Evidence for potentials and limitations of brain plasticity using an atlas of functional resectability of WHO grade II gliomas: Towards a “minimal common brain”
NeuroImage. 2011-06-01; 56(3): 992-1000
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1. Neuroimage. 2011 Jun 1;56(3):992-1000. doi: 10.1016/j.neuroimage.2011.03.022.
Epub 2011 Mar 21.
Evidence for potentials and limitations of brain plasticity using an atlas of
functional resectability of WHO grade II gliomas: towards a “minimal common
Ius T(1), Angelini E, Thiebaut de Schotten M, Mandonnet E, Duffau H.
(1)Department of Neurosurgery, Udine, Italy.
Despite recent advances in non-invasive brain mapping imaging, the resectability
of a given area in a patient harboring a WHO grade II glioma cannot be predicted
preoperatively with high reliability, due to mechanisms of functional
reorganization. Therefore, intraoperative mapping by direct electrical
stimulation remains the gold standard for detection and preservation of eloquent
areas during glioma surgery, because it enables to perform on-line
anatomo-functional correlations. To study potentials and limitations of brain
plasticity, we gathered 58 postoperative MRI of patients operated on for a WHO
grade II glioma under direct electrical cortico-subcortical stimulation.
Postoperative images were registered on the MNI template to construct an atlas of
functional resectability for which each voxel represents the probability to
observe residual non-resectable tumor, that is, non-compensable area. The
resulting atlas offers a rigorous framework to identify areas with high plastic
potential (i.e. with probabilities of residual tumor close to 0), with low
compensatory capabilities (i.e. probabilities of residual tumor close to 1) and
with intermediate level of resectability (probability around 0.5). The resulting
atlas highlights the utmost importance of preserving a core of connectivity
through the main associative pathways, namely, it supports the existence of a
“minimal common brain” among patients.
Copyright © 2011 Elsevier Inc. All rights reserved.
PMID: 21414413 [Indexed for MEDLINE]