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Edwards MR, Garcia Mora JK, Fowler KM, Vezza C, Robertson JL, Daniel GB, Shinn RL, Parker RL, Werre SR, Rossmeisl JH. Magnetic resonance and computed tomographic imaging characteristics and potential molecular mechanisms of feline meningioma associated calvarial hyperostosis. Vet Comp Oncol 2024; 22:174-185. [PMID: 38332673 DOI: 10.1111/vco.12964] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
Meningiomas are the most common feline primary brain tumours, and calvarial hyperostosis (CH) is frequently documented in association with this neoplastic entity. The clinical significance of and mechanisms driving the formation of CH in cats with meningiomas are poorly understood, although tumour invasion into the skull and tumour production of cytokines and enzymes have been implicated as causes of CH in humans. This retrospective study investigated relationships between signalment, MRI or CT imaging features, histopathologic tumour characteristics, alkaline phosphatase (ALP) isoenzyme concentrations, tumour expression of matrix metalloproteinases (MMP)-2, MMP-9, and interleukin-6 (IL-6), and progression free survival times (PFS) following surgical treatment in 27 cats with meningiomas with (n = 15) or without (n = 12) evidence of CH. No significant differences in breed, age, sex, body weight, tumour grade, tumour volume, peritumoral edema burden, ALP isoenzyme concentrations, tumour Ki-67 labelling indices or MMP-2 or MMP-9 expression and activity, or PFS were noted between cats with or without CH. There was a trend towards higher serum (p = .06) and intratumoral (p = .07) concentrations of IL-6 in cats with CH, but these comparisons were not statistically significant. Histologic evidence of tumour invasion into bone was observed in 5/12 (42%) with CH and in no (0/6) cats without CH, although this was not statistically significant (p = .07). Tumour invasion into bone and tumour production of IL-6 may contribute to the formation of meningioma associated CH in cats, although larger studies are required to further substantiate these findings and determine their clinical relevance.
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Affiliation(s)
- Michael R Edwards
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Josefa K Garcia Mora
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Kayla M Fowler
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Christina Vezza
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - John L Robertson
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Gregory B Daniel
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Richard L Shinn
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Rell L Parker
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Stephen R Werre
- Laboratory for Study Design and Statistical Analysis, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
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O'Neill K, Syed N, Crook T, Dubey S, Potharaju M, Limaye S, Ranade A, Anichini G, Patil D, Datta V, Datar R. Profiling of circulating glial cells for accurate blood-based diagnosis of glial malignancies. Int J Cancer 2024; 154:1298-1308. [PMID: 38146864 DOI: 10.1002/ijc.34827] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 12/27/2023]
Abstract
Here, we describe a blood test for the detection of glial malignancies (GLI-M) based on the identification of circulating glial cells (CGCs). The test is highly specific for GLI-M and can detect multiple grades (II-IV) and subtypes including gliomas, astrocytomas, oligodendrogliomas, oligoastrocytomas and glioblastomas, irrespective of gender and age. Analytical validation of the test was performed as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Real-world performance characteristics of the test were evaluated in four clinical (observational) studies. The test has high analytical sensitivity (95%), specificity (100%) and precision (coefficient of variation [CV] = 13.7% for repeatability and CV = 23.5% for within laboratory precision, both at the detection threshold) and is not prone to interference from common drugs and serum factors. The ability of the test to detect and differentiate GLI-M from non-malignant brain tumours (NBT), brain metastases from primary epithelial malignancies (EPI-M) and healthy individual donors (HD) was evaluated in four clinical cohorts. Across these clinical studies, the test showed 99.35% sensitivity (95% confidence interval [CI]: 96.44%-99.98%) and 100% specificity (95% CI: 99.37%-100%). The performance characteristics of this test support its clinical utility for diagnostic triaging of individuals presenting with intracranial space-occupying lesions (ICSOL).
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Affiliation(s)
- Kevin O'Neill
- Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK
| | - Nelofer Syed
- Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, UK
| | - Timothy Crook
- Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, UK
| | - Sudhir Dubey
- Institute of Neurosciences, Medanta-The Medicity, Gurugram, India
| | - Mahadev Potharaju
- Department of Radiation Oncology, Apollo Speciality Hospitals, Chennai, India
| | - Sewanti Limaye
- Department of Medical and Precision Oncology, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, India
| | | | - Giulio Anichini
- Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, UK
| | - Darshana Patil
- Department of Research and Innovations, Datar Cancer Genetics, Nasik, India
| | - Vineet Datta
- Department of Research and Innovations, Datar Cancer Genetics, Nasik, India
| | - Rajan Datar
- Department of Research and Innovations, Datar Cancer Genetics, Nasik, India
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Richards A, Zaben M, Patel C, Leach P. The need for hair removal in paediatric brain tumour surgery? Br J Neurosurg 2024; 38:346-348. [PMID: 33455445 DOI: 10.1080/02688697.2021.1872777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/22/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Preoperative hair removal is conventional practice within neurosurgery in an attempt to maintain antisepsis. However, there is a lack of evidence to suggest that it makes a difference with regards to infection. This article aims to relate preoperative hair removal to SSIs for paediatric patients. METHODS AND MATERIALS A retrospective analysis was conducted from a single paediatric neurosurgical database at the University Hospital of Wales. Patients were grouped according to whether they underwent preoperative hair removal or not. Findings were reviewed in light of the previously published literature. RESULTS One hundred eighty two paediatric intracranial tumours were operated on between November 2008 and 2019. A total of twenty-six patients (14%) developed an infection post-operatively, of which meningitis was the most common (77%). Eighty-nine operations were undertaken without preoperative hair removal, of which there were a total of fifteen infections (17%). In the hair removal group, there were a total of eleven infections out of ninety-three operations (12%). Overall, the patients without hair removal had a higher infection rate when compared to those with hair removal (17 and 12% respectively), however, this result was not statistically significant (p-value 0.3989). CONCLUSION We did not find evidence that hair removal in paediatric neurosurgery effects postoperative infection risk.
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Affiliation(s)
| | - Malik Zaben
- Department of Neurosurgery, School of Medicine, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Chirag Patel
- Department of Paediatric Neurosurgery, University Hospital of Wales, Cardiff, UK
| | - Paul Leach
- Department of Paediatric Neurosurgery, University Hospital of Wales, Cardiff, UK
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4
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Ruis C, Robe PA, Dijkerman HC. Preserving the ability to discriminate between left and right; A case study. J Neuropsychol 2024; 18 Suppl 1:85-90. [PMID: 37771271 DOI: 10.1111/jnp.12348] [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: 12/09/2022] [Revised: 08/29/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
Left-right orientation, a function related to the parietal lobe, is important for many daily activities. Here, we describe a left-handed patient with a right parietal brain tumour. During awake surgery, electric stimulation of the right inferior parietal lobe resulted in mistakes in his left-right orientation. Postoperatively our patient had no problems in discriminating left right. This case report shows that monitoring of left-right orientation during awake brain tumour surgery is feasible so that this function can be preserved.
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Affiliation(s)
- Carla Ruis
- Helmholtz Institute, Experimental Psychology, Utrecht University, Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Pierre A Robe
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - H Chris Dijkerman
- Helmholtz Institute, Experimental Psychology, Utrecht University, Utrecht, The Netherlands
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Chapman TP, Farrell SM, Plaha P, Green AL, Moosavi SH. Blunted perception of breathlessness in three cases of low grade insular-glioma. Front Neurosci 2024; 18:1339839. [PMID: 38410161 PMCID: PMC10894922 DOI: 10.3389/fnins.2024.1339839] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Better understanding of breathlessness perception addresses an unmet clinical need for more effective treatments for intractable dyspnoea, a prevalent symptom of multiple medical conditions. The insular-cortex is predominantly activated in brain-imaging studies of dyspnoea, but its precise role remains unclear. We measured experimentally-induced hypercapnic air-hunger in three insular-glioma patients before and after surgical resection. Tests involved one-minute increments in inspired CO2, raising end-tidal PCO2 to 7.5 mmHg above baseline (38.5 ± 5.7 mmHg), whilst ventilation was constrained (10.7 ± 2.3 L/min). Patients rated air-hunger on a visual analogue scale (VAS). Patients had lower stimulus-response (2.8 ± 2 vs. 11 ± 4 %VAS/mmHg; p = 0.004), but similar threshold (40.5 ± 3.9 vs. 43.2 ± 5.1 mmHg), compared to healthy individuals. Volunteered comments implicated diminished affective valence. After surgical resection; sensitivity increased in one patient, decreased in another, and other was unable to tolerate the ventilatory limit before any increase in inspired CO2.We suggest that functional insular-cortex is essential to register breathlessness unpleasantness and could be targeted with neuromodulation in chronically-breathless patients. Neurological patients with insula involvement should be monitored for blunted breathlessness to inform clinical management.
