scholarly journals Assessment of Structural Disconnections In Gliomas: Comparison of Indirect And Direct Approaches

2021 ◽  
Author(s):  
Erica Silvestri ◽  
Umberto Villani ◽  
Manuela Moretto ◽  
Maria Colpo ◽  
Alessandro Salvalaggio ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Brain Tumours ◽  
Low Grade ◽  
Clinical Progression ◽  
Primary Brain Tumours ◽  
Tumoral Lesion ◽  
Definition Of ◽  
Brain Gliomas ◽  
First Time ◽  
The Brain

Abstract Gliomas are amongst the most common primary brain tumours in adults and are often associated with poor prognosis. Understanding the extent of white matter (WM) which is affected outside the tumoral lesion may be of paramount importance to explain cognitive deficits and the clinical progression of the disease. To this end, we explored both direct (i.e., tractography based) and indirect (i.e., atlas based) approaches to quantifying WM structural disconnections in a cohort of 50 high- and low-grade glioma patients. While these methodologies have recently gained popularity in the context of stroke, to our knowledge this is the first time they are applied in patients with brain tumours. More specifically, in this work we present a quantitative comparison of the disconnection maps provided by the two methodologies by applying well known metrics of spatial similarity, extension and correlation. Given the important role the oedematous tissue plays in the physiopathology of tumours, we performed these analyses both by including and excluding it in the definition of the tumoral lesion. This was done to investigate possible differences determined by this choice.We found that direct and indirect approaches offer two distinct pictures of structural disconnections in patients affected by brain gliomas, presenting key differences in several regions of the brain. Following the outcomes of our analysis, we eventually discuss the strengths and pitfalls of these two approaches when applied in this critical field.

scholarly journals Cognitive Deficits in Primary Brain Tumours: A Framework for Management and Rehabilitation

2014 ◽  
Vol 05 (01) ◽  
pp. 74-81 ◽  
Author(s):  
Michael Back ◽  
Elizabeth Back ◽  
Marina Kastelan ◽  
Helen Wheeler
Keyword(s):  
Cognitive Deficits ◽  
Brain Tumours ◽  
Primary Brain Tumours

scholarly journals Developing guidelines for the management of brain tumour related epilepsy

2021 ◽  
Vol 23 (Supplement_4) ◽  
pp. iv3-iv4
Author(s):  
Elizabeth Vacher ◽  
Miguel Rodriguez Ruiz ◽  
Jeremy Rees
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Current Evidence ◽  
Low Grade ◽  
Clinical Nurse Specialists ◽  
Primary Brain Tumours ◽  
Low Incidence

Abstract Aims Brain Tumour Related Epilepsy (BTRE) has a significant impact on Quality of Life with implications for driving, employment and social and domestic activities. Management of BTRE is complex due to the higher incidence of pharmacoresistance and the potential for interaction between anti-cancer therapy and anti-epileptic drugs (AEDs). Neurologists, oncologists, palliative care physicians and clinical nurse specialists treating these patients would benefit from up-to-date clinical guidelines. We aim to review the current evidence to adapt current NICE guidelines for Epilepsy and to outline specific recommendations for the optimal treatment of BTRE, encompassing both primary and metastatic brain tumours. Method A comprehensive search of the literature from the past 20 years on BTRE was carried out in three databases: Embase, Medline and EMCARE. A broad search strategy was used and the evidence was evaluated and graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Results All patients with BTRE should be treated with AEDs. There is no proven benefit for the use of prophylactic AEDs, although there are no randomised trials testing newer agents. Seizure frequency varies between 10-40% (Class 2a evidence) in patients with Brain Metastases (BM) and from 30% (high-grade gliomas) to 90% (low-grade gliomas) (Class 2a evidence) in patients with Primary Brain Tumours (PBT). In patients with BM, risk factors include number of BM and melanoma histology (Class 2b evidence). In patients with PBT, risk factors include frontal and temporal location, oligodendroglial histology, IDH mutation and cortical infiltration (Class 2b evidence). There is a low incidence of seizures (13%) after stereotactic radiosurgery for BM (Class 2b evidence). Non-enzyme inducing AEDs are recommended as first line treatment for BTRE, but up to 50% of patients with BTRE due to PBT remain resistant (Class 2b evidence). Conclusion The review has highlighted the relative dearth of high quality evidence for the management of BTRE, and provides a framework for further studies aiming to improve seizure control, quality of life, and indications for AEDs.

