1
|
Sim S, Maldonado IL, Castelnau P, Barantin L, El-Hage W, Andersson F, Cottier JP. Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: similarities and differences. A scoping review. J Neuroradiol 2024; 51:131-144. [PMID: 37981196 DOI: 10.1016/j.neurad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Mindfulness meditation (MM) and hypnosis practices are gaining interest in mental health, but their physiological mechanisms remain poorly understood. This study aimed to synthesize the functional, morphometric and metabolic changes associated with each practice using magnetic resonance imaging (MRI), and to identify their similarities and differences. METHODS MRI studies investigating MM and hypnosis in mental health, specifically stress, anxiety, and depression, were systematically screened following PRISMA guidelines from four research databases (PubMed, Web of Science, Embase, PsycINFO) between 2010 and 2022. RESULTS In total, 97 references met the inclusion criteria (84 for MM and 13 for hypnosis). This review showed common and divergent points regarding the regions involved and associated brain connectivity during MM practice and hypnosis. The primary commonality between mindfulness and hypnosis was decreased default mode network intrinsic activity and increased central executive network - salience network connectivity. Increased connectivity between the default mode network and the salience network was observed in meditative practice and mindfulness predisposition, but not in hypnosis. CONCLUSIONS While MRI studies provide a better understanding of the neural basis of hypnosis and meditation, this review underscores the need for more rigorous studies.
Collapse
Affiliation(s)
- Sindy Sim
- CHRU de Tours, service de radiologie, Tours, France
| | | | - Pierre Castelnau
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Service de Neuropédiatrie et Handicaps, Hôpital Clocheville, CHRU, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France
| | | | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Jean-Philippe Cottier
- CHRU de Tours, service de radiologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France.
| |
Collapse
|
2
|
Dannhoff G, Morichon A, Smirnov M, Barantin L, Destrieux C, Maldonado IL. Direct Inside-Out Observation of Superficial White Matter Fasciculi in the Human Brain. Brain Connect 2024; 14:107-121. [PMID: 38308471 DOI: 10.1089/brain.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024] Open
Abstract
Background: Recent methodological advances in the study of the cerebral white matter have left short association fibers relatively underexplored due to their compact and juxtacortical nature, which represent significant challenges for both post-mortem post-cortex removal dissection and magnetic resonance-based diffusion imaging. Objective: To introduce a novel inside-out post-mortem fiber dissection technique to assess short association fiber anatomy. Methods: Six cerebral specimens were obtained from a body donation program and underwent fixation in formalin. Following two freezing and thawing cycles, a standardized protocol involving peeling fibers from deep structures towards the cortex was developed. Results: The inside-out technique effectively exposed the superficial white matter. The procedure revealed distinguishable intergyral fibers, demonstrating their dissectability and enabling the identification of their orientation. The assessment of layer thickness was possible through direct observation and ex vivo morphological magnetic resonance imaging. Conclusion: The inside-out fiber technique effectively demonstrates intergyral association fibers in the post-mortem human brain. It adds to the neuroscience armamentarium, overcoming methodological obstacles and offering an anatomical substrate essential for neural circuit modeling and the evaluation of neuroimaging congruence. Impact statement The inside-out fiber dissection technique enables a totally new perception of cerebral connectivity as the observer navigates inside the parenchyma and looks toward the cerebral surface with the subcortical white matter and the cortical mantle in place. This approach has proven very effective for exposing intergyral association fibers, which have shown to be much more distinguishable from an inner perspective. It gave rise to unprecedented images of the human superficial white matter and allowed, for the first time, direct observation of this vast mantle of fascicles on entire cerebral hemisphere aspects.
Collapse
Affiliation(s)
- Guillaume Dannhoff
- Service de Neurochirurgie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
| | - Alex Morichon
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
| | - Mykyta Smirnov
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
| | - Laurent Barantin
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
| | - Christophe Destrieux
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
- Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - Igor Lima Maldonado
- Université de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032, Tours, France
| |
Collapse
|
3
|
Maldonado IL, Descoteaux M, Rheault F, Zemmoura I, Benn A, Margulies D, Boré A, Duffau H, Mandonnet E. Multimodal study of multilevel pulvino-temporal connections: a new piece in the puzzle of lexical retrieval networks. Brain 2024:awae021. [PMID: 38243610 DOI: 10.1093/brain/awae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/18/2023] [Accepted: 01/18/2024] [Indexed: 01/21/2024] Open
Abstract
Advanced methods of imaging and mapping the healthy and lesioned brain allowed to identify the cortical nodes and white matter tracts supporting the dual neurofunctional organization of language networks in a dorsal phonological and a ventral semantic stream. Much less understood are the anatomical correlates of the interaction between the two streams, one hypothesis being that of a sub-cortically mediated interaction, through crossed cortico-striato-thalamo-cortical and cortico-thalamo-cortical loops. In this regard, the pulvinar is the thalamic subdivision that has most regularly appeared as implicated in the processing of lexical retrieval. However, descriptions of its connections with temporal (language) areas remain scarce. Here we assess this pulvino-temporal connectivity using a combination of state-of-the-art techniques: white matter stimulation in awake surgery and post-operative diffusion MRI (n = 4), virtual dissection from the Human Connectome Project 3 T and 7 T datasets (n = 172), and operative microscope-assisted post-mortem fiber dissection (n = 12). We demonstrate the presence of four fundamental fiber contingents: i) the anterior component (Arnold's bundle proper) initially described by Arnold in the 19th century, and destined to the anterior temporal lobe; ii) the Optic Radiations (OR)-like component, that leaves the pulvinar accompanying the optical radiations and reaches the posterior basal temporal cortices; iii) the lateral component, that crosses orthogonally the temporal stem and reaches the middle temporal gyrus; and iv) the Auditory Radiations (AR)-like component, that leaves the pulvinar accompanying the auditory radiations to the superomedial aspect of the temporal operculum, just posteriorly to Heschl's gyrus. Each of those components might correspond to a different level of information processing involved in the lexical retrieval process of picture naming.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- CHRU de Tours, 37000 Tours, France
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, J1 K 2X9 Sherbrooke, Quebec, Canada
- Imeka Solutions, J1H 4A7 Sherbrooke, Quebec, Canada
| | | | - Ilyess Zemmoura
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- CHRU de Tours, 37000 Tours, France
| | - Austin Benn
- CNRS, Integrative Neuroscience and Cognition Center (UMR 8002), Université de Paris Cité, 75006 Paris, France
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, OX1 3QD Oxford, UK
| | - Daniel Margulies
- CNRS, Integrative Neuroscience and Cognition Center (UMR 8002), Université de Paris Cité, 75006 Paris, France
| | - Arnaud Boré
- Sherbrooke Connectivity Imaging Lab, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, J1 K 2X9 Sherbrooke, Quebec, Canada
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34000 Montpellier, France
- Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, 34000, Montpellier, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, 75010 Paris, France
- Frontlab, CNRS UMR 7225, INSERM U1127, Paris Brain Institute (ICM), 75013 Paris, France
- Université de Paris Cité, 75006 Paris, France
| |
Collapse
|
4
|
Camargo LM, Smirnov M, Maldonado IL. The prey's perspective on the rise of predatory publishing. EXCLI J 2023; 22:904-906. [PMID: 37780943 PMCID: PMC10539542 DOI: 10.17179/excli2023-6392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 10/03/2023]
Affiliation(s)
| | - Mykyta Smirnov
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- SU 'Uzhhorod National University', Uzhhorod, Ukraine
| | | |
Collapse
|
5
|
Duque ACM, Cuesta TAC, Melo ADS, Lima Maldonado I. Right hemisphere and metaphor comprehension: A connectionist perspective. Neuropsychologia 2023; 187:108618. [PMID: 37321404 DOI: 10.1016/j.neuropsychologia.2023.108618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/11/2023] [Accepted: 06/10/2023] [Indexed: 06/17/2023]
Abstract
Metaphor comprehension is a cognitively complex task, with evidence pointing to the engagement of multiple cerebral areas. In addition, the involvement of the right hemisphere appears to vary with cognitive effort. Therefore, the interconnecting pathways of such distributed cortical centers should be taken into account when studying this topic. Despite this, the potential contribution of white matter fasciculi has received very little attention in the literature to date and is not mentioned in most metaphor comprehension studies. To highlight the probable implications of the right inferior fronto-occipital fasciculus, right superior longitudinal system, and callosal radiations, we bring together findings from different research fields. The aim is to describe important insights enabled by the cross-fertilization of functional neuroimaging, clinical findings, and structural connectivity.
