Reorganization of Language Areas in Patient with a Frontal Lobe Low Grade Glioma – fMRI Case Study

Abstract Background As molecular advances have deepened the knowledge on low-grade glioma (LGG), we investigated the effect of higher radiation dose on the survival of IDH-wildtype (IDHwt) LGG. Methods In the current study, 52 IDHwt LGG patients who received radiotherapy were enrolled from the Chinese Glioma Genome Atlas dataset. Radiation doses > 54 Gy were defined as high-dose, whereas doses ≤ 54 Gy were defined as low-dose. We performed univariate and multivariate survival analyses to examine the prognostic role of high-dose radiotherapy. Results In total, the radiation dose ranged from 48.6 Gy to 61.2 Gy, with a median of 55.8 Gy, and 31 patients were grouped into high-dose radiation. Univariate survival analysis indicated that high-dose radiotherapy (p = 0.015), tumors located in the frontal lobe (p = 0.009), and pathology of astrocytoma (p = 0.037) were significantly prognostic factors for overall survival. In multivariate survival analysis, high-dose radiotherapy (p = 0.028) and tumors located in the frontal lobe (p = 0.016) were independently associated with better overall survival. Conclusions In conclusion, high-dose radiotherapy independently improved the survival of IDHwt LGG. This can guide treatments for glioma with known molecular characteristics.

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Episodic nocturnal wandering in a patient with epilepsy due to a right temporoinsular low-grade glioma: relief following resection

Journal of Neurosurgery ◽

10.3171/jns.2006.104.3.436 ◽

2006 ◽

Vol 104 (3) ◽

pp. 436-439 ◽

Cited By ~ 10

Author(s):

Hugues Duffau ◽

Michèle Kujas ◽

Luc Taillandier

Keyword(s):

Frontal Lobe ◽

Antiepileptic Drugs ◽

Tumor Resection ◽

Low Grade Glioma ◽

Low Grade ◽

Atypical Form ◽

Patient Reported ◽

History Of ◽

Unusual Type

✓ Although controversial, episodic nocturnal wandering (ENW) is thought to be a rare and atypical form of nocturnal epilepsy, originating in the frontal lobe and responsive to antiepileptic drugs (AEDs). The authors report the case of a patient harboring a right temporoinsular low-grade glioma, who presented with a 3-year history of agitated somnambulent episodes resistant to AEDs. Interestingly, the ENW totally resolved after tumor resection and the patient reported no recurrence during a follow-up period of 4.5 years. To the authors’ knowledge, this is the first report of ENW due to a glioma; the findings support the theory that ENW may represent an unusual type of lesional epilepsy that is surgically correctable. Moreover, a temporoinsular origin of ENW can now be considered.

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High-dose Radiation Associated with Improved Survival in IDH-wildtype Low-grade Glioma

10.21203/rs.3.rs-184357/v1 ◽

2021 ◽

Author(s):

Shuai Liu ◽

Yanwei Liu ◽

Guanzhang Li ◽

Jin Feng ◽

Li Chen ◽

...

Keyword(s):

Overall Survival ◽

Survival Analysis ◽

Radiation Dose ◽

Frontal Lobe ◽

Low Grade Glioma ◽

Molecular Characteristics ◽

High Dose ◽

Low Grade ◽

Multivariate Survival ◽

Dose Radiation

Abstract PurposeAs molecular advances have deepened the knowledge on low-grade glioma (LGG), we investigated the effect of higher radiation dose on the survival of IDH-wildtype (IDHwt) LGG.MethodsIn the current study, 52 IDHwt LGG patients who received radiotherapy were enrolled from the Chinese Glioma Genome Atlas dataset. Radiation doses > 54 Gy were defined as high-dose, whereas doses ≤ 54 Gy were defined as low-dose. We performed univariate and multivariate survival analyses to examine the prognostic role of high-dose radiotherapy.ResultsIn total, the radiation dose ranged from 48.6 Gy to 61.2 Gy, with a median of 55.8 Gy, and 31 patients were grouped into high-dose radiation. Univariate survival analysis indicated that high-dose radiotherapy (p = 0.015), tumors located in the frontal lobe (p = 0.009), and pathology of astrocytoma (p = 0.037) were significantly prognostic factors for overall survival. In multivariate survival analysis, high-dose radiotherapy (p = 0.028) and tumors located in the frontal lobe (p = 0.016) were independently associated with better overall survival.ConclusionIn conclusion, high-dose radiotherapy independently improved the survival of IDHwt LGG. This can guide treatments for glioma with known molecular characteristics.

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Frontal language areas do not emerge in the absence of temporal language areas: A case study of an individual born without a left temporal lobe

10.1101/2021.05.28.446230 ◽

2021 ◽

Author(s):

Greta Tuckute ◽

Alexander Paunov ◽

Hope Kean ◽

Hannah Small ◽

Zachary Mineroff ◽

...

Keyword(s):

Frontal Cortex ◽

Frontal Lobe ◽

Temporal Lobe ◽

Language Processing ◽

Right Hemisphere ◽

Left Temporal Lobe ◽

High Level ◽

Temporal Language ◽

Language Areas

High-level language processing is supported by a left-lateralized fronto-temporal brain network. How this network emerges ontogenetically remains debated. Given that frontal cortex in general exhibits protracted development, frontal language areas presumably emerge later and/or mature more slowly than temporal language areas. But are temporal areas necessary for the development of the language areas in the frontal lobe, or do frontal language areas instead emerge independently? We shed light on this question through a case study of an individual (EG) born without a left temporal lobe. We use fMRI methods that have been previously extensively validated for their ability to elicit robust language responses at the individual-subject level. As expected in cases of early left hemisphere (LH) damage, we find that EG has a fully functional language network in her right hemisphere (RH) and performs within the normal range on standardized language assessments. However, her RH frontal language areas have no corresponding LH homotopic areas: no reliable response to language is detected on the lateral surface of EG's left frontal lobe. However, another network implicated in high-level cognition - the domain-general multiple demand, MD, network - is robustly present in both right and left frontal lobes, suggesting that EG's left frontal cortex is capable of supporting non-linguistic cognitive functions. The existence of temporal language areas therefore appears to be a prerequisite for the emergence of the language areas in the frontal lobe.

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