Similarities and differences in neuroplasticity mechanisms between brain gliomas and nonlesional epilepsy

Bourdillon, Pierre; Apra, Caroline; Guénot, Marc; Duffau, Hugues

doi:10.1111/epi.13935

Cited by 24 publications

(20 citation statements)

References 89 publications

(161 reference statements)

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“…The quality of the available data did not allow us to investigate the exact impact of these different aspects on the outcomes. Whether the efficacy of RF‐TC might be improved with integration of a functional brain connectome in order to target the essential hubs of the pathologic networks remains an open question. These issues are compounded by the paucity of available data concerning the number of RF‐TCs performed in the patients.…”

Section: Discussionmentioning

confidence: 99%

Stereo‐electroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy: A systematic review and meta‐analysis

et al. 2018

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Objective: Despite the increasing number of studies reporting results of stereo-electroencephalography (SEEG)-guided radiofrequency-thermocoagulation (SEEGguided RF-TC) in the treatment of patients with drug-resistant focal epilepsy, the exact efficacy of this approach remains unclear. The seizure-freedom rate varies greatly across studies and the factors associated with efficacy have not been formally investigated. Methods: All prospective or retrospective studies reporting efficacy and/or safety of SEEG-guided RF-TC in patients with drug-resistant focal epilepsy were included. The primary outcome was the seizure-free rate 1 year after the procedure. Secondary outcomes were (1) the responder rate 1 year after the procedure and (2) the proportion of patients with permanent neurologic deficit 1 year after the procedure. Each outcome was assessed in all patients and in 4 groups of patients defined by the etiology of epilepsy. Each outcome was pooled using inverse variance weighting, logit transformation of proportion, and a randomeffects model. Results: No prospective study was identified and a total of 6 retrospective studies, reporting efficacy and safety data of 296 patients, were included. The pooled rate of permanent neurologic deficit was 2.5% (95% confidence interval [CI] 1.2%-5.3%), without heterogeneity across studies. In contrast, both the seizure-free and responder rates varied greatly across studies, and statistical heterogeneity was high. The pooled seizure-free and responder rates were 23% (95% CI 8%-50%) and 58% (95% CI 36%-77%), respectively. Both for the seizure-free and responder rates, the greatest efficacy was observed in patients with periventricular nodular heterotopia and the lowest in patients with normal magnetic resonance imaging (MRI) findings. Significance: SEEG-guided RF-TC is a safe procedure with low risk of complications. In contrast, the level of evidence regarding its efficacy remains low. Better identification of factors associated with seizure outcome are needed. K E Y W O R D Sintracranial, neurosurgery, RF-TC, SEEG-guided, stereotactic, thermo-SEEG

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Section: Discussionmentioning

confidence: 99%

Stereo‐electroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy: A systematic review and meta‐analysis

et al. 2018

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“…Historically, in epilepsy surgery stereotactic procedures were mainly used to localize the seizure onset zones through the recording of intracranial-EEG by stereoelectroencephalography (SEEG) [2]. More recently, following the growing accuracy of the delineation of the seizure onset zone and epileptic networks, the surgical management of drug-resistant epileptic patients faced new challenges [3][4][5]. Alongside surgical advances in conventional epilepsy surgery, stereotactic lesioning has emerged as an alternative when surgery is not an option.…”

Section: Introductionmentioning

confidence: 99%

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Bourdillon

Rheims

Catenoix

et al. 2020

Seizure

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Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning directly through the recording electrodes. In this systematic review the surgical technique, indications, and outcomes are described. Maximum accuracy is reached when a frame-based procedure with a robotic assistance and a per-operative vascular X-ray imaging are performed. Monitoring of the lesioning procedure based on the impedance, a sharp modification of which indicates that the thermocoagulation has reached its maximum volume, allows the optimization of the lesion size. The first indication concerns patients in whom a SEEG is required to determine whether surgery is feasible and in whom resection is indeed possible. Even if surgery is performed owing to insufficient efficacy of SEEG-guided RF-TC, the procedure remains interesting owing to its high positive predictive value for good outcome after surgery. The second indication concerns patients in whom phase I non-invasive investigations have concluded to surgical contraindication and who may still undergo SEEG in a purely therapeutic perspective (small deep zones inaccessible to surgery and network nodes of large epileptic networks). Lastly, SEEG-guided RF-TC can be considered as a first-line treatment for periventricular nodular heterotopia (PNH). Independently of indication, the overall seizure-free rate is 23% and the responder rate is 58%. The best results are obtained for PNH (38% seizure-free and 81% responders), while the worst results have been reported for temporal lobe-epilepsy in a dedicated study. The overall complication rate is 2.5%. More evidence is needed to help determine the exact place of SEEG-guided RF-TC in the surgical management algorithm.

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“…The recovery of central nervous system function following an insult is poorly understood (1). How brain function reorganizes and how various brain structures involved in reorganization interconnect and interact with one another following an adverse event remain a matter of speculation (2–8).…”

Section: Introductionmentioning

confidence: 99%

Functional Translocation of Broca's Area in a Low-Grade Left Frontal Glioma: Graph Theory Reveals the Novel, Adaptive Network Connectivity

Dong

Ferraro

et al. 2019

Front. Neurol.

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We describe frontal language reorganization in a 50–60 year-old right-handed patient with a low-grade left frontotemporal insular glioma. Pre-operative fMRI revealed robust activation in the left superior temporal gyrus (Wernicke Area, WA) and in the right inferior frontal gyrus (right anatomical homolog of Broca Area, BA). Intra-operative cortical stimulation of the left inferior frontal gyrus and adjacent cortices elicited no speech deficits, and gross total resection including the expected location of BA resulted in no speech impairment. We employed statistical inference methods to reconstruct the functional brain network and determined how different brain areas connect with one another. We found that the right homolog of the BA in this patient functionally connected to the same areas as the left BA in a typical healthy control. As opposed to the functional connection of the left BA in a healthy brain, the right BA did not connect directly with the left WA, but connected indirectly, mediated by the pre-Supplementary Motor Area and the Middle Frontal Gyrus. This case illustrates that pre-surgical fMRI may be used to identify atypical hemispheric language reorganization in the presence of brain tumor and that network theory opens the possibility for future insight into the neural mechanism underlying the language reorganization.

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Similarities and differences in neuroplasticity mechanisms between brain gliomas and nonlesional epilepsy

Abstract: Putting together advances in understanding of connectomics and neuroplasticity, leads to significant conceptual improvements in epilepsy surgery.

Cited by 24 publications

References 89 publications

Stereo‐electroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy: A systematic review and meta‐analysis

Stereo‐electroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy: A systematic review and meta‐analysis

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Functional Translocation of Broca's Area in a Low-Grade Left Frontal Glioma: Graph Theory Reveals the Novel, Adaptive Network Connectivity

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