Collapse
Affiliation(s)
- Anna Clara Mota Duque
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Taryn Ariadna Castro Cuesta
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Ailton de Souza Melo
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Dep. Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| |
Collapse
|
6
|
Castro Cuesta TA, Maldonado IL. Comment on: "The ventral precuneal-posterior cingulate region as a site of epileptogenicity". Epileptic Disord 2023; 25:281-282. [PMID: 37318229 DOI: 10.1002/epd2.20007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 12/01/2023]
Affiliation(s)
- Taryn Ariadna Castro Cuesta
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Departamento de Biomorfologia - Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
- Department of Neurosurgery, CHRU de Tours, 37044, Tours, France
- UMR Inserm U1253, iBrain, Université de Tours, Tours, France
| |
Collapse
|
7
|
Terrier LM, Bergemer AM, Destrieux C, Maldonado IL. Anatomical study of the carotid-trigeminal interface: The missing link in the trigeminovascular system? J Anat 2022; 241:1303-1309. [PMID: 36156796 DOI: 10.1111/joa.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022] Open
Abstract
The trigeminal system is considered a prominent actor in brain nociceptive innervation. The trigeminovascular system is mainly composed of pseudounipolar neurons located within the trigeminal ganglion, whose dendrites originate in cerebral blood vessels. Anatomical studies demonstrating anatomical continuity between perivascular fibers and the trigeminal system are lacking. This issue is addressed in this study. Eleven cadaveric heads obtained from a body donation program were fixed in formalin. We performed a microanatomical study of the cavernous carotid-trigeminal interface and a histological examination of the tissue bridges crossing the virtual space between the medial aspect of the trigeminal ganglion and ophthalmic nerve and the lateral aspect of the cavernous segment of the internal carotid artery. Very strong adhesion was observed between the horizontal segment of the artery and the ophthalmic nerve in all specimens. The virtual space in this interface was crossed by a web of delicate filaments. Histological examination demonstrated the presence of nerve fibers in all samples. In this study, the carotid-trigeminal interface has been described in greater detail than ever before and could provide insight into disorders related to the trigeminovascular system. As the present results do not allow the exact nature of the axons to be affirmed, further investigation is necessary.
Collapse
Affiliation(s)
- Louis-Marie Terrier
- Department of Neurosurgery, Clairval Private Hospital, Ramsay Generale de Santé, Marseille, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Christophe Destrieux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - Igor Lima Maldonado
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Service de Neurochirurgie, CHRU de Tours, Tours, France
| |
Collapse
|
8
|
Ng S, Lima Maldonado I, Destrieux C, Yeh FC, Fernandez-Miranda J, Duffau H, Jacquesson T. Magnetic Resonance Diffusion Tractography of Brain White Matter tracts-An Educational 3-Dimensional Stereoscopic Overview for Operative Planning and Mapping in Brain Tumor Surgery: 3-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2022; 23:e177. [PMID: 35972103 DOI: 10.1227/ons.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | | | | | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Juan Fernandez-Miranda
- Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Timothée Jacquesson
- Department of Anatomy, University of Lyon 1, Lyon, France.,Multidisciplinary Skull Base Unit, Department of Neurosurgery, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
9
|
Smirnov M, Destrieux C, Maldonado IL. Cerebral white matter vasculature: still uncharted? Brain 2021; 144:3561-3575. [PMID: 34718425 DOI: 10.1093/brain/awab273] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/17/2021] [Accepted: 07/11/2021] [Indexed: 11/14/2022] Open
Abstract
White matter vasculature plays a major role in the pathophysiology of permanent neurological deficits following a stroke or progressive cognitive alteration related to small vessel disease. Thus, knowledge of the complex vascularization and functional aspects of the deep white matter territories is paramount to comprehend clinical manifestations of brain ischemia. This review provides a structured presentation of the existing knowledge of the vascularization of the human cerebral white matter from seminal historical studies to the current literature. First, we revisit the highlights of prenatal development of the endoparenchymal telencephalic vascular system that are crucial for the understanding of vessel organization in the adult. Second, we reveal the tangled history of debates on the existence, clinical significance, and physiological role of leptomeningeal anastomoses. Then, we present how conceptions on white matter vascularization transitioned from the mixed ventriculopetal/ventriculofugal theory, in which a low-flow area was interposed in between concurrent arterial flows, to the purely ventriculopetal theory. The latter model explains variable white matter sensitivity to ischemia by various organizations of ventriculopetal vessel terminals having different origin/length properties and interconnection patterns. Next, arteries supplying primarily the white matter are described according to their length and overall structure. Furthermore, the known distribution territories, to date, are studied in relation to primary anatomical structures of the human cerebral white matter, emphasizing the sparsity of the "ground-truth" data available in the literature. Finally, the implications for both large vessel occlusion and chronic small vessel disease are discussed, as well as the insights from neuroimaging. All things considered, we identify the need for further research on deep white matter vascularization, especially regarding the arterial supply of white matter fiber tracts.
Collapse
Affiliation(s)
- Mykyta Smirnov
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Christophe Destrieux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,CHRU de Tours, Tours, France
| | | |
Collapse
|
10
|
Camargo LM, Lima PCTM, Janot K, Maldonado IL. Safety of Oral P2Y12 Inhibitors in Interventional Neuroradiology: Current Status and Perspectives. AJNR Am J Neuroradiol 2021; 42:2119-2126. [PMID: 34674995 DOI: 10.3174/ajnr.a7303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
In the field of interventional neuroradiology, antiplatelet agents are commonly used to prepare patients before the implantation of permanent endovascular materials. Among the available drugs, clopidogrel is the most frequently used one, but resistance phenomena are considered to be relatively common. Prasugrel and ticagrelor were recently added to the pharmacologic arsenal, but the safety of these agents in patients undergoing neurointerventional procedures is still a subject of discussion. The cumulative experience with both drugs is less extensive than that with clopidogrel, and the experience with patients in the neurology field is less extensive than in the cardiology domain. In the present article, we provide a narrative review of studies that investigated safety issues of oral P2Y12 inhibitors in interventional neuroradiology and discuss potential routes for future research.
Collapse
Affiliation(s)
- L M Camargo
- From the Faculdade de Medicina (L.M.C.), Universidade Salvador, Salvador, Brazil
| | - P C T M Lima
- Serviço de Clínica Médica (P.C.T.M.L.), Hospital Santo Antônio, Associação Obras Sociais Irmã Dulce, Salvador, Brazil
| | - K Janot
- Service de Neuroradiologie (K.J.), Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - I L Maldonado
- U1253, iBrain (I.L.M.), Université de Tours, Institut National de la Santé et de la Recherche Médicale, Tours, France
| |
Collapse
|
11
|
Porto de Oliveira JVM, Raquelo-Menegassio AF, Maldonado IL. What's your name again? A review of the superior longitudinal and arcuate fasciculus evolving nomenclature. Clin Anat 2021; 34:1101-1110. [PMID: 34218465 DOI: 10.1002/ca.23764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/25/2021] [Accepted: 06/18/2021] [Indexed: 11/11/2022]
Abstract
Studies of the superior longitudinal fasciculus (SLF) have multiplied in recent decades owing to methodological advances, but the absence of a convention for nomenclature remains a source of confusion. Here, we have reviewed existing nomenclatures in the context of the research studies that generated them and we have identified their agreements and disagreements. A literature search was conducted using PubMed/MEDLINE, Web-of-Science, Embase, and a review of seminal publications, without restrictions regarding publication date. Our search revealed that diffusion imaging, autoradiography, and fiber dissection have been the main methods contributing to tract designation. The first two have been particularly influential in systematizing the horizontal elements distant from the lateral sulcus. Twelve approaches to naming were identified, eight of them differing considerably from each other. The terms SLF and arcuate fasciculus (AF) were often used as synonyms until the second half of the 20th century. During the last 15 years, this has ceased to be the case in a growing number of publications. The term AF has been used to refer to the assembly of three different segments, or exclusively to long frontotemporal fibers. Similarly, the term SLF has been employed to denote the whole superior longitudinal associative system, or only the horizontal frontoparietal parts. As only partial correspondence can be identified among the available nomenclatures, and in the absence of an official designation of all anatomical structures that can be encountered in clinical practice, a high level of vigilance regarding the effectiveness of every oral or written act of communication is mandatory.
