Introducing the concept of brain metaplasticity in glioma: how to reorient the pattern of neural reconfiguration to optimize the therapeutic strategy

Duffau, Hugues

doi:10.3171/2021.5.jns211214

Cited by 15 publications

(15 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Integrating the concept of meta-plasticity (plasticity of the synaptic plasticity), i.e., a higher-order plastic phenomenon that regulates the learning rule as a function of the dynamical context ( 81 ), may help to reorient the spatiotemporal pattern of network reconfiguration ( 67 ). The principle would be to redirect the mechanisms of brain reshaping to generate a shift from a prior pattern with prominent perilesional recruitment (thus preventing to increase the EOR at the periphery of the previous surgical cavity) to a pattern predominantly recruiting remote circuits—ideally relying on contralateral homotopic structures ( 82 ). In this spirit, the concept of neuromodulation-induced cortical reallocation by using non-invasive transcranial stimulation tools starts to be developed, both for postoperative neurorehabilitation and for prehabilitation before (re)operation ( 83 – 85 ).…”

Section: Discussionmentioning

confidence: 99%

Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Duffau

2022

Front. Oncol.

View full text Add to dashboard Cite

Early maximal surgical resection is the first treatment in diffuse low-grade glioma (DLGG), because the reduction of tumor volume delays malignant transformation and extends survival. Awake surgery with intraoperative mapping and behavioral monitoring enables to preserve quality of life (QoL). However, because of the infiltrative nature of DLGG, relapse is unavoidable, even after (supra)total resection. Therefore, besides chemotherapy and radiotherapy, the question of reoperation(s) is increasingly raised, especially because patients with DLGG usually enjoy a normal life with long-lasting projects. Here, the purpose is to review the literature in the emerging field of iterative surgeries in DLGG. First, long-term follow-up results showed that patients with DLGG who underwent multiple surgeries had an increased survival (above 17 years) with preservation of QoL. Second, the criteria guiding the decision to reoperate and defining the optimal timing are discussed, mainly based on the dynamic intercommunication between the glioma relapse (including its kinetics and pattern of regrowth) and the reactional cerebral reorganization—i.e., mechanisms underpinning reconfiguration within and across neural networks to enable functional compensation. Third, how to adapt medico-surgical strategy to this individual spatiotemporal brain tumor interplay is detailed, by considering the perpetual changes in connectome. These data support early reoperation in recurrent DLGG, before the onset of symptoms and before malignant transformation. Repeat awake resection(s) should be integrated in a global management including (neo)adjuvant medical treatments, to enhance long-lasting functional and oncological outcomes. The prediction of potential and limitation of neuroplasticity at each step of the disease must be improved to anticipate personalized multistage therapeutic attitudes.

show abstract

Section: Discussionmentioning

confidence: 99%

Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Duffau

2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Firstly, these cognition-related states have the potential to be effective biomarkers for language or speech deficits associated with expressive and receptive language or speech skills (American Psychiatric Association and Association, 2013). Second, the dynamic framework of language network could subserve as a “meta-networking” (network of networks) (Duffau, 2021), which would be useful for mapping and distinguishing subtypes of patients with different language or speech deficits severity (Bonkhoff et al, 2020; Guo et al, 2019; He et al, 2018), degree of neuroplasticity (Liu et al, 2020; Yuan et al, 2020) and recovery trajectories (Yuan et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…(network of networks) (Duffau, 2021), which would be useful for mapping and distinguishing subtypes of patients with different language or speech deficits severity (Bonkhoff et al, 2020;Guo et al, 2019;He et al, 2018), degree of neuroplasticity (Liu et al, 2020;Yuan et al, 2020) and recovery trajectories (Yuan et al, 2022).…”

Section: The Clinical Relevance Of the Dynamic "Meta-networking" Fram...mentioning

confidence: 99%

The domain-separation low-dimensional language network dynamics in the resting-state support the flexible functional segregation and integration during language and speech processing

