Can the knight capture the queen? The role of supramarginal gyrus in chess rule-retrieval as evidenced by a novel combined awake brain mapping and fMRI protocol.

Brain tumours represent a burden for society, not only due to the risks they entail but also because of the possibility of losing relevant cognitive functions for the patient's life after their resection. In the present study, we report how we monitored chess performance through a multimodal Electrical Stimulation Mapping (ESM) - functional Magnetic Resonance Imaging (fMRI) combined protocol. The ESM was performed under a left parietal lobe tumour resection surgery on a patient that expressed the desire to preserve his chess playing ability post-operative.

Brain metastasis treatment guidelines: consensus by the Spanish Society of Neurosurgery Tumor Section.

Brain metastases are tumors that arise from a tumor cell originated in another organ reaching the brain through the blood. In the brain this tumor cell is capable of growing and invading neighboring tissues, such as the meninges and bone. In most patients a known tumor is present when the brain lesion is diagnosed, although it is possible that the first diagnose is the brain tumor before there is evidence of cancer elsewhere in the body.

Eating-induced seizures: A semiological sign of the right temporal pole.

Objective: Eating-induced seizures (EIS) are a rare form of reflex seizures. The objective of this study was to report a series of cases of EIS involving patients admitted to our epilepsy unit, and to analyze the clinical characteristics, etiology, and treatment response of this type of infrequent seizure.

Methods: We performed a single-center retrospective analysis of all consecutive patients diagnosed with epilepsy with eating-induced seizures between 2008 and 2020.

Low grade gliomas guide-lines elaborated by the tumor section of Spanish Society of Neurosurgery.

Adult low-grade gliomas (Low Grade Gliomas, LGG) are tumors that originate from the glial cells of the brain and whose management involves great controversy, starting from the diagnosis, to the treatment and subsequent follow-up. For this reason, the Tumor Group of the Spanish Society of Neurosurgery (GT-SENEC) has held a consensus meeting, in which the most relevant neurosurgical issues have been discussed, reaching recommendations based on the best scientific evidence. In order to obtain the maximum benefit from these treatments, an individualised assessment of each patient should be made by a multidisciplinary team.

The role of the anterior insular cortex in self-monitoring: A novel study protocol with electrical stimulation mapping and functional magnetic resonance imaging.

Becoming aware of one's own states is a fundamental aspect for self-monitoring, allowing us to adjust our beliefs of the world to the changing context. Previous evidence points out to the key role of the anterior insular cortex (aIC) in evaluating the consequences of our own actions, especially whenever an error has occurred. In the present study, we propose a new multimodal protocol combining electrical stimulation mapping (ESM) and functional magnetic resonance imaging (fMRI) to explore the functional role of the aIC for self-monitoring in patients undergoing awake brain surgery.

Anterior transtemporal endoscopic selective amygdalohippocampectomy: a virtual and cadaveric feasibility study.

Purpose: Selective amygdalohippocampectomy (SelAH) is one of the most common surgical treatments for mesial temporal sclerosis. Microsurgical approaches are associated with the risk of cognitive and visual deficits due to damage to the cortex and white matter (WM) pathways. Our objective is to test the feasibility of an endoscopic approach through the anterior middle temporal gyrus (aMTG) to perform a SelAH.

Intraoperative Brain Mapping in Multilingual Patients: What Do We Know and Where Are We Going?

In this review, we evaluate the knowledge gained so far about the neural bases of multilingual language processing obtained mainly through imaging and electrical stimulation mapping (ESM). We attempt to answer some key questions about multilingualism in the light of recent literature evidence, such as the degree of anatomical-functional integration of two or more languages in a multilingual brain, how the age of L2-acquisition affects language organization in the human brain, or how the brain controls more than one language. Finally, we highlight the future trends in multilingual language mapping.

Voxel-level analysis of normalized DSC-PWI time-intensity curves: a potential generalizable approach and its proof of concept in discriminating glioblastoma and metastasis.