Collapse
Affiliation(s)
| | | | - Igor Lima Maldonado
- UMR Inserm U1253, iBrain, Université de Tours, Tours, France.,CHRU de Tours, Tours, France.,Departamento de Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil
| |
Collapse
|
12
|
Zhu F, Ben Hassen W, Bricout N, Kerleroux B, Janot K, Gory B, Anxionnat R, Richard S, Marchal A, Blanc R, Piotin M, Consoli A, Trystram D, Rodriguez Regent C, Desilles JP, Weisenburger-Lile D, Escalard S, Herbreteau D, Ifergan H, Lima Maldonado I, Labreuche J, Henon H, Naggara O, Lapergue B, Boulouis G. Effect of Operator's Experience on Proficiency in Mechanical Thrombectomy: A Multicenter Study. Stroke 2021; 52:2736-2742. [PMID: 34233462 DOI: 10.1161/strokeaha.120.031940] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND PURPOSE We aimed to evaluate among trained interventional neuroradiologist, whether increasing individual experience was associated with an improvement in mechanical thrombectomy (MT) procedural performance metrics. METHODS Individual MT procedural data from 5 centers of the Endovascular Treatment in Ischemic Stroke registry and 2 additional high-volume stroke centers were pooled. Operator experience was defined for each operator as a continuous variable, cumulating the number of MT procedures performed since January 2015, as MT became standard of care or, if later than this date, since the operator started performing mechanical thrombectomies in autonomy. We tested the associations between operator's experience and procedural metrics. RESULTS A total of 4516 procedures were included, performed by 36 operators at 7 distinct centers, with a median of 97.5 endovascular treatment procedures per operator (interquartile range, 57-170.2) over the study period. Higher operator's experience, analyzed as a continuous variable, was associated with a significantly shorter procedural duration (β estimate, -3.98 [95% CI, -5.1 to -2.8]; P<0.001), along with local anesthesia and M1 occlusion location in multivariable models. Increasing experience was associated with better Thrombolysis in Cerebral Infarction scores (estimate, 1.02 [1-1.04]; P=0.013). CONCLUSIONS In trained interventional neuroradiologists, increasing experience in MT is associated with significantly shorter procedural duration and better reperfusion rates, with a theoretical ceiling effect observed after around 100 procedures. These results may inform future training and practice guidelines to set minimal experience standards before autonomization, and to set-up operators' recertification processes tailored to individual case volume and prior experience.
Collapse
Affiliation(s)
- François Zhu
- Department of Diagnostic and Therapeutic Neuroradiology, F-54000, CHRU Nancy and IADI, INSERM U1254, F-54000, Université de Lorraine, Nancy, France (F.Z., B.G., R.A.)
| | - Wagih Ben Hassen
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.)
| | - Nicolas Bricout
- Department of Neuroradiology, CHRU Lille, France (N.B., A.M.)
| | - Basile Kerleroux
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.).,Department of Neuroradiology, CHRU Tours, Tours, France (B.K., K.J., D.H., H.I., G.B.)
| | - Kevin Janot
- Department of Neuroradiology, CHRU Tours, Tours, France (B.K., K.J., D.H., H.I., G.B.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, F-54000, CHRU Nancy and IADI, INSERM U1254, F-54000, Université de Lorraine, Nancy, France (F.Z., B.G., R.A.)
| | - René Anxionnat
- Department of Diagnostic and Therapeutic Neuroradiology, F-54000, CHRU Nancy and IADI, INSERM U1254, F-54000, Université de Lorraine, Nancy, France (F.Z., B.G., R.A.)
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, CHRU Nancy and INSERM U1116, F-54000, Université de Lorraine, Nancy, France (S.R.)
| | - Adrien Marchal
- Department of Neuroradiology, CHRU Lille, France (N.B., A.M.)
| | - Raphael Blanc
- Department of Neuroradiology, Fondation Ophtalmologique A. de Rothschild, Paris, France (R.B., M.P., J.-P.D., S.E.)
| | - Michel Piotin
- Department of Neuroradiology, Fondation Ophtalmologique A. de Rothschild, Paris, France (R.B., M.P., J.-P.D., S.E.)
| | - Arturo Consoli
- Department of Neuroradiology, Foch Hospital, Suresnes, France (A.C.)
| | - Denis Trystram
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.)
| | - Christine Rodriguez Regent
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.)
| | - Jean-Philippe Desilles
- Department of Neuroradiology, Fondation Ophtalmologique A. de Rothschild, Paris, France (R.B., M.P., J.-P.D., S.E.)
| | | | - Simon Escalard
- Department of Neuroradiology, Fondation Ophtalmologique A. de Rothschild, Paris, France (R.B., M.P., J.-P.D., S.E.)
| | - Denis Herbreteau
- Department of Neuroradiology, CHRU Tours, Tours, France (B.K., K.J., D.H., H.I., G.B.)
| | - Heloise Ifergan
- Department of Neuroradiology, CHRU Tours, Tours, France (B.K., K.J., D.H., H.I., G.B.)
| | | | - Julien Labreuche
- CHRU Lille, EA 2694, Santé Publique: épidémiologie et Qualité des Soins, Lille, France (J.L.)
| | - Hilde Henon
- Department of Neurology, Stroke Unit, CHRU Lille, Lille, France (H.H.)
| | - Olivier Naggara
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.)
| | - Bertrand Lapergue
- Department of Neurology, Stroke Unit, Foch Hospital, Suresnes, France (D.W.-L., B.L.)
| | - Grégoire Boulouis
- GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Service d'imagerie Morphologique et Fonctionnelle, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris (W.B.H., B.K., D.T., C.R.R., O.N., G.B.).,Department of Neuroradiology, CHRU Tours, Tours, France (B.K., K.J., D.H., H.I., G.B.)
| | | |
Collapse
|
13
|
Maldonado IL. Letter to the Editor Regarding "Clinical Application of Brain Plasticity in Neurosurgery". World Neurosurg 2021; 146:399. [PMID: 33607735 DOI: 10.1016/j.wneu.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Igor Lima Maldonado
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Department of Interventional Neuroradiology, CHRU de Tours, Tours, France.
| |
Collapse
|
14
|
Duque ACM, Monteiro L, Ghirello-Pires CSA, Maldonado IL, Zamilute IAG, Rodrigues B, Melo A. Hemisphere stroke: impact on the semantic lexical aspects of language. Clin Neurol Neurosurg 2021; 207:106722. [PMID: 34119899 DOI: 10.1016/j.clineuro.2021.106722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate if right hemisphere stroke is associated with decreased lexical-semantic ability. METHODS We compared subjects with right hemisphere brain damage after stroke with healthy controls using the validated version of the Montreal Evaluation of Communication to assess lexical-semantic domains of language. RESULTS Sixteen patients and thirty-two controls were included. The post-stroke group with right hemispheric brain lesions showed considerable limitations in metaphor interpretation, fluency, and semantic judgment. CONCLUSION Individuals with right hemisphere damage after stroke may present with language changes in the lexical-semantic aspects.
Collapse
Affiliation(s)
| | - Larissa Monteiro
- Postgraduate program in Medicine, Federal University of Bahia, Brazil.
| | | | - Igor Lima Maldonado
- Postgraduate program in Medicine and Health, Federal University of Bahia, Brazil.
| | | | | | - Ailton Melo
- Postgraduate program in Medicine and Health, Federal University of Bahia, Brazil.
