In the past decades, due to important conceptual and methodological advances, neurosciences have achieved significant progress in understanding the anatomic and functional connectivity of the brain. However, how this structural and functional organization adapts/reacts to a brain tumour is still poorly understood. From a clinical as well as tumour biological prospective, diffuse gliomas (DG) (WHO grade II and III) are extremely heterogeneous and challenging tumours. DG tend to preferentially infiltrate “secondary” functional areas (immediately near the primary eloquent regions), or the so called “minimal common brain”. These highly eloquent areas/networks often represent a limit for tumour resection based on intraoperative functional mapping. The relatively slow growth of the DG allows for cortical adaptor mechanisms enabling functional and morphologic reorganization of the brain. The tumour then tends to interfere with normal brain function by disrupting functional connectivity of brain networks within peritumoral and distant brain areas, thereby promoting for instance positive symptoms such as seizure activity.
These mechanisms of cortical subcortical plasticity at the individual level are not fully understood with important anatomical-functional variability that is huge at the cortical level and very low at the subcortical level.
The subcortical white matter bundles are, indeed, the main limit for a surgical resection of the eloquent areas and, at the same time, they represent the least resistance way that glioma cells use to disseminate. For this reason, a better comprehension of the white matter anatomy became pivotal in the last decades. There has been ever-evolving improvement in neuroimaging and surgical techniques to map brain regions as well as other fields of neurosurgical oncology including biomathematical models and oncological techniques. These new tools and techniques have the potential to assist in diagnosis, predict the infiltration pattern, optimize the surgical and postsurgical treatment, and ultimately improve the outcome of these patients.
The overall aim for this Research Topic it to focus on new imaging methods, biomathematical models, surgical and oncological approaches to improve the clinical outcome of patients with gliomas through the investigation of the white matter/gliomas interplay. New methods and techniques may include but are not limited to:
• Imaging and Image analyses e.g., concept of brain connectome, MR-tractography, confocal microscopy and electron microscopy
• Surgical e.g., new intraoperative strategies for mapping language and neuropsychological related networks
• Biomathematical models e.g., predicting glioma infiltration pattern through white matter
• Oncological techniques e.g., proton radiation therapy
In the past decades, due to important conceptual and methodological advances, neurosciences have achieved significant progress in understanding the anatomic and functional connectivity of the brain. However, how this structural and functional organization adapts/reacts to a brain tumour is still poorly understood. From a clinical as well as tumour biological prospective, diffuse gliomas (DG) (WHO grade II and III) are extremely heterogeneous and challenging tumours. DG tend to preferentially infiltrate “secondary” functional areas (immediately near the primary eloquent regions), or the so called “minimal common brain”. These highly eloquent areas/networks often represent a limit for tumour resection based on intraoperative functional mapping. The relatively slow growth of the DG allows for cortical adaptor mechanisms enabling functional and morphologic reorganization of the brain. The tumour then tends to interfere with normal brain function by disrupting functional connectivity of brain networks within peritumoral and distant brain areas, thereby promoting for instance positive symptoms such as seizure activity.
These mechanisms of cortical subcortical plasticity at the individual level are not fully understood with important anatomical-functional variability that is huge at the cortical level and very low at the subcortical level.
The subcortical white matter bundles are, indeed, the main limit for a surgical resection of the eloquent areas and, at the same time, they represent the least resistance way that glioma cells use to disseminate. For this reason, a better comprehension of the white matter anatomy became pivotal in the last decades. There has been ever-evolving improvement in neuroimaging and surgical techniques to map brain regions as well as other fields of neurosurgical oncology including biomathematical models and oncological techniques. These new tools and techniques have the potential to assist in diagnosis, predict the infiltration pattern, optimize the surgical and postsurgical treatment, and ultimately improve the outcome of these patients.
The overall aim for this Research Topic it to focus on new imaging methods, biomathematical models, surgical and oncological approaches to improve the clinical outcome of patients with gliomas through the investigation of the white matter/gliomas interplay. New methods and techniques may include but are not limited to:
• Imaging and Image analyses e.g., concept of brain connectome, MR-tractography, confocal microscopy and electron microscopy
• Surgical e.g., new intraoperative strategies for mapping language and neuropsychological related networks
• Biomathematical models e.g., predicting glioma infiltration pattern through white matter
• Oncological techniques e.g., proton radiation therapy