Creation and Validation of the Facial Diplegia Scale for Assessment of Bilateral Facial Palsy.

: House-Brackmann (HB) classification and the Sunnybrook Facial Grading System (SFGS), both reference tools for the assessment of facial palsy, are not suitable for bilateral facial palsy. The aim of this study was to develop, standardize, and validate the Facial Diplegia Scale (FDS). : The FDS was standardized in a healthy population ( = 111) and validated in 40 patients with diplegia.

Impact of Bell's palsy in facial emotion recognition: a prospective observational study of 60 patients.

Purpose: Patients with Bell's palsy suffer from functional deficits and cannot convey their emotions through the face as well as they used to. According to embodied cognition, automatic mimicry and facial feedback modulate emotion perception. The aim of our study was to determine the impact of Bell's palsy on facial emotion perception.

Repeated awake surgery and quality of life in patients with diffuse glioma: a systematic review and meta-analysis.

Diffuse gliomas significantly affect patients' daily lives. Because of the high risk of recurrence and anaplasic transformation, repeated surgery can be proposed in awake condition to prolongs overall survival by limiting and reducing residual tumour volume. However, oncological interest alone is no longer sufficient due to the consequent increase in median survival, and quality of life is becoming an important issue in clinical decision-making.

Impact of inspiratory threshold loading on brain activity and cognitive performances in healthy humans.

In healthy humans, inspiratory threshold loading deteriorates cognitive performances. This can result from motor-cognitive interference (activation of motor respiratory-related cortical networks vs. executive resources allocation), sensory-cognitive interference (dyspnea vs.

Outcomes and prognostic factors of facial nerve repair: a retrospective comparative study of 31 patients and literature review.

Purpose: To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors.

Methods: A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included.

Oro-facial motor assessment: validation of the MBLF protocol in facial palsy.

Background: Oro-facial myofunctional praxis assesses the muscular coordination and the degree of motor impairment of the lingual, mandibular and facial muscles necessary for articulation, mimicry and swallowing.

Purpose: The objective of this study was to create and validate the MBLF protocol, a French oro-facial myofunctional assessment in order to quantify patient's impairment and to specify the motor and functional deficit for an adapted management.

Methods: The MBLF was validated against the Sunnybrook Facial Grading System (criterion validity).

Oral mobility reflects rate of progression in advanced Friedreich's ataxia.

Our objective was to identify a sensitive marker of disease progression in Friedreich's ataxia. We prospectively evaluated speech, voice, and oromotor function in 40 patients at two timepoints. The mean disease duration was 20.

Smile Reanimation after Unilateral Facial Palsy by Lengthening Temporalis Myoplasty: Objective and Subjective Evaluation on 25 Cases.

Background: Comparison of functional results of lengthening temporalis myoplasty relies in current practice on subjective scales. The goal of this study was to define a simple, reproducible, objective scale validated through a comparison with a subjective scale for smile symmetrization results after temporal muscle myoplasty.

Methods: A retrospective study was conducted on 25 patients having a unilateral facial palsy and rehabilitated with lengthening temporalis myoplasty.

[Advantage of facial rehabilitation after facial palsy].

Visible and immediate trauma, facial palsy (FP) covers functional but also psychological damage and it is essential to evaluate before a comprehensive therapeutic care tailored. Few patients, however, are emerging with a prescription for rehabilitation after a consultation. Why? This rehabilitation is it ignored? Is it absolutely necessary? It is evident in the extension of medical care to minimize the effects.

Is the human left middle longitudinal fascicle essential for language? A brain electrostimulation study.

Human brain pathways required for language processing are poorly known. A new white matter tract in humans, the middle longitudinal fascicle, has recently been anatomically determined by diffusion tensor imaging and suggested to be essential for language. Our aim is to determine the importance of the middle longitudinal fascicle for language processing.

Comparison of diffusion tensor imaging tractography of language tracts and intraoperative subcortical stimulations.

Object: Diffusion tensor (DT) imaging tractography is increasingly used to map fiber tracts in patients with surgical brain lesions to reduce the risk of postoperative functional deficit. There are few validation studies of DT imaging tractography in these patients. The aim of this study was to compare DT imaging tractography of language fiber tracts by using intraoperative subcortical electrical stimulations.

Functional outcome after language mapping for insular World Health Organization Grade II gliomas in the dominant hemisphere: experience with 24 patients.

Object: Despite the report of recent experiences of insular surgery in the past decade, there has been no series specifically dedicated to studying functional outcome following resection of insular WHO Grade II gliomas involving the dominant hemisphere, in patients with no or only mild preoperative language deficit. In this article, the authors analyze the contribution of awake mapping for preservation of brain function, especially language, in a homogeneous series of 24 patients who underwent surgery for insular Grade II gliomas within the dominant insular lobe.

Methods: Twenty-four patients underwent surgery for an insular Grade II glioma involving the dominant hemisphere (22 left, 2 right), revealed by seizures in all but 1 case.

Agraphia after awake surgery for brain tumor: new insights into the anatomo-functional network of writing.