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Affiliation(s)
- Tom P. Chapman
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, United Kingdom
- Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
| | - Sarah M. Farrell
- Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Puneet Plaha
- Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Alexander L. Green
- Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Shakeeb H. Moosavi
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, United Kingdom
- Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
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Nisanova A, Barrios L, Chokshi T, Mannis M, Bloch O, Liu YA. A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours. Neuroophthalmology 2024; 48:3-12. [PMID: 38357627 PMCID: PMC10863346 DOI: 10.1080/01658107.2023.2273471] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.
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Affiliation(s)
- Arina Nisanova
- School of Medicine, University of California, Davis, California, USA
| | - Laurel Barrios
- School of Medicine, University of California, Davis, California, USA
| | - Tanvi Chokshi
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Mark Mannis
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, California, USA
| | - Yin Allison Liu
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
- Department of Neurological Surgery, University of California, Davis, California, USA
- Department of Neurology, University of California, Davis, California, USA
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Rethemiotaki I. Brain tumour detection from magnetic resonance imaging using convolutional neural networks. Contemp Oncol (Pozn) 2024; 27:230-241. [PMID: 38405206 PMCID: PMC10883197 DOI: 10.5114/wo.2023.135320] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/02/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction The aim of this work is to detect and classify brain tumours using computational intelligence techniques on magnetic resonance imaging (MRI) images. Material and methods A dataset of 3264 MRI brain images consisting of 4 categories: unspecified glioma, meningioma, pituitary, and healthy brain, was used in this study. Twelve convolutional neural networks (GoogleNet, MobileNetV2, Xception, DesNet-BC, ResNet 50, SqueezeNet, ShuffleNet, VGG-16, AlexNet, Enet, EfficientB0, and MobileNetV2 with meta pseudo-labels) were used to classify gliomas, meningiomas, pituitary tumours, and healthy brains to find the most appropriate model. The experiments included image preprocessing and hyperparameter tuning. The performance of each neural network was evaluated based on accuracy, precision, recall, and F-measure for each type of brain tumour. Results The experimental results show that the MobileNetV2 convolutional neural network (CNN) model was able to diagnose brain tumours with 99% accuracy, 98% recall, and 99% F1 score. On the other hand, the validation data analysis shows that the CNN model GoogleNet has the highest accuracy (97%) among CNNs and seems to be the best choice for brain tumour classification. Conclusions The results of this work highlight the importance of artificial intelligence and machine learning for brain tumour prediction. Furthermore, this study achieved the highest accuracy in brain tumour classification to date, and it is also the only study to compare the performance of so many neural networks simultaneously.
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Affiliation(s)
- Irene Rethemiotaki
- School of Electrical and Computer Engineering, Technical University of Crete, Chania, Crete, Greece
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Nyatanga B, Wormington R, Wilkinson L. Exploring the experiences of adults adjustment when living with a primary brain tumour. Int J Palliat Nurs 2024; 30:66-78. [PMID: 38407152 DOI: 10.12968/ijpn.2024.30.2.66] [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: 02/27/2024]
Abstract
BACKGROUND Brain tumours are the ninth most common cancer in the UK, and account for 3% of all new cancer cases. AIM To understand the impact of living with a primary brain tumour and identify adjustments that patients make in order to cope with their condition. This also encomapsses the impact of interventions like support groups in terms of care and therapeutic value. METHODS After ethical approval, a qualitative approach was employed, which set out to interview 11 adult patients living with primary brain tumours. The interviews were conducted face-to-face and were semi-structured interviews. Interview data were coded and thematic analysis used. FINDINGS Four themes were developed, namely: adjustment; loss of independence; support; and health and symptoms. CONCLUSION Living with a brain tumour leads to an inevitable adjustment to maintain day-to-day life. The findings suggest there are a number of adjustments that patients make to maintain some independence. Many people valued the support they received from support groups, while others felt that the support they received was inadequate. The mandatory loss of a driving licence for people in the UK was the most concerning. Its removal led to a loss of confidence and made them immediately dependent on others for travel. While support was provided, there was an apparent omission in the provision of psychological support. Oncology and palliative care nurses are in key positions to explore psychological concerns and offer tailored support.
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Affiliation(s)
- Brian Nyatanga
- Lead researcher, Senior Lecturer, Palliative and End of Life Care, University of Worcester
| | | | - Lucy Wilkinson
- Co-researcher, Support Professional, Brain Tumour Support
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Hagan AJ, Verity SJ. Key Questions on the Long-Term Utility of Methylphenidate in Paediatric Brain Tumour Survivorship: A Retrospective Clinical Case Series. Children (Basel) 2024; 11:187. [PMID: 38397299 PMCID: PMC10887678 DOI: 10.3390/children11020187] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Methylphenidate has an established role in the management of attention-deficit hyperactivity disorder and attentional deficit secondary to brain injury. Increasingly, methylphenidate is considered for the attentional deficit in paediatric brain tumour survivors. A small number of studies have explored the benefit of methylphenidate in this population; however, studies are of short duration and do not address the impact of medium to long-term use of methylphenidate on intellectual function. We identified six patients who are survivors of a paediatric brain tumour aged 12-18 years with greater than three years of use of methylphenidate for inclusion in a clinical case series. We used this patient cohort to identify key questions to inform a future long-term cohort study. Linear mixed model and reliable change index analyses were performed on the data. Reliable change index analyses showed benefits to working memory (n = 3), processing speed (n = 2), and full-scale IQ (n = 4) performance for some patients. This exploratory case series suggests the potential medium to long-term benefit of methylphenidate in brain tumour survivorship, indicating the need for larger, appropriately powered studies. These patient data, alongside a discussion of learning points from our previously published studies, are used as a conduit for the identification of questions relating to the use of methylphenidate in a paediatric brain tumour.
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Affiliation(s)
- Alexander J. Hagan
- Department of Paediatric Health Psychology, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Sarah J. Verity
- Department of Paediatric Health Psychology, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
- Newcastle University Centre for Cancer, Newcastle upon Tyne NE1 7RU, UK
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10
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Teager A, Dunning G, Mirza N, Methley A, Twigg J. A retrospective analysis of the ethnicity of individuals referred to a tertiary neuropsychology service in the United Kingdom. Clin Neuropsychol 2024; 38:262-278. [PMID: 37222375 DOI: 10.1080/13854046.2023.2215491] [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: 04/04/2022] [Accepted: 05/12/2023] [Indexed: 05/25/2023]
Abstract
Objective: Ethnic minorities comprise approximately 18% of the UK population and are at high risk of developing neurological conditions. Despite this, there is little information regarding their access to neuropsychology services. This study evaluated whether ethnic minorities were proportionally represented in a tertiary neuropsychology department in the UK in accordance with census data for the region. We also aimed to highlight which ethnic groups were over- and underrepresented. Method: Anonymised demographic data of 3429 outpatient and 3304 inpatient referrals to an adult UK neuropsychology department was collected. These data were compared to the 2021 UK census data for the region. Results: Ethnicities in both the outpatient referrals (χ2(15) = 24066.55, p < .001) and inpatient referrals (χ2(15) = 35940924.75, p < .001) are significantly different from the Census. All ethnic minorities were underrepresented in adult neuropsychology referral data for both outpatient settings (-0.06% to -4.66%) and inpatient settings (-0.01% to -4.99%). Pakistani individuals were the most underrepresented across all settings, followed by individuals from an African background. Conversely, individuals of White British ethnicity were overrepresented in both outpatient settings (+10.73%) and inpatient settings (+15.68%). Conclusions: The UK ethnic minorities were not referred to a neuropsychology service relative to regional population prevalence. This contradicts their increased susceptibility for risk of neurological conditions but may also indicate the inaccessibility of neuroscience services for ethnic minorities. Replicating this study across different regions and gathering data on prevalence rates for different neurological conditions across ethnicity is recommended. Additionally, improving accessibility of neuropsychology services for British ethnic minorities should be prioritised.
