The impact of high grade glial neoplasms on human cortical electrophysiology

Abstract

ObjectiveThe brain’s functional architecture of interconnected network-related oscillatory patterns in discrete cortical regions has been well established with functional magnetic resonance imaging (fMRI) studies or direct cortical electrophysiology from electrodes placed on the surface of the brain, or electrocorticography (ECoG). These resting state networks exhibit a robust functional architecture that persists through all stages of sleep and under anesthesia. While the stability of these networks provides a fundamental understanding of the organization of the brain, understanding how these regions can be perturbed is also critical in defining the brain’s ability to adapt while learning and recovering from injury.MethodsPatients undergoing an awake craniotomy for resection of a tumor were studied as a unique model of an evolving injury to help define how the cortical physiology and the associated networks were altered by the presence of an invasive brain tumor.ResultsThis study demonstrates that there is a distinct pattern of alteration of cortical physiology in the setting of a malignant glioma. These changes lead to a physiologic sequestration and progressive synaptic homogeneity suggesting that a de-learning phenomenon occurs within the tumoral tissue compared to its surroundings.SignificanceThese findings provide insight into how the brain accommodates a region of “defunctionalized” cortex. Additionally, these findings may have important implications for emerging techniques in brain mapping using endogenous cortical physiology.

Feasibility single-arm study of a medical device containing <em>Desmodium adscendens</em> and <em>Lithothamnium calcareum</em> combined with chemotherapy in head and neck cancer patients

“…CRP, an indicator of prognosis in cancer patients, 29 was stable throughout the course of the study. In addition, ECOG 24 and GPS, 25 indicators of prognosis and disease impact on the patients’ ability to conduct daily activities, remained stable throughout the study. Pain improved at weeks 8 and 10 and fatigue improved at week 10.…”

“…The patients, aged 63±2.3 years (mean ± standard error of the mean), had a histological or cytological diagnosis of head and neck cancer, stage IV (presence or absence of metastasis is described in Table 1 ) according to the Union for International Cancer Control (UICC) 23 and were previously subjected to first-line chemotherapy. They had Eastern Cooperative Oncology Group (ECOG) performance status 24 equal to or less than 2, a life expectancy of more than 12 weeks, adequate medullary function, and a creatinine clearance greater than 50 mL/min. The inclusion criteria are summarised in Table 2 .…”

“…The patients were monitored by investigation of the performance status according to the Glasgow Prognostic Score (GPS), 25 which evaluates the plasma level of CRP (measured by immunoturbidimetry) and albumin levels (measured by agarose gel electrophoresis), and the ECOG performance status examination. 24 Pain and fatigue were also monitored using the visual analog scale (VAS) 26 and visual analog fatigue scale (VAS-F), 27 respectively. The GPS was computed on the basis of serum concentrations of CRP and albumin.…”