Objective: Standard DSC-PWI analyses are based on concrete parameters and values, but an approach that contemplates all points in the time-intensity curves and all voxels in the region-of-interest may provide improved information, and more generalizable models. Therefore, a method of DSC-PWI analysis by means of normalized time-intensity curves point-by-point and voxel-by-voxel is constructed, and its feasibility and performance are tested in presurgical discrimination of glioblastoma and metastasis.

Methods: In this retrospective study, patients with histologically confirmed glioblastoma or solitary-brain-metastases and presurgical-MR with DSC-PWI (August 2007-March 2020) were retrieved.

Glioblastoma treatment guidelines: Consensus by the Spanish Society of Neurosurgery Tumor Section.

Introduction: Glioblastoma (GBM) treatment starts in most patients with surgery, either resection surgery or biopsy, to reach a histology diagnose. Multidisciplinar team, including specialists in brain tumors diagnose and treatment, must make an individualize assessment to get the maximum benefit of the available treatments.

Material And Methods: Experts in each GBM treatment field have briefly described it based in their experience and the reviewed of the literature.

White-matter pathways and semantic processing: intrasurgical and lesion-symptom mapping evidence.

In the present study, we aimed to test the association between the correct function of the left ventral white matter pathways and semantic processing (dual stream models for language processing, Hickok & Poeppel, 2004), using a new set of language tasks during intraoperative electrical stimulation at white matter level. Additionally, we evaluated brain regions needed for correct performance on the different semantic tasks using lesion-symptom analyses (voxel lesion-symptom mapping and track-wise lesion analysis) in a sample of 62 candidates for the awake brain surgery. We found that electrical stimulation in the vicinity of the inferior longitudinal and inferior fronto-occipital fasciculi disturbed performance on semantic processing tasks.

Treatment of cavernous malformations in supratentorial eloquent areas: experience after 10 years of patient-tailored surgical protocol.

Background: Eloquent area surgery has become safer with the development of intraoperative neurophysiological monitoring and brain mapping techniques. However, the usefulness of intraoperative electric brain stimulation techniques applied to the management and surgical treatment of cavernous malformations in supratentorial eloquent areas is still not proven. With this study, we aim to describe our experience with the use of a tailored functional approach to treat cavernous malformations in supratentorial eloquent areas.

Involvement of the middle frontal gyrus in language switching as revealed by electrical stimulation mapping and functional magnetic resonance imaging in bilingual brain tumor patients.

Neural basis of language switching and the cognitive models of bilingualism remain controversial. We explored the functional neuroanatomy of language switching implementing a new multimodal protocol assessing neuropsychological, functional magnetic resonance and intraoperative electrical stimulation mapping results. A prospective series of 9 Spanish-Catalan bilingual candidates for awake brain surgery underwent a specific language switching paradigm implemented both before and after surgery, throughout the electrical stimulation procedure and during functional magnetic resonance both pre- and postoperatively.

Ganglioglioma Progression to Combined Anaplastic Ganglioglioma and Anaplastic Pleomorphic Xanthoastrocytoma. Case Report and Literature Review.

Background: Composite ganglioma and pleomorphic xanthoastrocytoma with anaplastic features in both components is an extremely rare glioneuronal tumor. Five cases of anaplastic progression in the glioma component have been reported. These tumors generally affect young patients who have brain tumor-related epilepsy, which are usually located in the temporal lobe or in the cerebellum and may have associated leptomeningeal spreading.

Evaluation of the High-Frequency Monopolar Stimulation Technique for Mapping and Monitoring the Corticospinal Tract in Patients With Supratentorial Gliomas. A Proposal for Intraoperative Management Based on Neurophysiological Data Analysis in a Series of 92 Patients.

Background: Intraoperative identification and preservation of the corticospinal tract is often necessary for glioma resection.

Objective: To make a proposal for intraoperative management with the high-frequency monopolar stimulation technique for monitoring the corticospinal tract.

Methods: Ninety-two patients operated on with the assistance of the high-frequency monopolar stimulation.

Brain metastasis of carcinoma ex pleomorphic adenoma of the parotid gland: case report and review of the literature.