| |
Collapse
|
15
|
Maldonado IL, Destrieux C, Ribas EC, Siqueira de Abreu Brito Guimarães B, Cruz PP, Duffau H. Composition and organization of the sagittal stratum in the human brain: a fiber dissection study. J Neurosurg 2021; 135:1214-1222. [PMID: 33418529 DOI: 10.3171/2020.7.jns192846] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 07/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The sagittal stratum is divided into two layers. In classic descriptions, the stratum sagittale internum corresponds to optic radiations (RADs), whereas the stratum sagittale externum corresponds to fibers of the inferior longitudinal fasciculus. Although advanced for the time it was proposed, this schematic organization seems simplistic considering the recent progress on the understanding of cerebral connectivity and needs to be updated. Therefore, the authors sought to investigate the composition of the sagittal stratum and to detail the anatomical relationships among the macroscopic fasciculi. METHODS The authors performed a layer-by-layer fiber dissection from the superolateral aspect to the ventricular cavity in 20 cadaveric human hemispheres. RESULTS Diverse bundles of white matter were observed to contribute to the sagittal stratum and their spatial arrangement was highly consistent from one individual to another. This was the case of the middle longitudinal fasciculus, the inferior fronto-occipital fasciculus, the RADs, and other posterior thalamic radiations directed to nonvisual areas of the cerebral cortex. In addition, small contributions to the sagittal stratum came from the anterior commissure anteriorly and the inferior longitudinal fasciculus inferiorly. CONCLUSIONS A general model of sagittal stratum organization in layers is possible, but the composition of the external layer is much more complex than is mentioned in classic descriptions. A small contribution of the inferior longitudinal fasciculus is the main difference between the present results and the classic descriptions in which this bundle was considered to entirely correspond to the stratum sagittale externum. This subject has important implications both for fundamental research and neurosurgery, as well as for the development of surgical approaches for the cerebral parenchyma and ventricular system.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- 1UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,2CHRU de Tours, France.,3Le Studium Loire Valley Institute for Advanced Studies, Orléans, France
| | - Christophe Destrieux
- 1UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,2CHRU de Tours, France
| | - Eduardo Carvalhal Ribas
- 4Department of Neurology, Discipline of Neurosurgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | | | - Patrícia Pontes Cruz
- 6Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brazil
| | - Hugues Duffau
- 7Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; and.,8INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, France
| |
Collapse
|
16
|
Maldonado IL, Parente de Matos V, Castro Cuesta TA, Herbet G, Destrieux C. The human cingulum: From the limbic tract to the connectionist paradigm. Neuropsychologia 2020; 144:107487. [PMID: 32470344 DOI: 10.1016/j.neuropsychologia.2020.107487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/22/2020] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Abstract
The cingulum is a core component of the limbic lobe and part of the circuit that was described by Papez where environmental experiences become endowed with emotional awareness. Recent techniques for the study of cerebral connectivity have updated this fasciculus' morphology and led to the acknowledgment that its involvement in superior functions goes far beyond emotion processing. Long and robust, the cingulum is a long association fasciculus with terminations in all cerebral lobes. These observations plead for a pivotal rethinking of its role in the human brain and lead to the conclusion that to merely consider it as the main fasciculus of the limbic system was actually a reductionism. This paper summarizes the key facts regarding why the cingulum is now perceived as a primary interconnecting apparatus in the medial aspect of the cerebral hemisphere.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- UMR Inserm U1253, IBrain, Université de Tours, Tours, France; Le Studium Loire Valley Institute for Advanced Studies, Orleans, France; CHRU de Tours, Tours, France; Departamento de Biomorfologia - Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação Em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil.
| | | | - Taryn Ariadna Castro Cuesta
- Programa de Pós-Graduação Em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; University of Montpellier, Institute of Functional Genomics, INSERM, 1191, Montpellier, France
| | - Christophe Destrieux
- UMR Inserm U1253, IBrain, Université de Tours, Tours, France; CHRU de Tours, Tours, France; Laboratory of Anatomy, Faculté de Médecine, 10 Bd Tonnellé, 37032, Tours, France
| |
Collapse
|
17
|
Dupuy-Bonafé I, Maldonado IL. "Please don't move": Cone-beam computed tomography and obstructive sleep apnea hypopnea syndrome. Am J Orthod Dentofacial Orthop 2019; 155:616-617. [PMID: 31053272 DOI: 10.1016/j.ajodo.2019.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 12/22/2018] [Accepted: 01/17/2017] [Indexed: 11/28/2022]
|
18
|
Saleh A, Marhuenda E, Fabre C, Hassani Z, Weille JD, Boukhaddaoui H, Guelfi S, Maldonado IL, Hugnot JP, Duffau H, Bauchet L, Cornu D, Bakalara N. A novel 3D nanofibre scaffold conserves the plasticity of glioblastoma stem cell invasion by regulating galectin-3 and integrin-β1 expression. Sci Rep 2019; 9:14612. [PMID: 31601895 PMCID: PMC6787018 DOI: 10.1038/s41598-019-51108-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 09/16/2019] [Indexed: 01/07/2023] Open
Abstract
Glioblastoma Multiforme (GBM) invasiveness renders complete surgical resection impossible and highly invasive Glioblastoma Initiating Cells (GICs) are responsible for tumour recurrence. Their dissemination occurs along pre-existing fibrillary brain structures comprising the aligned myelinated fibres of the corpus callosum (CC) and the laminin (LN)-rich basal lamina of blood vessels. The extracellular matrix (ECM) of these environments regulates GIC migration, but the underlying mechanisms remain largely unknown. In order to recapitulate the composition and the topographic properties of the cerebral ECM in the migration of GICs, we have set up a new aligned polyacrylonitrile (PAN)-derived nanofiber (NF) scaffold. This system is suitable for drug screening as well as discrimination of the migration potential of different glioblastoma stem cells. Functionalisation with LN increases the spatial anisotropy of migration and modulates its mode from collective to single cell migration. Mechanistically, equally similar to what has been observed for mesenchymal migration of GBM in vivo, is the upregulation of galectin-3 and integrin-β1 in Gli4 cells migrating on our NF scaffold. Downregulation of Calpain-2 in GICs migrating in vivo along the CC and in vitro on LN-coated NF underlines a difference in the turnover of focal adhesion (FA) molecules between single-cell and collective types of migration.
Collapse
Affiliation(s)
- Ali Saleh
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Emilie Marhuenda
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Christine Fabre
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Zahra Hassani
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Jan de Weille
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Hassan Boukhaddaoui
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Sophie Guelfi
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Igor Lima Maldonado
- UMR 1253, iBrain, Univ. Tours, Inserm, Tours, CHRU de Tours, Le Studium Loire Valley Institute for Advanced Studies, Montpellier, France
| | - Jean- Philippe Hugnot
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Hugues Duffau
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - Luc Bauchet
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France
| | - David Cornu
- Institut Européen des Membranes, IEM, UMR-5635, Univ. Montpellier, ENSCM, CNRS, Montpellier, France
| | - Norbert Bakalara
- Institut des Neurosciences de Montpellier, INM, U-1051, Univ. Montpellier, CHU de Montpellier, ENSCM, INSERM, Montpellier, France.
| |
Collapse
|
19
|
Souza DCB, de Sales Santos M, da Silva Ribeiro NM, Maldonado IL. Inpatient trunk exercises after recent stroke: An update meta-analysis of randomized controlled trials. NeuroRehabilitation 2019; 44:369-377. [PMID: 31177237 DOI: 10.3233/nre-182585] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Although the role of trunk exercises in the chronic phase of stroke is acknowledged, the addition of specific inpatient training in the subacute stage is a matter of debate and varies among centers. Recent new evidence suggests the question should be revisited. OBJECTIVE To assess the impact of the addition of specific trunk training to inpatient rehabilitation protocols after a recent stroke. METHODS A systematic review was performed assessing the impact of inpatient trunk training. The search was performed in LILACS, SciELO, PEDro, Cochrane, and NCBI PubMed databases for clinical trials published up to December 31st, 2017. The initial bibliographic research identified 3202 articles. After analyzing the titles, 19 abstracts were selected for detailed analysis. After application of the eligibility criteria, the final selection included nine studies. Outcome measurements from the same evaluation instruments were submitted to a meta-analysis to improve homogeneity (7 studies). RESULTS All patients in the included studies were recruited less than three months after a stroke. Seven studies assessed trunk control using the Trunk Impairment Scale (TIS). There was a significant improvement in trunk control with a pooled increase in TIS score of 3.3 points from the baseline (CI95:2.54-4.06, p < 0.0001). Three studies assessed balance using the Brunel Balance Assessment (BBA) scale. There was also a significant improvement in balance with a pooled increase in BBA score of 2.7 points (CI95:1.5-4.03, p < 0.0001). The Berg Balance Scale was used for balance assessment in three studies. The meta-analysis of their results showed a pooled increase of 13.2 points (CI95:9.49-16.84, p < 0.0001). Weight transfer was evaluated in four studies using different methods. The addition of inpatient trunk exercises was associated with an improvement in the ability to transfer the trunk laterally in three studies. CONCLUSION The introduction of trunk-based inpatient training protocols brings short-term benefits in trunk performance and balance in stroke patients.