Background: Controversy still exists about neural basis underlying writing and its relation with the sites subserving oral language. Our objective is to study functional areas involved in writing network, based on the observations of different postoperative writing disorders in a population of patients without preoperative agraphia.

Methods: We analyzed the postoperative agraphia profiles in 15 patients who underwent surgery for cerebral LGGs in functional language areas, using electrical mapping under local anesthesia.

Naming performance in two bilinguals with frontal vs. temporal glioma.

Two bilingual patients had World Health Organization Grade II Gliomas removed from a language area, one in the left mesiofronto-cingular region and one in the left postero-temporal region. They performed a picture naming task in their two languages before their surgery and afterwards. Both patients showed slowness in naming in their first language but different patterns of naming performance across their first and second language.

Evidence for an occipito-temporal tract underlying visual recognition in picture naming.

A 24-year-old male underwent awake surgery for a lesion in the left dominant basal temporo-occipital junction. During the intraoperative functional mapping using picture naming, cortical stimulation near the visual word form area led to visual paraphasia. These visual paraphasias were also elicited axonally by subcortical stimulation at the anterior wall of the cavity.

Re-operation is a safe and effective therapeutic strategy in recurrent WHO grade II gliomas within eloquent areas.

Background: To analyze the functional and oncological results after re-operation for recurrent WHO grade II Glioma located in eloquent regions.

Method: We reviewed a consecutive series of 19 patients with GIIG within functional areas who underwent two operations separated by at least 1 year. Intraoperative electrical stimulation mapping was used in all operations for recurrence and in 14 of the initial procedures.

Speaking without Broca's area after tumor resection.

We present the case of a right-handed patient who received surgical treatment for a left frontal WHO grade II glioma invading the left inferior and middle frontal gyri, the head of the caudate nucleus, the anterior limb of the internal capsule and the anterior insula, in direct contact also with the anterior-superior part of the lentiform nucleus. The tumor resection was guided by direct electrical stimulation on brain areas, while the patient was awake. Adding a narrative production task to the neuropsychological assessment, we compared pre-, peri- and post-surgical language skills in order to analyze the effects of the tumor infiltration and the consequences of the left IFG resection, an area known to be involved in various language and cognitive processes.

Is the left uncinate fasciculus essential for language? A cerebral stimulation study.

Despite a better understanding of the anatomy of the uncinate fasciculus (UF), its function remains poorly known. Our aim was to study the exact role of UF in language, and the possible existence of parallel distributed language networks within the "ventral stream", underlaid by distinct subcortical tracts--namely the inferior occipito-temporal fasciculus (IOF) and UF.We report a series of 13 patients operated on awake for a glioma involving the left anterior temporal lobe or the orbitofrontal area.

Long-term brain plasticity allowing a multistage surgical approach to World Health Organization Grade II gliomas in eloquent areas.

Although the goal of surgery for World Health Organization Grade II gliomas is maximal extent of resection, complete tumor removal is not always possible when the glioma involves eloquent areas. The authors propose a multistage surgical approach to highly crucial areas that are classically considered inoperable, enabling optimization of the extent of resection while avoiding permanent cognitive deficits due to induced functional reshaping in the interim between the 2 consecutive operations. To demonstrate such plasticity, the authors used a combination of sequential functional MR imaging and intraoperative electrical stimulation mapping before and during surgeries spaced by several years in 2 patients who each underwent 2 separate resections of Grade II gliomas located in the left dominant premotor area.

Intraoperative subcortical stimulation mapping of language pathways in a consecutive series of 115 patients with Grade II glioma in the left dominant hemisphere.

Object: Despite better knowledge of cortical language organization, its subcortical anatomofunctional connectivity remains poorly understood. The authors used intraoperative subcortical stimulation in awake patients undergoing operation for a glioma in the left dominant hemisphere to map the language pathways and to determine the contribution of such a method to surgical results.

Methods: One hundred fifteen patients harboring a World Health Organization Grade II glioma within language areas underwent operation after induction of local anesthesia, using direct electrical stimulation to perform online cortical and subcortical language mapping throughout the resection.

Cortico-subcortical organization of language networks in the right hemisphere: an electrostimulation study in left-handers.

We have studied the configuration of the cortico-subcortical language networks within the right hemisphere (RH) in nine left-handers, being operated on while awake for a cerebral glioma. Intraoperatively, language was mapped using cortico-subcortical electrostimulation, to avoid permanent deficit. In frontal regions, cortical stimulation elicited articulatory disorders (ventral premotor cortex), anomia (dorsal premotor cortex), speech arrest (pars opercularis), and semantic paraphasia (dorsolateral prefrontal cortex).

Resection of World Health Organization Grade II gliomas involving Broca's area: methodological and functional considerations.

Objective: Advances in functional mapping have enabled us to extend the indications of surgery for low-grade gliomas (LGGs) within eloquent regions. However, to our knowledge, no study has been specifically dedicated to the resection of LGGs within Broca's area. We report the first surgical series of LGGs involving this area by focusing on methodological and functional considerations.