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Affiliation(s)
- Alistair Teager
- Northern Care Alliance NHS Foundation Trust, Salford, England
| | - Georgia Dunning
- Northern Care Alliance NHS Foundation Trust, Salford, England
| | - Nadine Mirza
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, England
| | - Abigail Methley
- Northern Care Alliance NHS Foundation Trust, Salford, England
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11
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Thielen H, Huenges Wajer IMC, Tuts N, Welkenhuyzen L, Lafosse C, Gillebert CR. The Multi-Modal Evaluation of Sensory Sensitivity (MESSY): Assessing a commonly missed symptom of acquired brain injury. Clin Neuropsychol 2024; 38:377-411. [PMID: 37291083 DOI: 10.1080/13854046.2023.2219024] [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: 02/23/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Objective: Sensory hypersensitivity is common after acquired brain injury. Since appropriate diagnostic tools are lacking, these complaints are overlooked by clinicians and available literature is limited to light and noise hypersensitivity after concussion. This study aimed to investigate the prevalence of sensory hypersensitivity in other modalities and after other types of brain injury. Method: We developed the Multi-Modal Evaluation of Sensory Sensitivity (MESSY), a patient-friendly questionnaire that assesses sensory sensitivity across multiple sensory modalities. 818 neurotypical adults (mean age = 49; 244 male) and 341 chronic acquired brain injury patients (including stroke, traumatic brain injury, and brain tumour patients) (mean age = 56; 126 male) completed the MESSY online. Results: The MESSY had a high validity and reliability in neurotypical adults. Post-injury sensory hypersensitivity (examined using open-ended questions) was reported by 76% of the stroke patients, 89% of the traumatic brain injury patients, and 82% of the brain tumour patients. These complaints occurred across all modalities with multisensory, visual, and auditory hypersensitivity being the most prevalent. Patients with post-injury sensory hypersensitivity reported a higher sensory sensitivity severity on the multiple-choice items of the MESSY as compared to neurotypical adults and acquired brain injury patients without post-injury sensory hypersensitivity (across all sensory modalities) (effect sizes (partial eta squared) ranged from .06 to .22). Conclusions: These results show that sensory hypersensitivity is prevalent after different types of acquired brain injury as well as across several sensory modalities. The MESSY can improve recognition of these symptoms and facilitate further research.
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Affiliation(s)
- Hella Thielen
- Department Brain & Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Nora Tuts
- Department Brain & Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Lies Welkenhuyzen
- Department Brain & Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department Psychology, Hospital East-Limbourgh, Genk, Belgium
- TRACE, Centre for Translational Psychological Research (TRACE), Genk, Belgium
| | - Cristophe Lafosse
- Paramedical and Scientific Director, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Celine R Gillebert
- Department Brain & Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- TRACE, Centre for Translational Psychological Research (TRACE), Genk, Belgium
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12
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Kierońska-Siwak S, Jabłońska M, Sokal P. Changes in frontal aslant tract tractography in selected types of brain tumours. Neurol Neurochir Pol 2024; 58:106-111. [PMID: 38230757 DOI: 10.5603/pjnns.98149] [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: 11/07/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/18/2024]
Abstract
AIM OF THE STUDY To present differences in frontal aslant tract (FAT) tractography among patients diagnosed with primary brain tumours and metastatic brain tumours. MATERIAL AND METHODS The analysis included 38 patients diagnosed with a frontal brain tumour. A control group of 30 healthy patients was also considered. The FAT was delineated, taking into account ROI 1 - the superior frontal gyrus, and ROI 2 - SMA. Endpoints were determined on the pars opercularis and pars triangularis of the inferior frontal gyrus. FAT was delineated in four different ways for each patient. RESULTS In the group of patients with a brain tumour, a lower volume of FAT and a reduced quantity of fibres were observed compared to the control group. Comparison of the examined parameters between patients with glioblastoma and metastasis revealed statistically significant differences for MD (p < 0.001) regardless of the selected projection. CONCLUSIONS The difference in MD (mean diffusivity) among patients with metastatic tumours may be related to an increased oedema zone.
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Affiliation(s)
- Sara Kierońska-Siwak
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital No. 2, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Magdalena Jabłońska
- Doctoral School of Medical and Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Paweł Sokal
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital No. 2, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
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13
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Poniatowski ŁA, Woźnica M, Wojdasiewicz P, Mela-Kalicka A, Romanowska-Próchnicka K, Purrahman D, Żurek G, Krawczyk M, Nameh Goshay Fard N, Furtak-Niczyporuk M, Jaroszyński J, Mahmoudian-Sani MR, Joniec-Maciejak I. The Role of Progranulin (PGRN) in the Pathogenesis of Glioblastoma Multiforme. Cells 2024; 13:124. [PMID: 38247816 PMCID: PMC10814625 DOI: 10.3390/cells13020124] [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: 11/10/2023] [Revised: 12/24/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Glioblastoma multiforme (GBM) represents the most common and aggressive malignant form of brain tumour in adults and is characterized by an extremely poor prognosis with dismal survival rates. Currently, expanding concepts concerning the pathophysiology of GBM are inextricably linked with neuroinflammatory phenomena. On account of this fact, the identification of novel pathomechanisms targeting neuroinflammation seems to be crucial in terms of yielding successful individual therapeutic strategies. In recent years, the pleiotropic growth factor progranulin (PGRN) has attracted significant attention in the neuroscience and oncological community regarding its neuroimmunomodulatory and oncogenic functions. This review of the literature summarizes and updates contemporary knowledge about PGRN, its associated receptors and signalling pathway involvement in GBM pathogenesis, indicating possible cellular and molecular mechanisms with potential diagnostic, prognostic and therapeutic targets in order to yield successful individual therapeutic strategies. After a review of the literature, we found that there are possible PGRN-targeted therapeutic approaches for implementation in GBM treatment algorithms both in preclinical and future clinical studies. Furthermore, PGRN-targeted therapies exerted their highest efficacy in combination with other established chemotherapeutic agents, such as temozolomide. The results of the analysis suggested that the possible implementation of routine determinations of PGRN and its associated receptors in tumour tissue and biofluids could serve as a diagnostic and prognostic biomarker of GBM. Furthermore, promising preclinical applications of PGRN-related findings should be investigated in clinical studies in order to create new diagnostic and therapeutic algorithms for GBM treatment.
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Affiliation(s)
- Łukasz A. Poniatowski
- Department of Neurosurgery, Dietrich-Bonhoeffer-Klinikum, Salvador-Allende-Straße 30, 17036 Neubrandenburg, Germany
| | - Michał Woźnica
- Department of Spine Surgery, 7th Navy Hospital, Polanki 117, 80-305 Gdańsk, Poland;
| | - Piotr Wojdasiewicz
- Department of Biophysics, Physiology and Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, Chałubińskiego 5, 02-004 Warsaw, Poland (K.R.-P.)
| | - Aneta Mela-Kalicka
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Katarzyna Romanowska-Próchnicka
- Department of Biophysics, Physiology and Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, Chałubińskiego 5, 02-004 Warsaw, Poland (K.R.-P.)
- Department of Systemic Connective Tissue Diseases, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland
| | - Daryush Purrahman
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; (D.P.)
| | - Grzegorz Żurek
- Department of Biostructure, Wrocław University of Health and Sport Sciences, I. J. Paderewskiego 35, 51-612 Wrocław, Poland;
| | - Maciej Krawczyk
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Najmeh Nameh Goshay Fard
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; (D.P.)
| | - Marzena Furtak-Niczyporuk
- Department of Public Health, Faculty of Medicine, Medical University of Lublin, Chodźki 1, 20-093 Lublin, Poland
| | - Janusz Jaroszyński
- Department of Administrative Proceedings, Faculty of Law and Administration, Maria Curie-Skłodowska University of Lublin, Marii Curie-Skłodowskiej 5, 20-031 Lublin, Poland
| | - Mohammad-Reza Mahmoudian-Sani
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; (D.P.)
| | - Ilona Joniec-Maciejak
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
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14
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Mari M, Voutyraki C, Zacharioudaki E, Delidakis C, Filippidis G. Lipid content evaluation of Drosophila tumour associated haemocytes through Third Harmonic Generation measurements. J Biophotonics 2023; 16:e202300171. [PMID: 37643223 DOI: 10.1002/jbio.202300171] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/01/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
Non-linear microscopy is a powerful imaging tool to examine structural properties and subcellular processes of various biological samples. The competence of Third Harmonic Generation (THG) includes the label free imaging with diffraction-limited resolution and three-dimensional visualization with negligible phototoxicity effects. In this study, THG records and quantifies the lipid content of Drosophila haemocytes, upon encountering normal or tumorigenic neural cells, in correlation with their shape or their state. We show that the lipid accumulations of adult haemocytes are similar before and after encountering normal cells. In contrast, adult haemocytes prior to their interaction with cancer cells have a low lipid index, which increases while they are actively engaged in phagocytosis only to decrease again when haemocytes become exhausted. This dynamic change in the lipid accrual of haemocytes upon encountering tumour cells could potentially be a useful tool to assess the phagocytic capacity or activation state of tumour-associated haemocytes.