Yuan

Xie

Wang

et al. 2022

Preprint

View full text Add to dashboard Cite

Modern linguistic theories and network science propose that the language and speech processing is organized into hierarchical, segregated large-scale subnetworks, with a core of dorsal (phonological) stream and ventral (semantic) stream. The two streams are asymmetrically recruited in receptive and expressive language or speech tasks, which showed flexible functional segregation and integration. We hypothesized that the functional segregation of the two streams was supported by the underlying network segregation. A dynamic conditional correlation approach was employed to construct frame-wise time-varying language networks and investigate the temporal reoccurring patterns. We found that the time-varying language networks in the resting-state robustly clustered into four low-dimensional states, which dynamically reconfigured following a domain-separation manner. Spatially, the hub distributions of the first three states highly resembled the neurobiology of primary auditory processing and lexical-phonological processing, motor and speech production processing, and semantic processing, respectively. The fourth state was characterized by the weakest functional connectivity and subserved as a baseline state. Temporally, the first three states appeared exclusively in limited time bins (~15%), and most of the time (> 55%), the language network kept inactive in state 4. Machine learning-based dFC-linguistics prediction analyses showed that dFCs of the four states significantly predicted individual linguistic performance. These findings suggest a domain-separation manner of language network dynamics in the resting-state, which forms a dynamic meta-networking (network of networks) framework.

show abstract

“…First, a lowered FA might be a sign of impending or proceeding neuroplasticity effects, protecting patients from further neurological damage [18]. Also, plasticity might be triggered by white matter damage to the CST and actually manifest elsewhere [27].…”

Section: Discussionmentioning

confidence: 99%

White Matter Integrity of the Corticospinal Tract for Estimation of Individual Patient Risk for Postoperative Neurological Deterioration after Glioma Surgery

Wende¹,

Hoffmann²,

Fehrenbach³

et al. 2022

J. Integr. Neurosci.

View full text Add to dashboard Cite

Background: Tractography has become a standard tool for planning neurosurgical operations and has been proven to be useful for risk stratification. In various conditions, tractography-derived white matter integrity has been shown to be associated with neurological outcome. Postoperative performance has been shown to be a prognostic marker in glioma. We aimed to assess the relation of preoperative corticospinal tract (CST) integrity with postoperative neurological deterioration in patients with malignant glioma. Methods: We retrospectively analyzed a cohort of 24 right-handed patients (41.7% female) for perioperative neurological performance score (NPS) and applied our anatomical tractography workflow to extract the median fractional anisotropy (FA) of the CST in preoperative magnetic resonance imaging (MRI). Results: Median FA of the CST ipsilateral to the tumor correlated significantly with preoperative NPS (p = 0.025). After rank order correlation and multivariate linear regression, we found that the preoperative median FA of the right CST correlates with preoperative NPS, independently from epidemiological data (p = 0.019). In patients with lesions of the right hemisphere, median FA of the right CST was associated with a declining NPS in multivariate linear regression (p = 0.024). Receiver operating characteristic (ROC) analysis revealed an optimal FA cutoff at 0.3946 in this subgroup (area under the curve 0.83). Patients below that cutoff suffered from a decline in neurological performance significantly more often (p = 0.020). Conclusions: Assessment of preoperative white matter integrity may be a promising biomarker for risk estimation of patients undergoing craniotomy for resection of malignant glioma.

show abstract

Introducing the concept of brain metaplasticity in glioma: how to reorient the pattern of neural reconfiguration to optimize the therapeutic strategy

Cited by 15 publications

References 42 publications

Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

The domain-separation low-dimensional language network dynamics in the resting-state support the flexible functional segregation and integration during language and speech processing

White Matter Integrity of the Corticospinal Tract for Estimation of Individual Patient Risk for Postoperative Neurological Deterioration after Glioma Surgery

Contact Info

Product

Resources

About