Collapse
Affiliation(s)
- Daniele Costa Borges Souza
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Matheus de Sales Santos
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Nildo Manoel da Silva Ribeiro
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Unidade de Reabilitação, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Unidade Neuro-Músculo-Esquelética, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Le Studium Loire Valley Institute for Advanced Studies, Orléans, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| |
Collapse
|
20
|
Junior VADS, Santos MDS, Ribeiro NMDS, Maldonado IL. Combining Proprioceptive Neuromuscular Facilitation and Virtual Reality for Improving Sensorimotor Function in Stroke Survivors: A Randomized Clinical Trial. J Cent Nerv Syst Dis 2019; 11:1179573519863826. [PMID: 31384139 PMCID: PMC6659177 DOI: 10.1177/1179573519863826] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 06/23/2019] [Indexed: 12/31/2022] Open
Abstract
Aim: To assess a program combining virtual reality (VR) games and proprioceptive
neuromuscular facilitation (PNF) and to compare it with the standalone
techniques in stroke survivors. Methods: A randomized controlled clinical trial. A total of 48 participants were
recruited in the outpatient clinic of a University Hospital in Salvador,
Brazil. They were randomly assigned to 3 groups (n = 16 each): PNF, VR, and
PNF/VR. Participants attended twice-weekly 50-minute sessions over a 2-month
period. The PNF/VR group performed both PNF and VR exercises employing
Nintendo Wii electronic games. Motor performance was assessed before and
immediately after the treatment using the Fugl-Meyer Assessment scale. Results: An improvement in the mean scores was observed after treatment independent of
the allocation group with significant intragroup changes: 14.5, 10.5, and
10.4 for PNF, VR, and PNF/VR, respectively. Score changes were also observed
in the analyses of specific sections as follows: (1) a significant
improvement in the passive movement and pain score was observed in the PNF
and PNF/VR groups; (2) the same was observed for the motor function of the
upper limb in all groups, for the motor function of the lower limb in the VR
group and for balance in the PNF and PNF/VR groups. Conclusions: The use of a program combining virtual rehabilitation and PNF presented
results that were comparable with those obtained with the isolated
techniques.
Collapse
Affiliation(s)
- Vitor Antônio Dos Santos Junior
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Matheus de Sales Santos
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Nildo Manoel da Silva Ribeiro
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Unidade de Reabilitação, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Fisioterapia, Instituto de Ciências da Saúde and Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Unidade Neuro-Músculo-Esquelética, Serviço de Neurocirurgia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Biomorfologia, Instituto de Ciências da Saúde and Unidade Neuro-Músculo-Esquelética, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Le Studium Loire Valley Institute for Advanced Studies, Orléans, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| |
Collapse
|
21
|
Janot K, Charbonnier G, Boustia F, Lima Maldonado I, Bibi R, Pucheux J, Herbreteau D. [Stroke prevention]. Presse Med 2019; 48:655-663. [PMID: 31151843 DOI: 10.1016/j.lpm.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/02/2019] [Indexed: 11/26/2022] Open
Abstract
Prevention is essential to stroke management because of the high risk of recurrence. Stroke incidence is increased by known risk factors, which can be prevented. Cardiovascular prevention after stroke or TIA also includes aetiology-specific treatment, when it is known. Endovascular treatment is not indicated as a first-line treatment for atheromatous cervical or intracranial stenosis. Endovascular or surgical treatment is not indicated as first-line treatment for cervical arterial dissection because of its minor risk of stroke recurrence.
Collapse
Affiliation(s)
- Kevin Janot
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France.
| | - Guillaume Charbonnier
- Centre hospitalier universitaire de Besançon, service de neurologie, 25000 Besançon, France
| | - Fakhreddine Boustia
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Igor Lima Maldonado
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Richard Bibi
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| | - Julien Pucheux
- Hôpital Trousseau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de radiologie interventionnelle, 37000 Tours, France
| | - Denis Herbreteau
- Hôpital Bretonneau, université François-Rabelais de Tours, centre hospitalier régional universitaire de Tours, service de neuroradiologie interventionnelle, 37000 Tours, France
| |
Collapse
|
22
|
Lechanoine F, Smirnov M, Armani-Franceschi G, Carneiro P, Cottier P, Destrieux C, Maldonado IL. Stereoscopic Images from Computed Tomography Angiograms. World Neurosurg 2019; 128:259-267. [PMID: 31078804 DOI: 10.1016/j.wneu.2019.04.257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To present an adaptation of the anaglyph photography technique to be used with radiological images from computed tomography angiograms, enabling stereoscopic visualization of a patient's individual abnormal vascular anatomy for teaching, case discussion, or surgical planning purposes. METHODS Traditional anaglyph procedures with actual objects yield 2 independent photographs, simulating the image perceived by each eye. Production of anaglyphs from angiograms involve 3 basic procedures: volume rendering, image capture, and image fusion. Volume renderings were reconstructed using a free, open-source DICOM (Digital Imaging and Communications in Medicine) reader. Subsequently, the virtual object was positioned to mimic the operator's angle of view, and different perspectives of the reconstructed volume could be obtained through exclusively horizontal rotation. The 2 images were then fused after their color composition was modified so that each eye would perceive only 1 image when using anaglyph glasses. RESULTS Forty-three angiograms were reviewed for the purpose of this study and a total of 6 examinations were selected for illustration of the technique. Stereoscopic display was possible for all of them and in the 3 types of support tested: computer monitor, tablet, and smartphone screens. CONCLUSIONS Anaglyph display of computed tomography angiograms is an effective and low-cost alternative for the stereoscopic visualization of a patient's individual intracranial vascular anatomy.
Collapse
Affiliation(s)
- François Lechanoine
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Neurosurgery Department, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - Mykyta Smirnov
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Pedro Carneiro
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Philippe Cottier
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Tours, France
| | - Christophe Destrieux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Tours, France
| | - Igor Lima Maldonado
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Departamento de Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; CHRU de Tours, Tours, France; Le Studium Loire Valley Institute for Advanced Studies, Orleans, France.
| |
Collapse
|
23
|
Lechanoine F, Janot K, Herbreteau D, Maldonado IL, Velut S. Surgical Thrombectomy Combined with Bilateral Decompressive Craniectomy in a Life-Threatening Case of Coma from Cerebral Venous Sinus Thrombosis: Case Report and Literature Review. World Neurosurg 2018; 120:485-489. [DOI: 10.1016/j.wneu.2018.09.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
|
24
|
Machi P, Costalat V, Lobotesis K, Lima Maldonado I, Vendrell JF, Riquelme C, Bonafé A. Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients. J Neurointerv Surg 2018; 10:i27-i32. [PMID: 30037950 PMCID: PMC6241203 DOI: 10.1136/jnis.2010.004051.rep] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 03/07/2011] [Indexed: 11/26/2022]
Abstract
Background and purpose Prompt recanalization of cerebral arteries in patients diagnosed with acute ischemic
stroke is known to be associated with a better clinical outcome. The aim of this study
was to present our initial experience regarding the efficacy and safety of the Solitaire
FR as a revascularization device. Methods 56 consecutive patients presenting with acute ischemic stroke underwent intra-arterial
therapy using the Solitaire FR revascularization device. Immediate angiographic results
and early clinical outcomes are presented. Results Solitaire FR was successful in achieving recanalization in 50 out of 56 patients (89%)
with a final Thrombolysis in Cerebral Infarction score ≥2b. Five out of 56
patients had procedure related complications: two asymptomatic subarachnoid hemorrhages,
two thromboembolic events and one symptomatic intracranial hemorrhage (PH2). Thirty
patients (53.5%) demonstrated at discharge a National Institutes of Health Stroke Scale
Score of ≤1 or an improvement of at least 10 points from baseline, and 26
patients (46%) had a modified Rankin Score ≤2. Conclusions Solitaire FR is successful in achieving a high rate of arterial recanalization with a
low complication rate. The Solitaire FR is a promising thrombectomy tool with a high
degree of effectiveness, safety and ease of use.
Collapse
Affiliation(s)
- Paolo Machi
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Vincent Costalat
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Kyriakos Lobotesis
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Igor Lima Maldonado
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France.,Department of Neurological Surgery, Montpellier University Hospital, Montpellier, France
| | | | - Carlos Riquelme
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Alain Bonafé
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| |
Collapse
|
25
|
Maldonado IL, de Champfleur NM, Velut S, Destrieux C, Zemmoura I, Duffau H. Evidence of a middle longitudinal fasciculus in the human brain from fiber dissection. J Anat 2013; 223:38-45. [PMID: 23621438 PMCID: PMC3798102 DOI: 10.1111/joa.12055] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2013] [Indexed: 11/30/2022] Open
Abstract
A rostrocaudal pathway connecting the temporal and parietal lobes was described in monkeys using autoradiography and was named the middle longitudinal fasciculus (MdLF). Recently, the use of diffusion tensor tractography has allowed it to be depicted in human volunteers. In the present study, a technique of fiber dissection was used in 18 cadaveric human brains to investigate the presence of this fasciculus and to detail its anatomical relationships. On the basis of our findings, fiber dissection provides evidence for a long horizontal bundle medial to the arcuate fasciculus and extending to the superior temporal gyrus. Its fibers occupy the lateral-most layer of the upper portion of the stratum sagittale and partially cover the inferior fronto-occipital fasciculus, which is situated deeper and slightly inferiorly. Whereas MdLF fibers continue on a relatively superficial level to reach the superior temporal gyrus, the inferior fronto-occipital fasciculus penetrates the deep temporal white matter and crosses the insular lobe. Although diffusion tensor imaging suggests that the MdLF terminates in the angular gyrus, this was not confirmed by the present study. These long association fibers continue onward posteriorly into upper portions of the occipital lobe. Further studies are needed to understand the role of the MdLF in brain function.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- Depart. Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.