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Affiliation(s)
- Meropi Mari
- Institute of Electronic Structure and Laser, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
| | - Chrysanthi Voutyraki
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
| | - Eva Zacharioudaki
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
| | - Christos Delidakis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
| | - George Filippidis
- Institute of Electronic Structure and Laser, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
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15
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Patil V, Malik R, Sarawagi R. Comparative study between dynamic susceptibility contrast magnetic resonance imaging and arterial spin labelling perfusion in differentiating low-grade from high-grade brain tumours. Pol J Radiol 2023; 88:e521-e528. [PMID: 38125817 PMCID: PMC10731442 DOI: 10.5114/pjr.2023.132889] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose Our aim was to distinguish between low-grade and high-grade brain tumours on the basis of dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) perfusion and arterial spin labelling (ASL) perfusion and to compare DSC and ASL techniques. Material and methods Forty-one patients with brain tumours were evaluated by 3-Tesla MRI. Conventional and perfusion MRI imaging with a 3D pseudo-continuous ASL (PCASL) and DSC perfusion maps were evaluated. Three ROIs were placed to obtain cerebral blood value (CBV) and cerebral blood flow (CBF) in areas of maximum perfusion in brain tumour and normal grey matter. Histopathological diagnosis was considered as the reference. ROC analysis was performed to compare the diagnostic performance and to obtain a feasible cut-off value of perfusion parameters to differentiate low-grade and high-grade brain tumours. Results Normalised perfusion parameters with grey matter (rCBF or rCBV lesion/NGM) of malignant lesions were significantly higher than those of benign lesions in both DSC (normalised rCBF of 2.16 and normalised rCBV of 2.63) and ASL (normalised rCBF of 2.22) perfusion imaging. The normalised cut-off values of DSC (rCBF of 1.1 and rCBV of 1.4) and ASL (rCBF of 1.3) showed similar specificity and near similar sensitivity in distinguishing low-grade and high-grade brain tumours. Conclusions Quantitative analysis of perfusion parameters obtained by both DSC and ASL perfusion techniques can be reliably used to distinguish low-grade and high-grade brain tumours. Normalisation of these values by grey matter gives us more reliable parameters, eliminating the different technical parameters involved in both the techniques.
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Affiliation(s)
- Vaibhav Patil
- All India Institute of Medical Sciences, Bhopal, India
| | - Rajesh Malik
- All India Institute of Medical Sciences, Bhopal, India
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Chong HK, Ma Z, Wong KKC, Morokoff A, French C. An In Vitro Brain Tumour Model in Organotypic Slice Cultures Displaying Epileptiform Activity. Brain Sci 2023; 13:1451. [PMID: 37891819 PMCID: PMC10605659 DOI: 10.3390/brainsci13101451] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Brain tumours have significant impacts on patients' quality of life, and current treatments have limited effectiveness. To improve understanding of tumour development and explore new therapies, researchers rely on experimental models. However, reproducing tumour-associated epilepsy (TAE) in these models has been challenging. Existing models vary from cell lines to in vivo studies, but in vivo models are resource-intensive and often fail to mimic crucial features like seizures. In this study, we developed a technique in which normal rat organotypic brain tissue is implanted with an aggressive brain tumour. This method produces a focal invasive lesion that preserves neural responsiveness and exhibits epileptiform hyperexcitability. It allows for real-time imaging of tumour growth and invasion for up to four weeks and microvolume fluid sampling analysis of different regions, including the tumour, brain parenchyma, and peritumoral areas. The tumour cells expand and infiltrate the organotypic slice, resembling in vivo behaviour. Spontaneous seizure-like events occur in the tumour slice preparation and can be induced with stimulation or high extracellular potassium. Furthermore, we assess extracellular fluid composition in various regions of interest. This technique enables live cell confocal microscopy to record real-time tumour invasion properties, whilst maintaining neural excitability, generating field potentials, and epileptiform discharges, and provides a versatile preparation for the study of major clinical problems of tumour-associated epilepsy.
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Affiliation(s)
- Harvey K. Chong
- Neural Dynamics Laboratory, Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia; (H.K.C.); (K.K.C.W.); (A.M.); (C.F.)
| | - Ziang Ma
- Neural Dynamics Laboratory, Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia; (H.K.C.); (K.K.C.W.); (A.M.); (C.F.)
| | - Kendrew Ka Chuon Wong
- Neural Dynamics Laboratory, Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia; (H.K.C.); (K.K.C.W.); (A.M.); (C.F.)
| | - Andrew Morokoff
- Neural Dynamics Laboratory, Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia; (H.K.C.); (K.K.C.W.); (A.M.); (C.F.)
- Department of Medicine, Royal Melbourne Hospital, Parkville, Melbourne, VIC 3000, Australia
| | - Chris French
- Neural Dynamics Laboratory, Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia; (H.K.C.); (K.K.C.W.); (A.M.); (C.F.)
- Department of Medicine, Royal Melbourne Hospital, Parkville, Melbourne, VIC 3000, Australia
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Sriganesh K, Singh G, Bidkar PU, Sethuraman M, Moningi S. Non-opioid versus Opioid Peri-operative Analgesia In Neurosurgery (NOPAIN): Study protocol for a multi-centric randomised controlled trial. Indian J Anaesth 2023; 67:920-926. [PMID: 38044909 PMCID: PMC10691613 DOI: 10.4103/ija.ija_610_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 12/05/2023] Open
Abstract
Background and Aims Many patients suffer from post-operative pain after neurosurgery despite using intra-operative opioids. Opioid side effects are problematic in neurosurgical patients. Hence, non-opioid alternatives for the management of nociception and pain are needed. Previous studies comparing opioids with non-opioids in the neurosurgical population were few, from single centres, of small sample sizes and were equivocal in findings, which prevented change in clinical practice. To overcome these limitations, we are conducting a multi-centre trial with objectives to compare intra-operative rescue opioid requirements and post-operative pain scores (primary objectives), adverse events, quality of recovery from anaesthesia, quality of sleep and patient satisfaction during hospital stay, and persistent post-surgical pain and quality of life at 3 and 6 months (secondary objectives) in patients receiving opioid and non-opioid analgesia for brain tumour surgeries. Methods This study protocol describes the methodology of a multi-centre randomised controlled trial. Ethics committee approval has been obtained from all five centres, the trial has been registered with the Clinical Trial Registry- India, and insurance has been obtained for this investigator-initiated funded study. In patients undergoing supra-tentorial brain tumour surgery (population), we will compare fentanyl (intervention) 1 µg/kg/h with dexmedetomidine (comparator) 0.5 µg/kg/h administered during surgery with regards to intra-operative rescue opioid requirement and post-operative pain (primary outcomes). Results We describe the study protocol of the multi-centre trial (protocol version 2, dated 29/01/2022). The first patient was recruited on 19/10/2022, and we will complete recruitment before March 2024. Conclusion We expect our study to establish dexmedetomidine as an effective non-opioid analgesic vis-à-vis opioids in the neurosurgical population.
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Affiliation(s)
- Kamath Sriganesh
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Georgene Singh
- Department of Neuroanaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prasanna Udupi Bidkar
- Division of Neuroanaesthesiology, Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Manikandan Sethuraman
- Division of Neuroanaesthesiology, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Srilata Moningi
- Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
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Nuijts MA, Stegeman I, Porro GL, Bennebroek CAM, van Seeters T, Proudlock FA, Schouten-van Meeteren AYN, Imhof SM. Diagnostic accuracy of retinal optical coherence tomography in children with a newly diagnosed brain tumour. Acta Ophthalmol 2023; 101:658-669. [PMID: 36924320 DOI: 10.1111/aos.15650] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE To estimate the diagnostic accuracy of circumpapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness measurements to discriminate an abnormal visual function (i.e. abnormal age-based visual acuity and/or visual field defect) in children with a newly diagnosed brain tumour. METHODS This cross-sectional analysis of a prospective longitudinal nationwide cohort study was conducted at four hospitals in the Netherlands, including the national referral centre for paediatric oncology. Patients aged 0-18 years with a newly diagnosed brain tumour and reliable visual acuity and/or visual field examination and optical coherence tomography were included. Diagnostic accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS Of 115 patients included in the study (67 [58.3%] male; median age 10.6 years [range, 0.2-17.8 years]), reliable RNFL thickness and GCL-IPL thickness measurements were available in 92 patients (80.0%) and 84 patients (73.0%), respectively. The sensitivity for detecting an abnormal visual function was 74.5% for average RNFL thickness and 41.7% for average GCL-IPL thickness at a specificity of 44.5% and 82.9%, respectively. The PPV and NPV were 33.0% and 82.6% for the average RNFL thickness and 57.1% and 82.2% for the average GCL-IPL thickness. CONCLUSION An abnormal visual function was discriminated correctly by using the average RNFL thickness in seven out of ten patients and by using the average GCL-IPL thickness in four out of ten patients. The relatively high NPVs signified that patients with normal average RNFL thickness and average GCL-IPL thickness measurements had a relative high certainty of a normal visual function.
