0000000000597196
AUTHOR
Hugues Duffau
Functional reorganization of the attentional networks in low-grade glioma patients: a longitudinal study.
International audience; Right brain damage often provokes deficits of visuospatial attention. Although the spatial attention networks have been widely investigated in stroke patients as well as in the healthy brain, little is known about the impact of slow growing lesions in the right hemisphere. We here present a longitudinal study of 20 patients who have been undergoing awake brain surgery with per-operative line bisection testing. Our aim was to investigate the impact of tumour presence and of tumour resection on the functional (re)organization of the attention networks. We assessed patients' performance on lateralized target detection, visual exploration and line bisection before surger…
Electrophysiological Effects of Direct Electrical Stimulations During Awake Brain Surgery: Methodological Considerations
International audience; IRECT electrical stimulation (DES) has long been used to perform real-time functional mapping of the brain. More recently, this technique was introduced in the neurosurgery of slow-growing and infiltrative brain tumors to guide the resection with great success. By generating transient perturbations, this method allows the real-time identification of both cortical areas and subcortical networks that are essential for the function. Thus, as much as possible, non-functional tissue can be removed while minimizing the sequelae. However, the understanding of the electrophysiological effects of DES and, in particular its remote propagation, remains an open and key question.…
Manual Reaction Times and Brain Dynamics after 'Awake Surgery' of Slow-Growing Tumours Invading the Parietal Area. A Case Report.
International audience; PRIMARY OBJECTIVES: Awake surgeries of slow-growing tumours invading the brain and guided by direct electrical stimulation induce major brain reorganizations accompanied with slight impairments post-operatively. In most cases, these deficits are so slight after a few days that they are often not detectable on classical neuropsychological evaluations. Consequently, this study investigated whether simple visuo-manual reaction time paradigms would sign some level of functional asymmetries between both hemispheres. Importantly, the visual stimulus was located in the saggital plane in order to limit attentional biases and to focus mainly on the inter-hemispheric asymmetry…
Case report: Remote neuromodulation with direct electrical stimulation of the brain, as evidenced by intra-operative EEG recordings during wide-awake neurosurgery
Letter to the editor; International audience
Awake Surgery: Skills of Neurosurgeon Matter but Those of Patient Too. How to Optimize Functional Brain Mapping by Improving Per-Operatory Testing?
International audience; It is now possible to perform resections of slowgrowing tumors in awake patients. Using direct electrical stimulation (DES), real-time functional mapping of the brain can be used to prevent the resection of essential areas near the tumor. For now, simple clinical tests are performed on conscious patients and combined with DES in order to discriminate functional and non-functional areas invaded by the tumors. In this work we try to develop a simple device based on a simple technology to better quantify the performances of the patients during the surgery itself and give a real-time feedback to the neurosurgeon that will help to further guide the surgery by improving th…
Disrupting the right pars opercularis with electrical stimulation frees the song: case report
International audience; The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporoinsular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted …
"Awake Surgery" of Slow-Growing Tumors and Cortical Excitability Measured by EEG Recordings. Preliminary Results
International audience; To investigate interhemispheric imbalance following "awake surgeries" of slow-growing tumors we recorded EEG in a visuo-manual RT paradigm. Increase of cortical excitability within the ipsilesional hemisphere was signed by increased ERPs amplitude for two patients. The cortical excitability in the lesioned hemisphere may be increased to maintain performances and cerebral plasticity.