| | | | | | | | | | | |
Collapse
|
26
|
Deras P, Moulinié G, Maldonado IL, Moritz-Gasser S, Duffau H, Bertram L. Intermittent general anesthesia with controlled ventilation for asleep-awake-asleep brain surgery: a prospective series of 140 gliomas in eloquent areas. Neurosurgery 2013; 71:764-71. [PMID: 22989957 DOI: 10.1227/neu.0b013e3182647ab8] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Awake brain tumor surgery is a unique opportunity for mapping sensorimotor and cognitive functions, allowing the operator to optimize the resection while preserving the patient's quality of life. During this type of procedure, active participation of the patient is necessary. OBJECTIVE To assess the efficacy and safety of a method of intermittent general anesthesia with controlled ventilation for performing invasive cerebral mapping. METHODS We report our prospective and observational single-center study with an asleep-awake-asleep protocol. Aspects of feasibility, airway management, timing of each phase, and occurrence of adverse events were detailed. RESULTS During a 35-month period, 140 patients underwent resection of a glioma in an eloquent area. During the asleep phases, controlled ventilation with a laryngeal mask was always efficient. Orotracheal intubation was performed for some patients for the second asleep period. The patients remained fully awake for a mean time of 98 minutes. Postural discomfort was reported in 17.8% of cases. There was 1 case of aspiration of gastric contents with a favorable outcome and no mortality. CONCLUSION Intermittent general anesthesia with controlled ventilation for this type of neurosurgical procedure remains an anesthesiological challenge. However, the results of this study suggest that it may be feasible, reproducible, and relatively safe in the context of a standardized protocol involving members of both anesthesiology and surgery teams. Such a technique has a great potential to improve the surgical results, from both oncological and functional perspectives.
Collapse
Affiliation(s)
- Pauline Deras
- Department of Anesthesiology C, Gui de Chauliac University Hospital, Montpellier, France
| | | | | | | | | | | |
Collapse
|
27
|
Menjot de Champfleur N, Lima Maldonado I, Moritz-Gasser S, Machi P, Le Bars E, Bonafé A, Duffau H. Middle longitudinal fasciculus delineation within language pathways: a diffusion tensor imaging study in human. Eur J Radiol 2012; 82:151-7. [PMID: 23084876 DOI: 10.1016/j.ejrad.2012.05.034] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 05/17/2012] [Accepted: 05/19/2012] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The existence in the human brain of the middle longitudinal fasciculus (MdLF), initially described in the macaque monkey, is supported by diffusion tensor imaging studies. In the present work, we aim (1) to confirm that this fascicle is found constantly in control subjects with the use of DTI techniques and (2) to delineate the MdLF from the other fiber bundles that constitute the language pathways. MATERIALS AND METHODS Tractography was realized in four right-handed healthy volunteers for the arcuate fascicle, uncinate fascicle, inferior fronto-occipital fascicle, inferior longitudinal fascicle and the middle longitudinal fascicle. The fiber tracts were characterized for their size, mean fractional anisotropy (FA), for their length, number of streamlines, and lateralization indices were calculated. RESULTS The MdLF is found constantly and it is clearly delineated from the other fascicles that constitute the language pathways, especially the ventral pathway. It runs within the superior temporal gyrus white matter from the temporal pole, then it extends caudally in the upper part of the sagittal stratum and the posterior part of the corona radiata, to reach the inferior parietal lobule (angular gyrus). We found a leftward asymmetry for all fiber tracts when considering the mean FA. DISCUSSION Using DTI methods, we confirm that the MdLF connects the angular gyrus and the superior temporal gyrus. On the basis of these findings, the role of the MdLF is discussed. CONCLUSION The middle longitudinal fasciculus, connects the angular gyrus and the superior temporal gyrus and its course can be systematically differenciated from those of other fascicles composing both ventral and dorsal routes (IFOF, IFL, AF and UF).
Collapse
|
28
|
Vendrell JF, Mernes R, Nagot N, Milhaud D, Lobotesis K, Costalat V, Machi P, Maldonado IL, Riquelme C, Arquizan C, Bonafe A. Evaluation of an intravenous-endovascular strategy in patients with acute proximal middle cerebral artery occlusion. AJNR Am J Neuroradiol 2012; 34:603-8. [PMID: 22878011 DOI: 10.3174/ajnr.a3230] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE IVT administered in acute ischemic stroke provides low recanalization rates in proximal intracranial occlusions, with consequently poor clinical outcome. The safety and efficacy of an IES by using mechanical thrombectomy after IVT failure were assessed in acute MCA occlusions. MATERIALS AND METHODS Patients presenting with acute MCA occlusion within 4.5 hours with an NIHSS score between 8 and 25 and a DWI ASPECTS of >5 were eligible. From September 2009 to September 2010, mechanical thrombectomy by using the Solitaire FR device was systematically performed if no clinical improvement was observed 1 hour after the initiation of IVT (IES group). Results in terms of clinical outcome were compared with those from an IVT series from January 2007 to August 2009 (IVT group). RESULTS Alteplase was administered in 123 patients with proximal intracranial occlusion. Fifty-six had a confirmed MCA occlusion: 32 were included in the IVT group; and 24, in the IES group. At 24 hours, the median NIHSS improvement was 8.5 points in the IES group (25%-75% CI, 1.5-13) and 3 points in the IVT group (25%-75% CI, 1-5) (P = .001). At 3 months, 17/22 (77%) patients from the IES group and 15/30 (50%) from the IVT group had an mRS score of ≤2. After adjustment for confounding variables, IES was strongly associated with favorable clinical outcome (77% versus 50%; adjusted odds ratio = 11.9; 95% CI, 1.6-89.1; P < .02). No symptomatic intracranial hemorrhage was observed. CONCLUSIONS IES by using systematic mechanical thrombectomy after IVT failure safely improves the clinical outcome at 3 months and could represent an interesting alternative in the management of patients with acute MCA occlusion.
Collapse
Affiliation(s)
- J-F Vendrell
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Moritz-Gasser S, Herbet G, Maldonado IL, Duffau H. Lexical access speed is significantly correlated with the return to professional activities after awake surgery for low-grade gliomas. J Neurooncol 2012; 107:633-41. [DOI: 10.1007/s11060-011-0789-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 12/26/2011] [Indexed: 01/06/2023]
|
30
|
Maldonado IL, De Champfleur NM, Bonafé A, El-Fertit H. Bilateral Idiopathic Occlusion of the Foramina of Monro. Eur Neurol 2012; 67:167. [DOI: 10.1159/000335080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 11/14/2011] [Indexed: 11/19/2022]
|
31
|
Costalat V, Maldonado IL, Vendrell JF, Riquelme C, Machi P, Arteaga C, Turjman F, Desal H, Sedat J, Bonafé A. Endovascular treatment of symptomatic intracranial stenosis with the Wingspan stent system and Gateway PTA balloon: a multicenter series of 60 patients with acute and midterm results. J Neurosurg 2011; 115:686-93. [DOI: 10.3171/2011.5.jns101583] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The limitations of the medical management of symptomatic intracranial arterial stenosis (SIAS) have encouraged the development of new strategies, such as endovascular treatment. In this study, the authors report and analyze a series of 63 endovascular procedures in which the Wingspan stent system was used.
Methods
Data from 60 patients presenting with refractory SIAS, treated in 5 French neurointerventional centers between September 2006 and August 2009, were retrieved. An angiogram was systematically obtained 6 months after the procedure and yearly thereafter. The clinical neurological status was assessed and reported using the modified Rankin scale at 1-month, 6-month, and 1-year follow-up visits.
Results
A total of 63 stenotic lesions was treated. The mean age of the patients was 65.3 years, and the mean diameter of the stenosis was 80.2%. Technical success was achieved in 95.2% of cases. The overall incidence of procedural complications was 20.6%, with a 4.8% rate of permanent postoperative morbidity and death. In-stent restenosis (ISR)/occlusion occurred in 11 cases (17.4%), of which 10 were asymptomatic and 9 were detected less than 1 year from the endovascular treatment. In 1 case, the patient presented with a recurrent transient ischemic attack and was treated again with angioplasty. The mean follow-up was 13.2 months.
Conclusions
Endovascular treatment of SIAS demonstrates a moderate risk of neurological complication. Nevertheless, considering the critical natural history of severe refractory lesions, this may be considered the first alternative in cases of failed medical therapy. Technical failure, residual stenosis, or in-stent restenosis did not lead to systematic recurrent stroke in this series, which suggests the importance of plaque stabilization and neoendothelialization.