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Affiliation(s)
- Myrthe A Nuijts
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Otorhinolaryngology and Head & Neck Surgery University, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Giorgio L Porro
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carlien A M Bennebroek
- Department of Ophthalmology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Tom van Seeters
- Department of Radiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | | | - Saskia M Imhof
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
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19
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de Sain AM, Pellikaan LWM, van Voskuilen J, Migdis M, Sommers-Spijkerman MPJ, Visser-Meily JMA, Huenges Wajer IMC. Sensory hypersensitivity after acquired brain injury: the patient perspective. Disabil Rehabil 2023:1-8. [PMID: 37649314 DOI: 10.1080/09638288.2023.2251401] [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: 11/30/2022] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Sensory hypersensitivity is a frequently reported complaint after acquired brain injury (ABI). This study explores patients' perceptions of sensory hypersensitivity following ABI and its impact on everyday life. MATERIALS AND METHODS Semi-structured interviews were conducted with 18 patients with ABI (stroke, brain tumour, TBI) who reported complaints of sensory hypersensitivity. Interview data were analysed using qualitative thematic analysis. RESULTS Six themes emerged from the data: (1) definition of sensory hypersensitivity, relating to individual perceptions of sensory hypersensitivity; (2) type of sensory stimuli, relating to the variety of stimuli that patients may be sensitive to; (3) course, relating to changes in sensory hypersensitivity following ABI; (4) fatigue, relating to its association with sensory hypersensitivity; (5) consequences of sensory hypersensitivity, relating to the physical, social and emotional impact of sensory hypersensitivity on patients' lives; and (6) coping strategies, relating to behaviours used to cope with sensory hypersensitivity. CONCLUSIONS Sensory hypersensitivity can have a major impact on patients' physical well-being, return to work and (social) participation after ABI. Characteristics of sensory hypersensitivity vary between patients with ABI. To develop treatments for sensory hypersensitivity, future studies should focus on cognitive (e.g., filtering information) and psychological factors (e.g., coping) in relation to sensory hypersensitivity.
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Affiliation(s)
- A M de Sain
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L W M Pellikaan
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - J van Voskuilen
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - M Migdis
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - M P J Sommers-Spijkerman
- Department of Rehabilitation, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J M A Visser-Meily
- Department of Rehabilitation, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - I M C Huenges Wajer
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
- Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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20
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Tomasino B, De Fraja G, Guarracino I, Ius T, D’Agostini S, Skrap M, Ida Rumiati R. Cognitive reserve and individual differences in brain tumour patients. Brain Commun 2023; 5:fcad198. [PMID: 37483531 PMCID: PMC10361024 DOI: 10.1093/braincomms/fcad198] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 05/08/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023] Open
Abstract
The aim of the paper is to determine the effects of the cognitive reserve on brain tumour patients' cognitive functions and, specifically, if cognitive reserve helps patients cope with the negative effects of brain tumours on their cognitive functions. We retrospectively studied a large sample of around 700 patients, diagnosed with a brain tumour. Each received an MRI brain examination and performed a battery of tests measuring their cognitive abilities before they underwent neurosurgery. To account for the complexity of cognitive reserve, we construct our cognitive reserve proxy by combining three predictors of patients' cognitive performance, namely, patients' education, occupation, and the environment where they live. Our statistical analysis controls for the type, side, site, and size of the lesion, for fluid intelligence quotient, and for age and gender, in order to tease out the effect of cognitive reserve on each of these tests. Clinical neurological variables have the expected effects on cognitive functions. We find a robust positive effect of cognitive reserve on patients' cognitive performance. Moreover, we find that cognitive reserve modulates the effects of the volume of the lesion: the additional negative impact of an increase in the tumour size on patients' performance is less severe for patients with higher cognitive reserve. We also find substantial differences in these effects depending on the cerebral hemisphere where the lesion occurred and on the cognitive function considered. For several of these functions, the positive effect of cognitive reserve is stronger for patients with lesions in the left hemisphere than for patients whose lesions are in the right hemisphere. The development of prevention strategies and personalized rehabilitation interventions will benefit from our contribution to understanding the role of cognitive reserve, in addition to that of neurological variables, as one of the factors determining the patients' individual differences in cognitive performance caused by brain tumours.
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Affiliation(s)
- Barbara Tomasino
- Correspondence to: Barbara Tomasino, Scientific Institute, IRCCS E. Medea, Unità Operativa Pasian di Prato, Via Cialdini 29, Udine 33037, Italy E-mail:
| | - Gianni De Fraja
- Nottingham School of Economics, University of Nottingham, University Park, Nottingham NG7 2RD, UK
- CEPR, London EC1V 7DB, UK
| | - Ilaria Guarracino
- Scientific Institute, IRCCS E. Medea, Unità Operativa Pasian di Prato, Udine 33037, Italy
| | - Tamara Ius
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italy
| | - Serena D’Agostini
- Unità Operativa di Neuroradiologia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Miran Skrap
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italy
| | - Raffaella Ida Rumiati
- Neuroscience Area, Scuola Internazionale Superiore di Studi Avanzati, Trieste 34136, Italy
- Dipartimento di Medicina dei Sistemi, University of Rome ‘Tor Vergata’, Roma 00133, Italy
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Mukherjee T, Pournik O, Lim Choi Keung SN, Arvanitis TN. Clinical Decision Support Systems for Brain Tumour Diagnosis and Prognosis: A Systematic Review. Cancers (Basel) 2023; 15:3523. [PMID: 37444633 DOI: 10.3390/cancers15133523] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
CDSSs are being continuously developed and integrated into routine clinical practice as they assist clinicians and radiologists in dealing with an enormous amount of medical data, reduce clinical errors, and improve diagnostic capabilities. They assist detection, classification, and grading of brain tumours as well as alert physicians of treatment change plans. The aim of this systematic review is to identify various CDSSs that are used in brain tumour diagnosis and prognosis and rely on data captured by any imaging modality. Based on the 2020 preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol, the literature search was conducted in PubMed and Engineering Village Compendex databases. Different types of CDSSs identified through this review include Curiam BT, FASMA, MIROR, HealthAgents, and INTERPRET, among others. This review also examines various CDSS tool types, system features, techniques, accuracy, and outcomes, to provide the latest evidence available in the field of neuro-oncology. An overview of such CDSSs used to support clinical decision-making in the management and treatment of brain tumours, along with their benefits, challenges, and future perspectives has been provided. Although a CDSS improves diagnostic capabilities and healthcare delivery, there is lack of specific evidence to support these claims. The absence of empirical data slows down both user acceptance and evaluation of the actual impact of CDSS on brain tumour management. Instead of emphasizing the advantages of implementing CDSS, it is important to address its potential drawbacks and ethical implications. By doing so, it can promote the responsible use of CDSS and facilitate its faster adoption in clinical settings.
