Recently, a large number of surgical studies based on the objective evaluation of EOR have been published, suggesting that EOR has a significant effect not only on the rate of tumor progression and OS but also on the decrease Object. A growing number of published studies have recently demonstrated the role of resection in overall survival (OS) for patients with gliomas. In this retrospective study, the authors objectively investigated the role of the extent of resection (EOR) in OS in patients with low-grade gliomas (LGGs).Methods. Between 1998 and 2011, 190 patients underwent surgery for LGGs. All surgical procedures were conducted under corticosubcortical stimulation. The EOR was established by analyzing the pre-and postoperative volumes of the gliomas on T2-weighted MRI studies. The difference between the preoperative tumor volumes was also investigated by measuring the volumetric difference between the T2-and T1-weighted MRI images (DVT2T1) to evaluate how the diffusive tumor-growing pattern affected the EOR achieved.Results. The median preoperative tumor volume was 55 cm 3 , and in almost half of the patients the EOR was greater than 90%. In this study, patients with an EOR of 90% or greater had an estimated 5-year OS rate of 93%, those with EOR between 70% and 89% had a 5-year OS rate of 84%, and those with EOR less than 70% had a 5-year OS rate of 41% (p < 0.001). New postoperative deficits were noted in 43.7% of cases, while permanent deficits occurred in 3.16% of cases. There were 41 deaths (21.6%), and the median follow-up was 4.7 years.A further volumetric analysis was also conducted to compare 2 different intraoperative protocols (Series 1 [intraoperative electrical stimulation alone] vs Series 2 [intraoperative stimulation plus overlap of functional MRI/fiber tracking diffusion tensor imaging data on a neuronavigation system]). Patients in Series 1 had a median EOR of 77%, while those in Series 2 had a median EOR of 90% (p = 0.0001). Multivariate analysis showed that OS is influenced not only by EOR (p = 0.001) but also by age (p = 0.003), histological subtype (p = 0.005), and the DVT2T1 value (p < 0.0001). Progression-free survival is similarly influenced by histological subtype (fibrillary astrocytoma, p = 0.003), EOR (p < 0.0001), and DVT2T1 value (p < 0.0001), as is malignant progression-free survival (p = 0.003, p < 0.0001, and p < 0.0001, respectively). Finally, the study shows that the higher the DVT2T1 value, the less extensive the currently possible resection, highlighting an apparent correlation between the DVT2T1 value itself and EOR (p < 0.0001).Conclusions. The EOR and the DVT2T1 values are the strongest independent predictors in improving OS as well as in delaying tumor progression and malignant transformation. Furthermore, the DVT2T1 value may be useful as a predictive index for EOR. Finally, due to intraoperative corticosubcortical mapping and the overlap of functional data on the neuronavigation system, major resection is possible with an acceptable risk and a significant increase ...
We can predict how an object would look like if we were to see it from different viewpoints. The brain network governing mental rotation (MR) has been studied using a variety of stimuli and tasks instructions. By using activation likelihood estimation (ALE) meta-analysis we tested whether different MR networks can be modulated by the type of stimulus (body vs. non-body parts) or by the type of tasks instructions (motor imagery-based vs. non-motor imagery-based MR instructions). Testing for the bodily and non-bodily stimulus axis revealed a bilateral sensorimotor activation for bodily-related as compared to non-bodily-related stimuli and a posterior right lateralized activation for non-bodily-related as compared to bodily-related stimuli. A top-down modulation of the network was exerted by the MR tasks instructions with a bilateral (preferentially sensorimotor left) network for motor imagery- vs. non-motor imagery-based MR instructions and the latter activating a preferentially posterior right occipito-temporal-parietal network. The present quantitative meta-analysis summarizes and amends previous descriptions of the brain network related to MR and shows how it is modulated by top-down and bottom-up experimental factors.
Neuropsychological studies suggest that the human brain is endowed with two body representations: the body schema (BS), coding the orientation of one's body parts in space, and the body structural description (BSD), coding the location of body parts relative to a standard body. We used fMRI to disentangle the neural mechanisms underlying these putatively distinct body representations. Participants saw an arm or a pot's handle (stimulus: arm, handle) rotated at different angles (angle: 30 -150°). If the stimulus was an arm, subjects were instructed to imagine (1) rotating their own arm until it matched the stimulus orientation (comparing the seen arm to their own) or (2) seeing the stimulus moving toward its appropriate position on a simultaneously presented human body [comparing the arm to the one of a standard body (strategy: motor, visual imagery)]. If the stimulus was a handle, subjects were instructed to imagine (1) placing the handle on its appropriate position on a simultaneously presented pot or (2) seeing it moving toward its pot's position. The analysis of the interaction stimulus ϫ strategy revealed activation of left secondary somatosensory cortex (SII), specifically when comparing the stimulus arm to one's own. The analysis of the parameters describing the linear effect of angle revealed that neural activity of left posterior intraparietal sulcus was modulated by the stimulus's rotation, but only when relating the arm to a standard body. The results associate BS and BSD with differential neural substrates, thereby suggesting that these are independent body representations, and furthermore extend current concepts of SII function.
The brain network governing meditation has been studied using a variety of meditation practices and techniques practices eliciting different cognitive processes (e.g., silence, attention to own body, sense of joy, mantras, etc.). It is very possible that different practices of meditation are subserved by largely, if not entirely, disparate brain networks. This assumption was tested by conducting an activation likelihood estimation (ALE) meta-analysis of meditation neuroimaging studies, which assessed 150 activation foci from 24 experiments. Different ALE meta-analyses were carried out. One involved the subsets of studies involving meditation induced through exercising focused attention (FA). The network included clusters bilaterally in the medial gyrus, the left superior parietal lobe, the left insula and the right supramarginal gyrus (SMG). A second analysis addressed the studies involving meditation states induced by chanting or by repetition of words or phrases, known as “mantra.” This type of practice elicited a cluster of activity in the right SMG, the SMA bilaterally and the left postcentral gyrus. Furthermore, the last analyses addressed the effect of meditation experience (i.e., short- vs. long-term meditators). We found that frontal activation was present for short-term, as compared with long-term experience meditators, confirming that experts are better enabled to sustain attentional focus, rather recruiting the right SMG and concentrating on aspects involving disembodiment.
Language representation in the bilingual brain is the result of many factors, of which age of appropriation (AoA) and proficiency of the second language (L2) are probably the most studied. Many studies indeed compare early and late bilinguals, although it is not yet clear what the role of the so-called critical period in L2 appropriation is. In this study, we carried out coordinate-based meta-analyses to address this issue and to inspect the role of proficiency in addition to that of AoA. After the preliminary inspection of the early (also very early) and late bilinguals’ language networks, we explored the specific activations associated with each language and compared them within and between the groups. Results confirmed that the L2 language brain representation was wider than that associated with L1. This was observed regardless of AoA, although differences were more relevant in the late bilinguals’ group. In particular, L2 entailed a greater enrollment of the brain areas devoted to the executive functions, and this was also observed in proficient bilinguals. The early bilinguals displayed many activation clusters as well, which also included the areas involved in cognitive control. Interestingly, these regions activated even in L1 of both early and late bilingual groups, although less consistently. Overall, these findings suggest that bilinguals in general are constantly subjected to cognitive effort to monitor and regulate the language use, although early AoA and high proficiency are likely to reduce this.
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