Collapse
Affiliation(s)
- Vincent Costalat
- 1Department of Neuroradiology, Montpellier University Hospital, Montpellier
| | | | | | - Carlos Riquelme
- 1Department of Neuroradiology, Montpellier University Hospital, Montpellier
| | - Paolo Machi
- 1Department of Neuroradiology, Montpellier University Hospital, Montpellier
| | - Charles Arteaga
- 2Department of Neuroradiology, Sainte-Anne Army Hospital, Toulon
| | - Francis Turjman
- 3Department of Diagnostic and Interventional Neuroradiology, Lyon Neurological Hospital, Lyon
| | - Hubert Desal
- 4Department of Neuroradiology, Nantes University Hospital, Nantes; and
| | - Jacques Sedat
- 5Department of Neuroradiology, Nice University Hospital, Nice, France
| | - Alain Bonafé
- 1Department of Neuroradiology, Montpellier University Hospital, Montpellier
| |
Collapse
|
32
|
Blonski M, Taillandier L, Herbet G, Maldonado IL, Beauchesne P, Fabbro M, Campello C, Gozé C, Rigau V, Moritz-Gasser S, Kerr C, Rudà R, Soffietti R, Bauchet L, Duffau H. Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life. J Neurooncol 2011; 106:353-66. [PMID: 21785913 DOI: 10.1007/s11060-011-0670-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 07/13/2011] [Indexed: 11/26/2022]
Abstract
Diffuse WHO grade II (GIIG) may be unresectable when involving critical structures. To assess the feasibility and functional tolerance (cognition and quality of life) of an original therapeutic strategy combining neoadjuvant chemotherapy followed by surgical resection for initially inoperable GIIG. Ten patients underwent Temozolomide for unresectable GIIG, as initial treatment or at recurrence after previous partial resection, due to invasion of eloquent areas or bi-hemispheric diffusion preventing a total/subtotal removal. Functional outcome after both treatments was assessed, with evaluation of seven cognitive domains. Chemotherapy induced tumor shrinkage (median volume decrease 38.9%) in ipsilateral functional areas in six patients and in the contralateral hemisphere in four. Only four patients had a 1p19q codeletion. The tumor shrinkage made possible the resection (mean extent of resection 93.3%, 9 total or subtotal removals) of initially inoperable tumors. Postoperatively, three patients had no deficits, while verbal episodic memory and executive functions were slightly impaired in seven patients. However, global quality of life was roughly preserved on the EORTC QLQ C30 + BN 20 (median score: 66.7%). Role functioning score was relatively reduced (median score: 66.7%) whereas KPS was preserved (median score: 90, range 80-100). Seven patients became seizure-free while three improved. This combined treatment is feasible, efficient (surgery made possible by neoadjuvant chemotherapy) and well-tolerated (preservation of quality of life, no serious cognitive disturbances). Cognitive deficits seem mostly related to tumor location. Because KPS is not reliable enough, a detailed neuropsychological assessment should be systematically performed in GIIG.
Collapse
Affiliation(s)
- Marie Blonski
- Division of Neuro-Oncology, Department of Neurology, Nancy University Hospital, Nancy, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Maldonado IL, Moritz-Gasser S, de Champfleur NM, Bertram L, Moulinié G, Duffau H. Surgery for gliomas involving the left inferior parietal lobule: new insights into the functional anatomy provided by stimulation mapping in awake patients. J Neurosurg 2011; 115:770-9. [PMID: 21699481 DOI: 10.3171/2011.5.jns112] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Surgery in the left dominant inferior parietal lobule (IPL) is challenging because of a high density of somatosensory and language structures, both in the cortex and white matter. In the present study, on the basis of the results provided by direct cerebral stimulation in awake patients, the authors revisit the anatomofunctional aspects of surgery within the left IPL. METHODS Fourteen consecutive patients underwent awake craniotomy for a glioma involving the left IPL. Intraoperative motor, sensory, and language mapping was performed before and during the tumor removal, at both the cortical and subcortical levels, to optimize the extent of resection, which was determined based on functional boundaries. Anatomofunctional correlations were performed by combining the results of intraoperative mapping and those provided by pre- and postoperative MR imaging. RESULTS At the cortical level, the primary somatosensory area (retrocentral gyrus) limited the resection anteriorly in all cases, at least partially. Less frequently, speech arrest or articulatory problems were observed within the parietal operculum (4 cases). The lateral limit was determined by language sites that were variably distributed. Anomia was the most frequent response (9 cases) at the posterior third of the superior (and/or middle) temporal gyrus. Posteriorly, less reproducible reorganized language sites were seldom observed in the posterior portion of the angular gyrus (2 cases). At the subcortical level, in addition to somatosensory responses due to stimulation of the thalamocortical pathways, articulatory disturbances were induced by stimulation of white matter in the anterior and lateral part of the surgical cavity (11 cases). This tract anatomically corresponds to the horizontal portion of the lateral segment of the superior longitudinal fascicle (SLF III). Deeper and superiorly, phonemic paraphasia was the main language disturbance (12 cases), elicited by stimulation of the posterosuperior portion of the arcuate fascicle. All these eloquent structures were surgically preserved. Despite slight cognitive disorders (working memory, writing, or calculation) in 6 cases, no patient retained a severe or a moderate postoperative deficit (except one with right hemianopia [mean follow-up 41.8 months]). Resection was total or near total in 9 patients and partial in 3 cases. CONCLUSIONS To the authors' knowledge, this is the first series dedicated to the surgery of gliomas involving the left IPL. Interestingly, a certain degree of interindividual variability was observed in the distribution of the cortical maps, especially for language. Therefore, it is suggested that no rigid pattern of resection can be considered within the left IPL, and that surgery in this region should be performed in awake patients to adapt the tumor removal to individual functional limits. Nonetheless, several landmarks have been regularly identified, especially at the subcortical levels (SLF III and arcuate fascicle); a better knowledge of these functional tracts could be helpful to optimize functional outcomes.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier University Hospital, Montpellier, France
| | | | | | | | | | | |
Collapse
|
34
|
Machi P, Costalat V, Lobotesis K, Maldonado IL, Vendrell JF, Riquelme C, Bonafé A. Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients. J Neurointerv Surg 2011; 4:62-6. [PMID: 21990438 PMCID: PMC3240775 DOI: 10.1136/jnis.2010.004051] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background and purpose Prompt recanalization of cerebral arteries in patients diagnosed with acute ischemic stroke is known to be associated with a better clinical outcome. The aim of this study was to present our initial experience regarding the efficacy and safety of the Solitaire FR as a revascularization device. Methods 56 consecutive patients presenting with acute ischemic stroke underwent intra-arterial therapy using the Solitaire FR revascularization device. Immediate angiographic results and early clinical outcomes are presented. Results Solitaire FR was successful in achieving recanalization in 50 out of 56 patients (89%) with a final Thrombolysis in Cerebral Infarction score ≥2b. Five out of 56 patients had procedure related complications: two asymptomatic subarachnoid hemorrhages, two thromboembolic events and one symptomatic intracranial hemorrhage (PH2). Thirty patients (53.5%) demonstrated at discharge a National Institutes of Health Stroke Scale Score of ≤1 or an improvement of at least 10 points from baseline, and 26 patients (46%) had a modified Rankin Score ≤2. Conclusions Solitaire FR is successful in achieving a high rate of arterial recanalization with a low complication rate. The Solitaire FR is a promising thrombectomy tool with a high degree of effectiveness, safety and ease of use.