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Affiliation(s)
- Teesta Mukherjee
- Department of Electronic, Electrical and Systems Engineering, School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Omid Pournik
- Department of Electronic, Electrical and Systems Engineering, School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Sarah N Lim Choi Keung
- Department of Electronic, Electrical and Systems Engineering, School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Theodoros N Arvanitis
- Department of Electronic, Electrical and Systems Engineering, School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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22
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Capozzi LC, Daun JT, Francis GJ, de Guzman Wilding M, Urgoiti GR, Langelier D, Culos-Reed N. Feasibility and Implementation of an Oncology Rehabilitation Triage Clinic: Assessing Rehabilitation, Exercise Need, and Triage Pathways within the Alberta Cancer Exercise-Neuro-Oncology Study. Curr Oncol 2023; 30:6220-6245. [PMID: 37504321 PMCID: PMC10377964 DOI: 10.3390/curroncol30070461] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Individuals living with and beyond cancer face physical impairment and inactivity in survivorship. Neuro-oncology populations have especially high rates of sedentary behaviour and functional deficits, including impaired balance, motor skills, and cognition. Our purpose was to assess the rehabilitation and exercise needs of patients with brain tumours while examining the feasibility of a rehabilitation triage clinic as a part of the Alberta Cancer Exercise-Neuro-Oncology study, where patients were referred to a triage clinic, where health, neurologic, and functional status was assessed, followed by a referral to one or multiple resources, including exercise, physiotherapy, occupational therapy, or physiatry. Qualitative perception of the triage clinic was collected. Overall, the triage clinic was feasible and safe for participants, facilitating referral into rehabilitation and exercise resources. Pre-determined enrollment and attendance rates were met, but referral rates to the triage clinic were not met. Oncology clinic staff reported forgetting to refer patients or uncertainty of who was appropriate for rehabilitation as barriers. Oncology clinic-based screening may improve the identification of patients who are sedentary or have a physical impairment. A proposed screening tool, the Cancer Rehabilitation and Exercise Screening Tool (CREST), is presented within our Cancer Rehabilitation and Exercise Pathways Model. The CREST can identify patients who are sedentary or have a functional impairment, facilitating referral to appropriate rehabilitation resources and ultimately improving patient recovery and functioning.
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Affiliation(s)
- Lauren C Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - George J Francis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Marie de Guzman Wilding
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Gloria Roldan Urgoiti
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - David Langelier
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Supportive Care, Cancer Rehabilitation and Survivorship, Princess Margaret Hospital, Toronto, ON M5G 2C1, Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
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23
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Fuchs D, Rohrer Bley C, Morandi L, Tonon C, Weyland MS, Nytko KJ. Triple combination of lomustine, temozolomide and irradiation reduces canine glioma cell survival in vitro. Vet Med Sci 2023. [PMID: 37365849 DOI: 10.1002/vms3.1181] [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: 09/18/2022] [Revised: 04/08/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Combined chemoradiation offers a promising therapeutic strategy for dogs with glioma. The alkylating agents temozolomide (TMZ) and lomustine (CCNU) penetrate the blood-brain barrier, and doses for dogs are established. Whether such combinations are clinically advantageous remains to be explored together with tumour-specific markers. OBJECTIVE To investigate if triple combination of lomustine, temozolomide and irradiation reduces canine glioma cell survival in vitro. METHODS We evaluated the sensitising effect of CCNU alone and in combination with TMZ-irradiation in canine glioma J3T-BG cells and long-term drug-exposed subclones by using clonogenic survival and proliferation assays. Bisulphite-SEQ and Western Blot were used to investigate molecular alterations. RESULTS TMZ (200 μM) or CCNU alone (5 μM) reduced the irradiated survival fraction (4 Gy) from 60% to 38% (p = 0.0074) and 26% (p = 0.0002), respectively. The double-drug combination reduced the irradiated survival fraction (4 Gy) more potently to 12% (p < 0.0001). After long-term drug exposure, both subclones show higher IC50 values against CCNU and TMZ. For CCNU-resistant cells, both, single-drug CCNU (p = 0.0006) and TMZ (p = 0.0326) treatment combined with irradiation (4 Gy) remained effective. The double-drug-irradiation combination reduced the cell survival by 86% (p < 0.0001), compared to 92% in the parental (nonresistant) cell line. For TMZ-resistant cells, only the double-drug combination with irradiation (4 Gy) reduced the cell survival by 88% (p = 0.0057) while single-drug treatment lost efficacy. Chemoresistant cell lines demonstrated higher P-gp expression while MGMT-methylation profile analysis showed a general high methylation level in the parental and long-term treated cell lines. CONCLUSIONS Our findings indicate that combining CCNU with TMZ-irradiation significantly reduces canine glioma cell survival. Such a combination could overcome current challenges of therapeutic resistance to improve overall patient survival.
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Affiliation(s)
- Daniel Fuchs
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Luca Morandi
- Department of biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Caterina Tonon
- Department of biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Katarzyna J Nytko
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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24
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Zanotto A, Goodall K, Ellison M, McVittie C. 'Make Them Wonder How You Are Still Smiling': The Lived Experience of Coping With a Brain Tumour. Qual Health Res 2023; 33:601-612. [PMID: 37026898 DOI: 10.1177/10497323231167345] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A brain tumour can be a life-threatening illness and cause unique symptoms compared to other types of cancer, such as cognitive or language deficits, or changes in personality. It is an exceptionally distressing diagnosis which can affect quality of life, even for those with a low-grade tumour or many years after the diagnosis. This study sought to gain an in-depth understanding of the lived experience of adjustment to living with a brain tumour. Twelve individuals (83% female) with a primary brain tumour (83% low-grade) took part in the study. Participants were aged 29-54 years, on average 43 months following the diagnosis, and were recruited through the charitable support organisations in the United Kingdom. In-depth semi-structured interviews were conducted, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). Six inter-related themes were identified: making sense of the diagnosis, seeking empowerment, feeling appreciative, taking charge of coping, learning to accept, and negotiating a new normality. Notions of empowerment, gratitude, and acceptance throughout the illness journey were prominent in the participants' narratives. Receiving sufficient information and initiating treatment were important in negotiation of control. The results highlighted what facilitates and hinders adaptive coping. Aspects which facilitated positive coping were as follows: trust in clinician, feeling in control, feeling grateful, or accepting. Participants on a 'watch and wait' approach, while feeling appreciative, perceived the lack of treatment as difficult and frustrating. Implications for patient-clinician communication are discussed, particularly for patients on a 'watch and wait' who might need additional support in adjusting.
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Affiliation(s)
- Anna Zanotto
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Karen Goodall
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Marion Ellison
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Chris McVittie
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
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25
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Dejonckheere CS, Thelen A, Simon B, Greschus S, Köksal MA, Schmeel LC, Wilhelm-Buchstab T, Leitzen C. Impact of Postoperative Changes in Brain Anatomy on Target Volume Delineation for High-Grade Glioma. Cancers (Basel) 2023; 15:2840. [PMID: 37345177 DOI: 10.3390/cancers15102840] [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: 04/20/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
High-grade glioma has a poor prognosis, and radiation therapy plays a crucial role in its management. Every step of treatment planning should thus be optimised to maximise survival chances and minimise radiation-induced toxicity. Here, we compare structures needed for target volume delineation between an immediate postoperative magnetic resonance imaging (MRI) and a radiation treatment planning MRI to establish the need for the latter. Twenty-eight patients were included, with a median interval between MRIs (range) of 19.5 (8-50) days. There was a mean change in resection cavity position (range) of 3.04 ± 3.90 (0-22.1) mm, with greater positional changes in skull-distant (>25 mm) resection cavity borders when compared to skull-near (≤25 mm) counterparts (p < 0.001). The mean differences in resection cavity and surrounding oedema and FLAIR hyperintensity volumes were -32.0 ± 29.6% and -38.0 ± 25.0%, respectively, whereas the mean difference in midline shift (range) was -2.64 ± 2.73 (0-11) mm. These data indicate marked short-term volumetric changes and support the role of an MRI to aid in target volume delineation as close to radiation treatment start as possible. Planning adapted to the actual anatomy at the time of radiation limits the risk of geographic miss and might thus improve outcomes in patients undergoing adjuvant radiation for high-grade glioma.
