Evaluation of Selective Tibial Neurotomy for the Spastic Foot Treatment Using a Personal Goal-Centered Approach: A 1-Year Cohort Study.

Background: Selective tibial neurotomy (STN) has already demonstrated its effectiveness to reduce foot deformities and spasticity, but assessment according to a goal-centered approach is missing.

Objective: To evaluate the effectiveness of STN associated with a postoperative rehabilitation program for the treatment of the spastic foot, according to a goal-centered approach.

Methods: Interventional study (before-after STN and rehabilitation program) with observational design including consecutive adult patients with spastic foot, who received STN followed by a rehabilitation program, was performed.

Stimulation of the motor cerebral cortex in chronic neuropathic pain: the role of electrode localization over motor somatotopy.

Background: Previous studies have reported the pain-relieving effect of chronic electrical motor cortex stimulation (eMCS) in various types of neuropathic pain. The study aimed to explore the potential relationship between the clinical efficacy of eMCS for the treatment of chronic neuropathic pain and the precise localization of the contacts over the motor cortex somatotopic representation of the painful area.

Methods: A total of 22 patients with neuropathic pain were implanted with eMCS electrodes.

Insular gliomas: a surgical reappraisal based on a systematic review of the literature.

Introduction: Insular gliomas are heterogeneous lesions whose management presents multiple challenges for their tendency to affect young patients in good neurological and cognitive conditions, their deep anatomic location and proximity with critical functional and vascular structures. The appropriate management of insular gliomas requires a multidisciplinary evidence-centred teamwork grounded on the best anatomic, neurophysiological and oncological knowledge. The present study provides a reappraisal of the management of insular gliomas based on a systematic review of the literature with the aim of guiding clinicians in the management of such tumors.

Development of the sensorimotor cortex in the human fetus: a morphological description.

Twenty-one human fetal brains from 13 to 28 gestational weeks were studied macroscopically to describe the morphological stages of sulcal and gyral development in the sensorimotor cortex. In particular, the morphological appearance of the pericentral lateral cortex (sensorimotor cortex) and opercula was noted, as well as the vascularization of these regions. The central cerebral sulci were the first macroscopical structures to be identified on the lateral surface of the human cerebral hemisphere.

Is Life better after motor cortex stimulation for pain control? Results at long-term and their prediction by preoperative rTMS.

Background: A positive effect of motor cortex stimulation (MCS) (defined as subjective estimations of pain relief ≥ 30%) has been reported in 55 - 64% of patients. Repetitive magnetic cortical stimulation (rTMS) is considered a predictor of MCS effect. These figures are, however, mostly based on subjective reports of pain intensity, and have not been confirmed in the long-term.

Morphometry and localization of the temporal transverse Heschl's gyrus in magnetic resonance imaging: a guide for cortical stimulation of chronic tinnitus.

Purpose: Subjective tinnitus is considered a phantom auditory phenomenon. Recent studies show that electrical or magnetic stimulation of the cortex can alleviate some tinnitus. The usual target of the stimulation is the primary auditory cortex (PAC) on Heschl's gyrus (HG).

Definition of a stereotactic 3-dimensional magnetic resonance imaging template of the human insula.

Background: This study proposes a 3-dimensional (3-D) template of the insula in the bicommissural reference system with posterior commissure (PC) as the center of coordinates.

Objective: Using the bicommissural anterior commissure (AC)-PC reference system, this study aimed to define a template and design a method for the 3-D reconstruction of the human insula that may be used at an individual level during stereotactic surgery.

Methods: Magnetic resonance imaging (MRI)-based morphometric analysis was performed on 100 cerebral cortices with normal insulae based on a 3-step procedure: Step 1: AC-PC reference system-based reconstruction of the insula from the 1-mm thick 3-D T1-weighted MRI slices.

Anatomofunctional organization of the insular cortex: a study using intracerebral electrical stimulation in epileptic patients.

Purpose: Different lines of evidence suggest that the insular cortex has many important functional roles. Direct electrical stimulation (ES) of the human insular cortex during surgical procedures for epilepsy, functional imaging techniques, and lesion studies also occasionally induces clinical responses.

Methods: In this study, we evaluated 25 patients with drug-refractory focal epilepsy by stereotactically implanting at least one electrode into the insular cortex using an oblique approach (transfrontal or transparietal).

Description of sulcal organization of the insular cortex.

Purpose: To study the morphology of the gyri and sulci of the insular region.

Materials And Methods: This study examined 20 formalin-fixed cerebral hemispheres (10 right and 10 left). Observations described: the peri-insular sulci, anatomical variations in the insular sulci and gyri, and the relationships between the central insular sulcus and the central cerebral sulcus and the anatomy of the insular arteries.

MRI-based definition of a stereotactic two-dimensional template of the human insula.

Objective: This study aimed to create a stereotactic two-dimensional description of the human insula based on accurate radiological morphometric studies.

Methods: Seventy-five normal cerebral MRIs were selected and drawings of the insula then obtained from serial sagittal slices. These drawings were digitalized before superimposing the anterior (AC) and posterior (PC) commissures as references.

Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy.

Purpose: Different lines of evidence have suggested an involvement of the insular cortex in speech production. These have included results from lesion studies, functional imaging techniques, and electrical stimulation of the human insular cortex during invasive evaluation of epileptic patients.

Methods: We evaluated 25 patients who had drug refractory focal epilepsy with at least one electrode stereotactically implanted in the insular cortex.

Safety and usefulness of insular depth electrodes implanted via an oblique approach in patients with epilepsy.

Objective: This study investigates the feasibility, safety, and usefulness of depth electrodes stereotactically implanted within the insular cortex.

Methods: Thirty patients with suspected insular involvement during epileptic seizure underwent presurgical stereotactic electroencephalographic recordings using 10 to 16 depth electrodes per patient. Among these, one or two electrodes were implanted via an oblique approach to widely sample the insular cortex.

Middle short gyrus of the insula implicated in pain processing.

Different lines of evidence have suggested an involvement of the insular cortex in pain processing. Direct electrical stimulation (ES) of the human insular cortex during surgical procedure sometimes induces painful sensations and painful stimuli induce activation of the insular cortex as shown by functional neuroimaging. Invasive evaluation of epileptic patients by deep brain stereotactically implanted electrodes provides an opportunity to analyze responses induced by ES of the insular cortex in awake and fully conscious patients.