scholarly journals Clinical applications of proton MR spectroscopy in the diagnosis of brain tumours

2004 ◽  
Vol 18 (2) ◽  
pp. 143-153 ◽  
Author(s):  
Nail Bulakbasi
Keyword(s):  
Mr Spectroscopy ◽  
Brain Tumours ◽  
Radiation Necrosis ◽  
Signal To Noise Ratio ◽  
Brain Parenchyma ◽  
Clinical Applications ◽  
Exact Nature ◽  
Physiological Changes ◽  
Definition Of ◽  
The Brain

There are few but important problems in magnetic resonance (MR) diagnosis of the brain tumours such as predicting the grade, exact definition of the tumour borders, differentiation of the cystic tumours from abscess, the tumoral core from peritumoral oedema, and the tumour recurrence from radiation necrosis. MR spectroscopy (MRS) can add more information to MR imaging (MRI) in solving many of these problems. Widespread usage of faster MRS applications with higher signal‒to‒noise ratio (SNR) and spatial resolution, allows us to detect functional metabolic changes, which provides more data to understand the exact nature of the tumour and the morphological and physiological changes occurring in the surrounding brain parenchyma.

scholarly journals Understanding the design of warning signals: a predator’s view

2021 ◽  
Author(s):  
Olivier Pennacchio ◽  
Christina Halpin ◽  
Innes Cuthill ◽  
P. Lovell ◽  
Matthew Wheelwright ◽  
...  
Keyword(s):  
Visual Processing ◽  
Visual Features ◽  
Natural Scenes ◽  
Signal Design ◽  
Warning Signals ◽  
Wing Patterns ◽  
Definition Of ◽  
Palatable Species ◽  
First Time ◽  
The Brain

Abstract Animal warning signals show remarkable diversity, yet subjectively appear to share visual features that make defended prey stand out and look different from more cryptic palatable species. Here we develop and apply a computational model that emulates avian visual processing of pattern and colour to Lepidopteran wing patterns to show that warning signals have specific neural signatures that set them apart not only from the patterns of undefended species but also from natural scenes. For the first time, we offer an objective and quantitative neural-level definition of warning signals based on how the pattern generates neural activity in the brain of the receiver. This opens new perspectives for understanding and testing how warning signals function and evolve, and, more generally, how sensory systems constrain general principles for signal design.

The influence of rest primary brain tumours on disease free and overall survival

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 11529-11529
Author(s):  
D. D. Scepanovic ◽  
N. D. Bajic
Keyword(s):  
Overall Survival ◽  
Regression Model ◽  
Anaplastic Astrocytoma ◽  
Brain Tumours ◽  
Performance Status ◽  
Low Grade ◽  
Female Ratio ◽  
Primary Brain Tumours ◽  
Significant Difference ◽  
Disease Free

