation(s)
- Adam Kenji Yamamoto
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- *Correspondence: Adam Kenji Yamamoto,
| | - Ana Sanjuán
- Neuropsychology and Functional Imaging Group, Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón de La Plana, Spain
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rebecca Pope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Oiwi Parker Jones
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- FMRIB Centre and Jesus College, University of Oxford, Oxford, United Kingdom
| | - Thomas M. H. Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Susan Prejawa
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Faculty of Medicine, Collaborative Research Centre 1052 “Obesity Mechanisms”, University Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Marion Oberhuber
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Laura Mancini
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Justyna O. Ekert
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Andrea Garjardo-Vidal
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile
| | - Megan Creasey
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Tarek A. Yousry
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - David W. Green
- Experimental Psychology, University College London, London, United Kingdom
| | - Cathy J. Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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11
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Romero-Garcia R, Hart MG, Bethlehem RAI, Mandal A, Assem M, Crespo-Facorro B, Gorriz JM, Burke GAA, Price SJ, Santarius T, Erez Y, Suckling J. BOLD Coupling between Lesioned and Healthy Brain Is Associated with Glioma Patients' Recovery. Cancers (Basel) 2021; 13:5008. [PMID: 34638493 PMCID: PMC8508466 DOI: 10.3390/cancers13195008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
Predicting functional outcomes after surgery and early adjuvant treatment is difficult due to the complex, extended, interlocking brain networks that underpin cognition. The aim of this study was to test glioma functional interactions with the rest of the brain, thereby identifying the risk factors of cognitive recovery or deterioration. Seventeen patients with diffuse non-enhancing glioma (aged 22-56 years) were longitudinally MRI scanned and cognitively assessed before and after surgery and during a 12-month recovery period (55 MRI scans in total after exclusions). We initially found, and then replicated in an independent dataset, that the spatial correlation pattern between regional and global BOLD signals (also known as global signal topography) was associated with tumour occurrence. We then estimated the coupling between the BOLD signal from within the tumour and the signal extracted from different brain tissues. We observed that the normative global signal topography is reorganised in glioma patients during the recovery period. Moreover, we found that the BOLD signal within the tumour and lesioned brain was coupled with the global signal and that this coupling was associated with cognitive recovery. Nevertheless, patients did not show any apparent disruption of functional connectivity within canonical functional networks. Understanding how tumour infiltration and coupling are related to patients' recovery represents a major step forward in prognostic development.
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Affiliation(s)
- Rafael Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
- Department of Medical Physiology and Biophysics, Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Michael G Hart
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | | | - Ayan Mandal
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Moataz Assem
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Instituto de Investigación Sanitaria de Sevilla, IBiS, Hospital Universitario Virgen del Rocio, CIBERSAM, 41013 Sevilla, Spain
| | - Juan Manuel Gorriz
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
- Department of Signal Theory, Networking and Communications, Universidad de Granada, 18071 Granada, Spain
| | - G A Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Stephen J Price
- Academic Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Thomas Santarius
- Academic Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Yaara Erez
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Faculty of Engineering, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK
- Cambridge and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
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12
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Papatzalas C, Fountas K, Kapsalaki E, Papathanasiou I. The Use of Standardized Intraoperative Language Tests in Awake Craniotomies: A Scoping Review. Neuropsychol Rev 2021; 32:20-50. [PMID: 33786797 DOI: 10.1007/s11065-021-09492-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022]
Abstract
Assessment of speech and language functions is an essential part of awake craniotomies. Although standardized and validated tests have several advantages compared to homemade (or mixed) batteries, in the literature it is unclear how such tests are used or whether they are used at all. In this study, we performed a scoping review in order to locate standardized and validated intraoperative language tests. Our inquiry included two databases (PubMED and MEDLINE), gray literature, and snowball referencing. We discovered 87 studies reporting use of mixed batteries, which consist of homemade tasks and tests borrowed from other settings. The tests we found to meet the validation and standardization criteria we set were ultimately three (n = 3) and each one has its own advantages and disadvantages. We argue that tests with high sensitivity and specificity not only can lead to better outcomes postoperatively, but they can also help us to gain a better understanding of the neuroanatomy of language.
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Affiliation(s)
- Christos Papatzalas
- Department of Medicine, University of Thessaly, Larisa, Greece.
- Department of Neurosurgery, University Hospital of Larisa, Larisa, Greece.
| | - Kostas Fountas
- Department of Medicine, University of Thessaly, Larisa, Greece
- Department of Neurosurgery, University Hospital of Larisa, Larisa, Greece
| | - Eftychia Kapsalaki
- Department of Medicine, University of Thessaly, Larisa, Greece
- Department of Radiology, University Hospital of Larisa, Larisa, Greece
| | - Ilias Papathanasiou
- Department of Speech & Language Therapy, University of Patras, Patras, Greece
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13
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Cargnelutti E, Ius T, Skrap M, Tomasino B. What do we know about pre- and postoperative plasticity in patients with glioma? A review of neuroimaging and intraoperative mapping studies. NEUROIMAGE-CLINICAL 2020; 28:102435. [PMID: 32980599 PMCID: PMC7522801 DOI: 10.1016/j.nicl.2020.102435] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
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.