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Affiliation(s)
| | - Anja Thelen
- Faculty of Medicine, University Bonn, 53127 Bonn, Germany
| | - Birgit Simon
- Department of Radiology, University Hospital Bonn, 53127 Bonn, Germany
| | | | - Mümtaz Ali Köksal
- Department of Radiation Oncology, University Hospital Bonn, 53127 Bonn, Germany
| | | | | | - Christina Leitzen
- Department of Radiation Oncology, University Hospital Bonn, 53127 Bonn, Germany
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26
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Baroni LV, Fernández Ponce N, Freytes C, Maldonado FR, Pinto N, González Ramos J, Lubieniecki F, Zubizarreta P, Alderete D. Closing the gap: National Argentinian discussion forum on paediatric brain tumours. Front Oncol 2023; 13:1185766. [PMID: 37274284 PMCID: PMC10234697 DOI: 10.3389/fonc.2023.1185766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/28/2023] [Indexed: 06/06/2023] Open
Affiliation(s)
- Lorena V. Baroni
- Service of Haematology/Oncology, Hospital Juan P. Garrahan, Buenos Aires, Argentina
| | | | - Candela Freytes
- Service of Haematology/Oncology, Hospital Juan P. Garrahan, Buenos Aires, Argentina
| | | | - Natalia Pinto
- Service of Radiotherapy, Hospital Juan P. Garrahan, Buenos Aires, Argentina
| | | | | | - Pedro Zubizarreta
- Service of Haematology/Oncology, Hospital Juan P. Garrahan, Buenos Aires, Argentina
| | - Daniel Alderete
- Service of Haematology/Oncology, Hospital Juan P. Garrahan, Buenos Aires, Argentina
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27
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Starup-Hansen J, Williams SC, Funnell JP, Hanrahan JG, Islam S, Al-Mohammad A, Hill CS. Optimising trajectory planning for stereotactic brain tumour biopsy using artificial intelligence: a systematic review of the literature. Br J Neurosurg 2023:1-10. [PMID: 37177983 DOI: 10.1080/02688697.2023.2210225] [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] [Indexed: 05/15/2023]
Abstract
PURPOSE Despite advances in technology, stereotactic brain tumour biopsy remains challenging due to the risk of injury to critical structures. Indeed, choosing the correct trajectory remains essential to patient safety. Artificial intelligence can be used to perform automated trajectory planning. We present a systematic review of automated trajectory planning algorithms for stereotactic brain tumour biopsies. METHODS A PRISMA adherent systematic review was conducted. Databases were searched using keyword combinations of 'artificial intelligence', 'trajectory planning' and 'brain tumours'. Studies reporting applications of artificial intelligence (AI) to trajectory planning for brain tumour biopsy were included. RESULTS All eight studies were in the earliest stage of the IDEAL-D development framework. Trajectory plans were compared through a variety of surrogate markers of safety, of which the minimum distance to blood vessels was the most common. Five studies compared manual to automated planning strategies and favoured automation in all cases. However, this comes with a significant risk of bias. CONCLUSIONS This systematic review reveals the need for IDEAL-D Stage 1 research into automated trajectory planning for brain tumour biopsy. Future studies should establish the congruence between expected risk of algorithms and the ground truth through comparisons to real world outcomes.
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Affiliation(s)
- Joachim Starup-Hansen
- Charing Cross Hospital, Imperial College NHS Healthcare Trust, London, United Kingdom
| | - Simon C Williams
- Department of Neurosurgery, St George's Hospital, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Jonathan P Funnell
- Department of Neurosurgery, St George's Hospital, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - John G Hanrahan
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
- National Hospital for Neurology and Neurosurgery, University College London NHS Trust, London, United Kingdom
| | - Shah Islam
- National Hospital for Neurology and Neurosurgery, University College London NHS Trust, London, United Kingdom
| | - Alaa Al-Mohammad
- National Hospital for Neurology and Neurosurgery, University College London NHS Trust, London, United Kingdom
| | - Ciaran S Hill
- National Hospital for Neurology and Neurosurgery, University College London NHS Trust, London, United Kingdom
- UCL Cancer Institute, London, United Kingdom
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28
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Thomas S, Embry L, Walsh K, Bull K, Grundy R, Kennedy C, Lemiere J, Hernáiz Driever P, Limond J, Chevignard M, Hardy K. Transatlantic progress in measurement of cognitive outcomes in paediatric oncology trials. Pediatr Blood Cancer 2023; 70:e30171. [PMID: 36734371 DOI: 10.1002/pbc.30171] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 02/04/2023]
Abstract
The importance of measuring quality of survival within paediatric oncology trials is increasingly recognised. However, capturing neuropsychological outcomes and other aspects of quality of survival in the context of large or multinational trials can be challenging. We provide examples of protocols designed to address this challenge recently employed in clinical trials in the USA and Europe. We discuss their respective strengths and challenges, obstacles encountered and future opportunities for transatlantic collaboration.
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Affiliation(s)
- Sophie Thomas
- Department of Paediatric Neuropsychology, Nottingham Children's Hospital, Queen's Medical Centre, Nottingham, UK
- Child Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Leanne Embry
- Pediatric Hematology/Oncology, UT Health, San Antonio, Texas, USA
| | - Karin Walsh
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, DC, USA
- Departments of Psychiatry & Behavioral Medicine and Pediatrics, The George Washington University School of Medicine, Washington, DC, USA
| | - Kim Bull
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, UK
| | - Richard Grundy
- Department of Paediatric Neuropsychology, Nottingham Children's Hospital, Queen's Medical Centre, Nottingham, UK
- Child Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Colin Kennedy
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, UK
| | - Jurgen Lemiere
- Department Oncology, Pediatric Hemato-Oncology, KULeuven, University Hospital Leuven, Leuven, Belgium
| | - Pablo Hernáiz Driever
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury; and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France
- Laboratoire d'Imagerie Biomédicale, LIB, Sorbonne Université, Paris, France
- GRC24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Sorbonne Université, Paris, France
| | - Kristina Hardy
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, DC, USA
- Departments of Psychiatry & Behavioral Medicine and Pediatrics, The George Washington University School of Medicine, Washington, DC, USA
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29
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Bates EA, Lovatt C, Plein AR, Davies JA, Siebzehnrubl FA, Parker AL. Engineering Adenoviral Vectors with Improved GBM Selectivity. Viruses 2023; 15:v15051086. [PMID: 37243172 DOI: 10.3390/v15051086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Glioblastoma (GBM) is the most common and aggressive adult brain cancer with an average survival rate of around 15 months in patients receiving standard treatment. Oncolytic adenovirus expressing therapeutic transgenes represent a promising alternative treatment for GBM. Of the many human adenoviral serotypes described to date, adenovirus 5 (HAdV-C5) has been the most utilised clinically and experimentally. However, the use of Ad5 as an anti-cancer agent may be hampered by naturally high seroprevalence rates to HAdV-C5 coupled with the infection of healthy cells via native receptors. To explore whether alternative natural adenoviral tropisms are better suited to GBM therapeutics, we pseudotyped an HAdV-C5-based platform using the fibre knob protein from alternative serotypes. We demonstrate that the adenoviral entry receptor coxsackie, adenovirus receptor (CAR) and CD46 are highly expressed by both GBM and healthy brain tissue, whereas Desmoglein 2 (DSG2) is expressed at a low level in GBM. We demonstrate that adenoviral pseudotypes, engaging CAR, CD46 and DSG2, effectively transduce GBM cells. However, the presence of these receptors on non-transformed cells presents the possibility of off-target effects and therapeutic transgene expression in healthy cells. To enhance the specificity of transgene expression to GBM, we assessed the potential for tumour-specific promoters hTERT and survivin to drive reporter gene expression selectively in GBM cell lines. We demonstrate tight GBM-specific transgene expression using these constructs, indicating that the combination of pseudotyping and tumour-specific promoter approaches may enable the development of efficacious therapies better suited to GBM.
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Affiliation(s)
- Emily A Bates
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - Charlotte Lovatt
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - Alice R Plein
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - James A Davies
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - Florian A Siebzehnrubl
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK
| | - Alan L Parker
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
- Systems Immunity University Research Institute, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
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30
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Sahrizan NSA, Manan HA, Abdul Hamid H, Abdullah JM, Yahya N. Functional Alteration in the Brain Due to Tumour Invasion in Paediatric Patients: A Systematic Review. Cancers (Basel) 2023; 15:cancers15072168. [PMID: 37046828 PMCID: PMC10093754 DOI: 10.3390/cancers15072168] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
Working memory, language and speech abilities, motor skills, and visual abilities are often impaired in children with brain tumours. This is because tumours can invade the brain's functional areas and cause alterations to the neuronal networks. However, it is unclear what the mechanism of tumour invasion is and how various treatments can cause cognitive impairment. Therefore, this study aims to systematically evaluate the effects of tumour invasion on the cognitive, language, motor, and visual abilities of paediatric patients, as well as discuss the alterations and modifications in neuronal networks and anatomy. The electronic database, PubMed, was used to find relevant studies. The studies were systematically reviewed based on the type and location of brain tumours, cognitive assessment, and pre- and post-operative deficits experienced by patients. Sixteen studies were selected based on the inclusion and exclusion criteria following the guidelines from PRISMA. Most studies agree that tumour invasion in the brain causes cognitive dysfunction and alteration in patients. The effects of a tumour on cognition, language, motor, and visual abilities depend on the type of tumour and its location in the brain. The alteration to the neuronal networks is also dependent on the type and location of the tumour. However, the default mode network (DMN) is the most affected network, regardless of the tumour type and location.Furthermore, our findings suggest that different treatment types can also contribute to patients' cognitive function to improve or deteriorate. Deficits that persisted or were acquired after surgery could result from surgical manipulation or the progression of the tumour's growth. Meanwhile, recovery from the deficits indicated that the brain has the ability to recover and reorganise itself.