We present an extremely infrequent case of brain metastasis of a parotid tumor. To our knowledge, this is the second case reported of a brain metastasis of a malignant parotid tumor, carcinoma ex pleomorphic adenoma. Pleomorphic adenoma represents 60% of tumors of the parotid gland, and although it is a benign tumor, it can transform into carcinoma ex pleomorphic adenoma in 5% of cases, one of the most aggressive neoplasms of the salivary glands.

Age of language acquisition and cortical language organization in multilingual patients undergoing awake brain mapping.

OBJECTIVE Most knowledge regarding the anatomical organization of multilingualism is based on aphasiology and functional imaging studies. However, the results have still to be validated by the gold standard approach, namely electrical stimulation mapping (ESM) during awake neurosurgical procedures. In this ESM study the authors describe language representation in a highly specific group of 13 multilingual individuals, focusing on how age of acquisition may influence the cortical organization of language.

Words are not enough: nonword repetition as an indicator of arcuate fasciculus integrity during brain tumor resection.

OBJECTIVE Subcortical electrical stimulation during brain surgery may allow localization of functionally crucial white matter fibers and thus tailoring of the tumor resection according to its functional limits. The arcuate fasciculus (AF) is a white matter bundle connecting frontal, temporal, and parietal cortical areas that is often disrupted by left brain lesions. It plays a critical role in several cognitive functions related to phonological processing, but current intraoperative monitoring methods do not yet allow mapping of this tract with sufficient precision.

Functional approach using intraoperative brain mapping and neurophysiological monitoring for the surgical treatment of brain metastases in the central region.

OBJECTIVE Brain metastases are the most frequent intracranial malignant tumor in adults. Surgical intervention for metastases in eloquent areas remains controversial and challenging. Even when metastases are not infiltrating intra-parenchymal tumors, eloquent areas can be affected.

Improving Ribosomal RNA Integrity in Surgically Resected Human Brain Tumor Biopsies.

Background: Biopsies extracted from brain cancer patients often display degraded ribosomal RNA, which makes them unusable in transcriptomic experiments. This has not been properly documented in previous works aimed at refining the molecular classification of brain cancer.

Objective: To determine RNA integrity in a large cohort of human brain cancer biopsies and to evaluate different factors that may influence RNA integrity in both a murine model of glioblastoma and in additional subsets of patient biopsies.

Subcortical anatomy as an anatomical and functional landmark in insulo-opercular gliomas: implications for surgical approach to the insular region.

Object: Little attention has been given to the functional challenges of the insular approach to the resection of gliomas, despite the potential damage of essential neural networks that underlie the insula. The object of this study is to analyze the subcortical anatomy of the insular region when infiltrated by gliomas, and compare it with the normal anatomy in nontumoral hemispheres.

Methods: Ten postmortem human hemispheres were dissected, with isolation of the inferior fronto-occipital fasciculus (IFOF) and the uncinate fasciculus.

Morphological derivation overflow as a result of disruption of the left frontal aslant white matter tract.

The frontal aslant tract (FAT) is a recently described major connection between the preSMA and Broca's area, whose functional role remains undefined. In this study we examined a patient presenting a morphological overregularization strategy in a verb generation task during awake surgery. This specific language deficit coincided with brain tumor resection at the level of the left FAT.

The persistent crucial role of the left hemisphere for language in left-handers with a left low grade glioma: a stimulation mapping study.

Background: Left-handers have a more bilateral language representation than right-handers. Therefore, in left-handers with a low-grade glioma (LGG) in the left hemisphere (LH), one could hypothesize that the right hemisphere (RH) might allow language compensation, at least partly, with no or only a minor persistent role of the LH in speech. However, although LGG induces language reorganization in right-handed patients, little is known in left-handers.

Selection of intraoperative tasks for awake mapping based on relationships between tumor location and functional networks.

Intraoperative electrical brain mapping is currently the most reliable method to identify eloquent cortical and subcortical structures at the individual level and to optimize the extent of resection of intrinsic brain tumors. The technique allows the preservation of quality of life, not only allowing avoidance of severe neurological deficits but also facilitating preservation of high neurocognitive functions. To accomplish this goal, however, it is crucial to optimize the selection of appropriate intraoperative tasks, given the limited intrasurgical awake time frame.