Brain plasticity potential is a central theme in neuro-oncology and is currently receiving increased attention. Advances in treatment have prolonged life expectancy in neuro-oncological patients and the long-term preservation of their quality of life is, therefore, a new challenge. To this end, a better understanding of brain plasticity mechanisms is vital as it can help prevent permanent deficits following neurosurgery. Indeed, reorganization processes can be fundamental to prevent or recover neurological and cognitive deficits by reallocating brain functions outside the lesioned areas. According to more recent studies in the literature, brain reorganization taking place following neurosurgery is associated with good neurofunctioning at follow-up. Interestingly, in the last few years, the number of reports on plasticity has notably increased. Aim of the current review was to provide a comprehensive overview of pre- and postoperative neuroplasticity patterns. Within this framework, we aimed to shed light on some tricky issues, including i) involvement of the contralateral healthy hemisphere, ii) role and potential changes of white matter and connectivity patterns, and iii) reorganization in low- versus high-grade gliomas. We finally discussed the practical implications of these aspects and role of additional potentially relevant factors to be explored. Final purpose was to provide a guideline helpful in promoting increase in the extent of tumor resection while preserving the patients’ neurological and cognitive functioning.
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Affiliation(s)
- Elisa Cargnelutti
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy
| | - Tamara Ius
- SOC Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Miran Skrap
- SOC Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy.
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14
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Suarez-Meade P, Marenco-Hillembrand L, Prevatt C, Murguia-Fuentes R, Mohamed A, Alsaeed T, Lehrer EJ, Brigham T, Ruiz-Garcia H, Sabsevitz D, Middlebrooks EH, Bechtle PS, Quinones-Hinojosa A, Chaichana KL. Awake vs. asleep motor mapping for glioma resection: a systematic review and meta-analysis. Acta Neurochir (Wien) 2020; 162:1709-1720. [PMID: 32388682 DOI: 10.1007/s00701-020-04357-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/16/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Intraoperative stimulation (IS) mapping has become the preferred standard treatment for eloquent tumors as it permits a more accurate identification of functional areas, allowing surgeons to achieve higher extents of resection (EOR) and decrease postoperative morbidity. For lesions adjacent to the perirolandic area and descending motor tracts, mapping can be done with both awake craniotomy (AC) and under general anesthesia (GA). OBJECTIVE We aimed to determine which anesthetic protocol-AC vs. GA-provides better patient outcomes by comparing EOR and postoperative morbidity for surgeries using IS mapping in gliomas located near or in motor areas of the brain. METHODS A systematic literature search was carried out to identify relevant studies from 1983 to 2019. Seven databases were screened. A total of 2351 glioma patients from 17 studies were analyzed. RESULTS A random-effects meta-analysis revealed a trend towards a higher mean EOR in AC [90.1% (95% C.I. 85.8-93.8)] than with GA [81.7% (95% C.I. 72.4-89.7)] (p = 0.06). Neurological deficits were divided by timing and severity for analysis. There was no significant difference in early neurological deficits [20.9% (95% C.I. 4.1-45.0) vs. 25.4% (95% C.I. 13.6-39.2)] (p = 0.74), late neurological deficits [17.1% (95% C.I. 0.0-50.0) vs. 3.8% (95% C.I. 1.1-7.6)] (p = 0.06), or in non-severe [28.4% (95% C.I. 0.0-88.5) vs. 20.1% (95% C.I. 7.1-32.2)] (p = 0.72), and severe morbidity [2.6% (95% C.I. 0.0-15.5) vs. 4.5% (95% C.I. 1.1-9.6)] (p = 0.89) between patients who underwent AC versus GA, respectively. CONCLUSION Mapping during resection of gliomas located in or near the perirolandic area and descending motor tracts can be safely carried out with both AC and GA.
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Affiliation(s)
- Paola Suarez-Meade
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Lina Marenco-Hillembrand
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Calder Prevatt
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Ricardo Murguia-Fuentes
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Alea Mohamed
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Thannon Alsaeed
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tara Brigham
- Mayo Clinic Libraries, Mayo Clinic, Jacksonville, FL, USA
| | - Henry Ruiz-Garcia
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - David Sabsevitz
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Perry S Bechtle
- Anesthesiology Department, Mayo Clinic, Jacksonville, FL, USA
| | | | - Kaisorn L Chaichana
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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15
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Bowyer SM, Pang EW, Huang M, Papanicolaou AC, Lee RR. Presurgical Functional Mapping with Magnetoencephalography. Neuroimaging Clin N Am 2020; 30:159-174. [DOI: 10.1016/j.nic.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Rudas J, Martínez D, Castellanos G, Demertzi A, Martial C, Carriére M, Aubinet C, Soddu A, Laureys S, Gómez F. Time-Delay Latency of Resting-State Blood Oxygen Level-Dependent Signal Related to the Level of Consciousness in Patients with Severe Consciousness Impairment. Brain Connect 2020; 10:83-94. [DOI: 10.1089/brain.2019.0716] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jorge Rudas
- Institute of Biotechnology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Darwin Martínez
- Department of Computer Science, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Computer Science, Universidad Central de Colombia, Bogotá, Colombia
| | - Gabriel Castellanos
- Department of Physiological Sciences, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Athena Demertzi
- Physiology of Cognition Research Lab, GIGA-Consciousness, GIGA Institute, University of Liege, Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Manon Carriére
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Charlène Aubinet
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Andrea Soddu
- Department of Physics and Astronomy, University of Western Ontario, London, Ontario
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Francisco Gómez
- Department of Mathematics, Universidad Nacional de Colombia, Bogotá, Colombia
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