Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery: lessons from a case series.

Autor:	Boccuni L; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain., Roca-Ventura A; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain., Buloz-Osorio E; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain., Leno-Colorado D; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain., Delgado-Gallén S; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain., Cabello-Toscano M; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain., Perellón-Alfonso R; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain., Villalba-Martínez G; Department of Neurosurgery, Hospital del Mar, Barcelona, Spain.; Systems Neurologic and Neurotherapeutic Group at Research Institute Hospital del Mar, Barcelona, Spain.; Universitat Pompeu Fabra, Barcelona, Spain., Martínez-Ricarte F; Department of Neurosurgery, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain., Martín-Fernández J; Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier, France.; Department of Neurosurgery, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain.; Universidad de La Laguna, Tenerife, Spain., Buxeda-Rodriguez M; Department of Neurosurgery, University Hospital Mútua Terrassa, Barcelona, Spain., Conesa-Bertrán G; Department of Neurosurgery, Teknon Medical Center, Barcelona, Spain., Illueca-Moreno M; Department of Neurosurgery, HM Nou Delfos, Barcelona, Spain., Lladó-Carbó E; Department of Neurosurgery, HM Nou Delfos, Barcelona, Spain., Perla Y Perla C; Department of Neurosurgery, HM Nou Delfos, Barcelona, Spain., Garrido C; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain.; Neuroradiology Section, Radiology Department, Diagnostic Image Centre, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain., Pariente JC; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain., Laredo C; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain., Muñoz-Moreno E; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain., Bargalló N; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain.; Neuroradiology Section, Radiology Department, Diagnostic Image Centre, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain., Trompetto C; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.; IRCCS Ospedale Policlinico San Martino, Genova, Italy., Marinelli L; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.; IRCCS Ospedale Policlinico San Martino, Genova, Italy., Bartrés-Faz D; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain., Abellaneda-Pérez K; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain. kabellaneda@guttmann.com.; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain. kabellaneda@guttmann.com.; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain. kabellaneda@guttmann.com., Pascual-Leone A; Wolk Center for Memory Health and Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.; Department of Neurology, Harvard Medical School, Boston, MA, USA., Tormos-Muñoz JM; Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain. jm.tormos@ucv.es.; Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain. jm.tormos@ucv.es.
Jazyk:	angličtina
Zdroj:	Journal of neuro-oncology [J Neurooncol] 2024 Oct; Vol. 170 (1), pp. 185-198. Date of Electronic Publication: 2024 Jul 23.
DOI:	10.1007/s11060-024-04774-4
Abstrakt:	Purpose: The objective of this prospective, single-centre case series was to investigate feasibility, clinical outcomes, and neural correlates of non-invasive Neuromodulation-Induced Cortical Prehabilitation (NICP) before brain tumor surgery. Previous studies have shown that gross total resection is paramount to increase life expectancy but is counterbalanced by the need of preserving critical functional areas. NICP aims at expanding functional margins for extensive tumor resection without functional sequelae. Invasive NICP (intracranial neuromodulation) was effective but characterized by elevated costs and high rate of adverse events. Non-invasive NICP (transcranial neuromodulation) may represent a more feasible alternative. Nonetheless, up to this point, non-invasive NICP has been examined in only two case reports, yielding inconclusive findings. Methods: Treatment sessions consisted of non-invasive neuromodulation, to transiently deactivate critical areas adjacent to the lesion, coupled with intensive functional training, to activate alternative nodes within the same functional network. Patients were evaluated pre-NICP, post-NICP, and at follow-up post-surgery. Results: Ten patients performed the intervention. Feasibility criteria were met (retention, adherence, safety, and patient's satisfaction). Clinical outcomes showed overall stability and improvements in motor and executive function from pre- to post-NICP, and at follow-up. Relevant plasticity changes (increase in the distance between tumor and critical area) were observed when the neuromodulation target was guided by functional neuroimaging data. Conclusion: This is the first case series demonstrating feasibility of non-invasive NICP. Neural correlates indicate that neuroimaging-guided target selection may represent a valid strategy to leverage neuroplastic changes before neurosurgery. Further investigations are needed to confirm such preliminary findings. (© 2024. The Author(s).)
Databáze:	MEDLINE
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