Collapse
Affiliation(s)
- Paolo Machi
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France.
| | | | | | | | | | | | | |
Collapse
|
35
|
Maldonado IL, Moritz-Gasser S, Duffau H. Does the left superior longitudinal fascicle subserve language semantics? A brain electrostimulation study. Brain Struct Funct 2011; 216:263-74. [PMID: 21538022 DOI: 10.1007/s00429-011-0309-x] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Accepted: 03/05/2011] [Indexed: 11/30/2022]
Abstract
Recent diffusion tensor imaging (DTI) tractography studies indicate that the supramarginal gyrus (SMG) represents a relay between frontal and temporal language sites. Some authors postulate that pathways connecting SMG to the posterior temporal lobe, i.e., the posterior part of the superior longitudinal fascicle (SLF) subserve semantic aspects of language. However, DTI provides only anatomic but not functional data. Therefore, it is impossible to conclude. Interestingly, intra-operative electrical mapping of cortical and subcortical language structures during tumor surgery is recognized as a reliable technique in functional neuroanatomy research. We mapped the underlying white matter of the SMG, especially the SLF, in 11 patients who underwent awake surgery for a glioma involving the left inferior parietal lobule. Using direct electrostimulation, we investigated the exact role of the SLF in language. Our findings indicate that the white matter under the inferior parietal lobule is highly involved in the dorsal phonological system. First, the SMG, connected to the ventral premotor cortex by horizontal fibers of the SLF, subserves articulatory processing, as demonstrated by dysarthria elicited by stimulation. Second, long arcuate fibers, found deeper in the white matter, subserve phonological processing, as supported by phonemic paraphasia induced by electrostimulation. Third, the most important result is that no semantic disturbances were elicited by stimulating the SLF, including its posterior part. Furthermore, no semantic disorders occurred postoperatively. Subcortical brain mapping by direct electrical stimulation does not provide arguments for a possible role of the left SLF in language semantic processing.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- Department of Neurosurgery, Hôpital Gui de Chauliac, CHU Montpellier, 80 Av Augustin Fliche, 34295 Montpellier, France
| | | | | |
Collapse
|
36
|
Maldonado IL, Moritz-Gasser S, Duffau H. Does the left superior longitudinal fascicle subserve language semantics? A brain electrostimulation study. Brain Struct Funct 2011. [DOI: 10.1007/s00429-011-0309-x (2011)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
|
37
|
Costalat V, Maldonado IL, Zerlauth JB, Menjot N, Riquelme C, Machi P, Vendrell JF, Bonafé A. Endovascular Treatment of Symptomatic Intracranial Arterial Stenosis: Six-Year Experience in a Single-Center Series of 42 Consecutive Patients With Acute and Mid-Term Results. Neurosurgery 2010; 67:1505-13; discussion 1513-4. [DOI: 10.1227/neu.0b013e3181f7ef1f] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
The limitations of the medical management of symptomatic intracranial arterial stenosis encourage the development of new therapeutic strategies such as intracranial stenting.
OBJECTIVE:
To report and analyze the results of a series of 42 patients treated with 3 different endovascular techniques: isolated angioplasty, balloon-expandable coronary stents, and the Wingspan self-expandable intracranial stent system.
METHODS:
Forty-two patients presenting with symptomatic intracranial arterial stenosis were treated with one of these techniques. Computed tomography angiography was performed 6 months after the procedure, and the clinical neurological statuses were categorized using the modified Rankin Scale and the National Institutes of Health Stroke Scale.
RESULTS:
A total of 42 lesions were treated: 9 with isolated angioplasty, 14 with balloon-expandable coronary stents, and 19 with Wingspan self-expandable intracranial stents. The mean patient age was 62.9 years, and the mean arterial diameter stenosis was 73.9%. Technical success was achieved in 97.6% of the patients. The overall incidence of procedural complications was 21.4%, and the postoperative permanent morbidity/mortality rate was 7.1%. There were 3 cases of in-stent thrombosis (1 fatal) and 5 cases of asymptomatic restenosis (11.9%), 3 in the isolated angioplasty group and 2 in the Wingspan self-expandable intracranial stent group (mean follow-up 20.4 months). The rate of restenosis was higher in the angioplasty group (33%) than in the coronary (0%) and Wingspan stent (10.5%) groups.
CONCLUSION:
Endovascular treatment of symptomatic intracranial stenosis has significant overall morbidity and mortality rates. Nevertheless, the very critical natural history of severe refractory lesions and the relatively favorable postoperative evolution suggest that it should be considered the first alternative strategy in cases in which medical therapy has failed.
Collapse
Affiliation(s)
- Vincent Costalat
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Igor Lima Maldonado
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | | | - Nicolas Menjot
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Carlos Riquelme
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | - Paolo Machi
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| | | | - Alain Bonafé
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
| |
Collapse
|
38
|
Maldonado IL, Machi P, Costalat V, Mura T, Bonafé A. Neuroform stent-assisted coiling of unruptured intracranial aneurysms: short- and midterm results from a single-center experience with 68 patients. AJNR Am J Neuroradiol 2010; 32:131-6. [PMID: 20966053 DOI: 10.3174/ajnr.a2245] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Intracranial stent placement assists in the coiling of wide-neck aneurysms and aids in reconstructing and protecting the parent artery. In this study, we analyze our experience in the use of the Neuroform system. MATERIALS AND METHODS Records of patients treated with a Neuroform stent from June 2003 to September 2007 were retrieved from a data base for analysis of population characteristics, occurrence of complications, and acute and midterm angiographic results. RESULTS Sixty-eight patients harboring 76 aneurysms located primarily in the anterior circulation were treated. There were 5 cases (6.6%) of clot formation after deployment (1 with a permanent neurologic deficit), 1 case of perioperative stent displacement with hemorrhage, and 5 cases (6.6%) of transient neurologic deficit due to thromboembolic events. The morbidity-mortality rate at discharge was 2.9%. One patient presented with a delayed in-stent thrombosis, and 3 others, with silent stenosis. Twenty-four aneurysms (31.6%) were completely occluded in the initial embolization. However, a marked increase in the occlusion rate was observed, with 44 of the 68 aneurysms (64.7%) examined at the 18-month follow-up and 26 of the 46 aneurysms (56.5%) examined in the 3-year follow-up presenting with complete occlusion. At the end of the study, a neck remnant was present in 6 aneurysms (13%) and a residual sac, in 7 (15.2%). Mean follow-up time was 25.7 months. CONCLUSIONS The present series demonstrates the relative safety and feasibility of the Neuroform stent-assisted coiling technique, which seems to provide better results over coiling alone for wide-neck aneurysms. Angiographic results improve with time due to progressive thrombosis of the aneurysm.
Collapse
Affiliation(s)
- I L Maldonado
- Department of Neuroradiology, Montpellier University Hospital, Montpellier, France.
| | | | | | | | | |
Collapse
|
39
|
Abstract
INTRODUCTION Chronically shunted patients are believed to be unable to have a shunt-free life. Nevertheless, sometimes shunt removal is possible after an endoscopic third ventriculostomy, even after long periods of cerebral spinal fluid diversion. RESULTS AND DISCUSSION We perform a literature review that leads to a discussion of this subject in the light of the current medical knowledge.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- Division of Neurological Surgery, Gui de Chauliac Hospital, University of Montpellier I, Montpellier, France.
| | | | | |
Collapse
|
40
|
Maldonado IL, Roujeau T, Cif L, Gonzalez V, El-Fertit H, Vasques X, Bonafe A, Coubes P. Magnetic Resonance-Based Deep Brain Stimulation Technique: A Series of 478 Consecutive Implanted Electrodes With No Perioperative Intracerebral Hemorrhage. Oper Neurosurg (Hagerstown) 2009; 65:196-201; discussion 201-2. [DOI: 10.1227/01.neu.0000342404.14347.fb] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
Objective:
The aim of this study was to determine the safety of a deep brain stimulation technique consisting of a combination of routine general anesthesia, magnetic resonance imaging direct targeting, and a single penetration technique in a large population of patients undergoing operation for movement disorders.
Methods:
One hundred ninety-four patients treated with deep brain stimulation between 1996 and 2007 were assessed via a computerized database for intra- and perioperative events. Most patients were young; only 62 of them were older than 40 years (mean age, 31.1 years). General anesthesia was induced in all cases before placement of a magnetic resonance imaging-compatible stereotactic frame. Electrode implantation was done under radioscopic control via a rigid immobile cannula using a single cerebral perforation. No perioperative microelectrode recording or neurostimulation testing was used. Systematic postoperative magnetic resonance imaging was performed before frame removal.
Results:
A total of 478 electrodes were implanted in 220 procedures: 426 for d ystonic-dyskinetic syndromes and 52 for Parkinson disease. The mean number of parenchymal penetrations per patient was 2.5 for the dystonic-dyskinetic syndrome group and 2.08 for the Parkinson disease group. Postimplantation magnetic resonance imaging detected no perioperative intraparenchymal hemorrhages.
Conclusion:
We consider that the risk of hemorrhagic complication is multifactorial but closely related to the chosen technique.
Collapse
Affiliation(s)
- Igor Lima Maldonado
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| | - Thomas Roujeau
- Department of Neurosurgery, University Hospital Necker-Enfants Malades, Paris, France
| | - Laura Cif
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| | - Victoria Gonzalez
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| | - Hassan El-Fertit
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| | - Xavier Vasques
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| | - Alain Bonafe
- Department of Neuroradiology, University Hospital of Montpellier, Montpellier, France
| | - Phillippe Coubes
- Department of Neurosurgery, Research Unit on Movement Disorders, University Hospital of Montpellier, Montpellier, France
| |
Collapse
|