11529 Background: We analysed the influence of rest primary brain tumours on disease free survival (DFS) and overall survival (OS). Methods: From 1998 till 2004, 80 patients (pts) with primary brain tumours were treated with postoperative radiotherapy (RT). The male–female ratio was 44 versus (vs) 36 pts (55% vs 45%). The median age was 50 years (yrs) (min 17, max 79 yrs). Performance status was 90–100% in 30 pts, 80–90% in 39 pts and 70–80% in 11 pts. Low grade astrocytoma was reported in 13 pts, anaplastic astrocytoma and glioblastoma in 49 pts, low grade oligodendroglioma in 2 pts, meningeoma in 9 pts and others in 7 pts. The postoperative RT dose was 50 Gy in 20 pts while 60 pts was treated with dose above 50 Gy, 2 Gy per day, 5 fractions per week, linear accelerator X rays, 6 MeV energy. We analysed two groups of pts (50 pts had rest tumours after surgery and RT within 6 months (mo) of operation and 30 pts without rest tumours). We analysed the influence of age, pts ambulatory, corticosteroids therapy during RT, pathohystological diagnoses (PH), RT doses and chemotherapy (CT) application (carmustine, 80 mg/m2, i.v. 1–3 days after 6 weeks of RT completion) on DFS and OS. Results: The median follow up time was 16 mo (min 6, max 96 mo). Thirty pts (37.5%) is still alive while 50 pts (62.5%) died. Cox regression model gave us data of influence on DFS in this way: cortocosteroids therapy during RT, CT application, RT dose and furthermore on OS: age, pts ambulatory, PH report and RT dose. Logistic regression model gave us data for rest tumours group of pts (50 pts) to be the greatest influence on survival patients ambulatory and corticosteroids therapy during RT. Between two groups of pts there is statistically significant difference on DFS and OS (p < 0.001). 1 yrs DFS was 30% and 2 yrs DFS was found in 26% of pts while 1 yrs OS was 44% and 2 yrs OS was 42% of pts. Conclusions: Pts with rest tumours especially anaplastic astrocytoma and glioblastoma have a shorter life span. However, RT dose does influence DFS and OS in pts with good performance status. No significant financial relationships to disclose.

The Whole-Brain Concept of Death Remains Optimum Public Policy

2006 ◽  
Vol 34 (1) ◽  
pp. 35-43 ◽  
Author(s):  
James L. Bernat
Keyword(s):  
Brain Injuries ◽  
Positive Pressure ◽  
Mechanical Ventilators ◽  
Definition Of Death ◽  
Vital Functions ◽  
The 1950S ◽  
Definition Of ◽  
First Time ◽  
The Brain ◽  
Defining Death

The definition of death is one of the oldest and most enduring problems in biophilosophy and bioethics. Serious controversies over formally defining death began with the invention of the positive-pressure mechanical ventilator in the 1950s. For the first time, physicians could maintain ventilation and, hence, circulation on patients who had sustained what had been previously lethal brain damage. Prior to the development of mechanical ventilators, brain injuries severe enough to induce apnea quickly progressed to cardiac arrest from hypoxemia. Before the 1950s, the loss of spontaneous breathing and heartbeat (“vital functions”) were perfect predictors of death because the functioning of the brain and of all other organs ceased rapidly and nearly simultaneously thereafter, producing a unitary death phenomenon. In the pretechnological era, physicians and philosophers did not have to consider whether a human being who had lost certain “vital functions” but had retained others was alive, because such cases were technically impossible.

Application of Scanning Electron Microscopy to Medical Research

1969 ◽  
Vol 27 ◽  
pp. 12-13
Author(s):  
J. D. Hutchison
Keyword(s):  
Electron Microscopy ◽  
Electron Microscope ◽  
Medical Research ◽  
Prosthetic Heart Valve ◽  
School Of Medicine ◽  
Transmission Electron ◽  
Definition Of ◽  
Mechanism Of Failure ◽  
The Brain ◽  
Scanning Electron

When the transmission electron microscope was commercially introduced a few years ago, it was heralded as one of the most significant aids to medical research of the century. It continues to occupy that niche; however, the scanning electron microscope is gaining rapidly in relative importance as it fills the gap between conventional optical microscopy and transmission electron microscopy.IBM Boulder is conducting three major programs in cooperation with the Colorado School of Medicine. These are the study of the mechanism of failure of the prosthetic heart valve, the study of the ultrastructure of lung tissue, and the definition of the function of the cilia of the ventricular ependyma of the brain.

Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa

2014 ◽  
Vol 42 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Jochen Seitz ◽  
Katharina Bühren ◽  
Georg G. von Polier ◽  
Nicole Heussen ◽  
Beate Herpertz-Dahlmann ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Deficits ◽  
Time Course ◽  
Morphological Changes ◽  
Meta Analysis ◽  
Short Term ◽  
Clinical Prognosis ◽  
Qualitative Review ◽  
Brain Changes ◽  
The Brain

Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2–5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2–8 years of remission GM and WM were nearly normalized, and differences to HC (GM: –1.0%, WM: –0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.

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