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Affiliation(s)
- Nur Shaheera Aidilla Sahrizan
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Hanani Abdul Manan
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Jafri Malin Abdullah
- Jabatan Neurosains, Pusat Pengajian Sains Perubatan, Jalan Hospital USM, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Brain and Behaviour Cluster, Pusat Pengajian Sains Perubatan, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Department of Neurosciences & Brain Behaviour Cluster, Hospital Universiti Sains Malaysia, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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31
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Gupta I, Singh S, Gupta S, Ranjan Nayak S. Classification of Brain Tumours in MRI Images using a Convolutional Neural Network. Curr Med Imaging 2023:CMIR-EPUB-130365. [PMID: 37018519 DOI: 10.2174/1573405620666230327124902] [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: 08/25/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 04/07/2023]
Abstract
INTRODUCTION Recent advances in deep learning have aided the well-being business in Medical Imaging of numerous disorders like brain tumours, a serious malignancy caused by unregulated and aberrant cell portioning. The most frequent and widely used machine learning algorithm for visual learning and image identification is CNN. METHODS In this article, the convolutional neural network (CNN) technique is used. Augmentation of data and processing of images is used to classify scan imagery of brain MRI as malignant or benign. The performance of the proposed CNN model is compared with pre-trained models: VGG-16, ResNet-50, and Inceptionv3 using the technique which is transfer learning. RESULTS Even though the experiment was conducted on a relatively limited dataset, the experimental results reveal that the suggested scratched CNN model accuracy achieved is 94 percent, VGG-16 was extremely effective and had a very low complexity rate with an accuracy of 90 percent, whereas ResNet- 50 reached 86 percent and Inception v3 obtained 64 percent accuracy. CONCLUSION When compared to previous pre-trained models, the suggested model consumes significantly less processing resources and achieves significantly higher accuracy outcomes and reduction in losses.
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Affiliation(s)
- Isha Gupta
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Swati Singh
- University Institute of Technology, Himachal Pradesh University, Shimla, 171005, India
| | - Sheifali Gupta
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Soumya Ranjan Nayak
- School of Computer Engineering, KIIT Deemed to be University, Bhubaneswar 751024, Odisha, India
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32
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Kirkman MA, Ekert JO, Hunn BHM, Thomas MSC, Tolmie AK. A systematic review of cognitive interventions for adult patients with brain tumours. Cancer Med 2023. [PMID: 36880363 DOI: 10.1002/cam4.5760] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/15/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Neurocognitive impairments are common in patients with current or previously treated brain tumours, and such impairments can negatively affect patient outcomes including quality of life and survival. This systematic review aimed to identify and describe interventions used to ameliorate (improve) or prevent cognitive impairments in adults with brain tumours. METHODS We performed a literature search of the Ovid MEDLINE, PsychINFO and PsycTESTS databases from commencement until September 2021. RESULTS In total, 9998 articles were identified by the search strategy; an additional 14 articles were identified through other sources. Of these, 35 randomised and nonrandomised studies were deemed to meet the inclusion/exclusion criteria of our review and were subsequently included for evaluation. A range of interventions were associated with positive effects on cognition, including pharmacological agents such as memantine, donepezil, methylphenidate, modafinil, ginkgo biloba and shenqi fuzheng, and nonpharmacological interventions such as general and cognitive rehabilitation, working memory training, Goal Management Training, aerobic exercise, virtual reality training combined with computer-assisted cognitive rehabilitation, hyperbaric oxygen therapy and semantic strategy training. However, most identified studies had a number of methodological limitations and were judged to be at moderate-to-high risk of bias. In addition, it remains unclear whether and to what extent the identified interventions lead to durable cognitive benefits after cessation of the intervention. CONCLUSION The 35 studies identified in this systematic review have indicated potential cognitive benefits for a number of pharmacological and nonpharmacological interventions in patients with brain tumours. Study limitations were identified and further studies should focus on improved study reporting, methods to reduce bias and minimise participant drop-out and withdrawal where possible, and consider standardisation of methods and interventions across studies. Greater collaboration between centres could result in larger studies with standardised methods and outcome measures, and should be a focus of future research in the field.
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Affiliation(s)
- Matthew A Kirkman
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK.,Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Justyna O Ekert
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Benjamin H M Hunn
- Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Australia.,Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia.,School of Medicine, University of Tasmania, Hobart, Australia
| | - Michael S C Thomas
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Andrew K Tolmie
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
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Yao J, Li S, Cui Q, Ren Y, Li M, Wang J, Zeng M, Ji N, Peng Y, Sessler DI. Intraoperative hypotension and postoperative stroke in older patients who had brain tumour resections: a retrospective cohort analysis. World Neurosurg 2023:S1878-8750(23)00284-X. [PMID: 36878404 DOI: 10.1016/j.wneu.2023.02.136] [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: 01/11/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND At some level intraoperative hypotension causes strokes. Elderly neurosurgical patients are presumably at especially high risk. We therefore tested the primary hypothesis that intraoperative hypotension is associated with postoperative stroke in older brain tumour patients. METHODS We considered patients more than 65 years old who had elective craniotomy for tumour resections. Our primary exposure was the area under the threshold of intraoperative hypotension. The primary outcome was newly diagnosed ischemic stroke within 30 days, confirmed by scheduled brain imaging. RESULTS Among 724 eligible patients, 98 (13.5%) had strokes within 30 days after surgery, 86% of which were clinically silent. Curves of lowest mean arterial pressure versus stroke incidence suggested a threshold at 75 mmHg. Area under thresholds of mean arterial pressure below 75 mmHg was therefore incorporated into multivariable modelling. There was no association of area below 75 mmHg and stroke (adjusted odds ratio [aOR], 1.00; 95% CI, 1.00 to 1.00). The aOR for area below 75 mmHg between 1 to 148 mmHg*min, was 1.21 (95% CI, 0.23 to 6.23). When the area below 75 mmHg exceeding 1117 mmHg*min, the association remained insignificant. In contrast, malignant tumour and history of previous stroke or myocardial ischemia were associated with strokes. CONCLUSIONS Postoperative strokes were common in older patients who had brain tumour resections, with about 14% having ischemic cerebrovascular events within 30 days - of which 86% were clinically silent. Malignant brain tumours and previous ischemic vascular events were associated with postoperative strokes, but area under 75mmHg was not.
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Affiliation(s)
- Jingxin Yao
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Shu Li
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Qianyu Cui
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Yue Ren
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Muhan Li
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Juan Wang
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Min Zeng
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Nan Ji
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Yuming Peng
- Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P.R. China.
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
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Ozer E, Bilecen AE, Ozer NB, Yanikoglu B. Intraoperative cytological diagnosis of brain tumours: A preliminary study using a deep learning model. Cytopathology 2023; 34:113-119. [PMID: 36458464 DOI: 10.1111/cyt.13192] [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: 09/29/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Intraoperative pathological diagnosis of central nervous system (CNS) tumours is essential to planning patient management in neuro-oncology. Frozen section slides and cytological preparations provide architectural and cellular information that is analysed by pathologists to reach an intraoperative diagnosis. Progress in the fields of artificial intelligence and machine learning means that AI systems have significant potential for the provision of highly accurate real-time diagnosis in cytopathology. OBJECTIVE To investigate the efficiency of machine-learning models in the intraoperative cytological diagnosis of CNS tumours. MATERIALS AND METHODS We trained a deep neural network to classify biopsy material for intraoperative tissue diagnosis of four major brain lesions. Overall, 205 medical images were obtained from squash smear slides of histologically correlated cases, with 18 high-grade and 11 low-grade gliomas, 17 metastatic carcinomas, and 9 non-neoplastic pathological brain tissue samples. The neural network model was trained and evaluated using 5-fold cross-validation. RESULTS The model achieved 95% and 97% diagnostic accuracy in the patch-level classification and patient-level classification tasks, respectively. CONCLUSIONS We conclude that deep learning-based classification of cytological preparations may be a promising complementary method for the rapid and accurate intraoperative diagnosis of CNS tumours.
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Affiliation(s)
- Erdener Ozer
- Department of Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey.,Division of Anatomical Pathology, Sidra Medicine and Research Center, Doha, Qatar
| | - Ali Enver Bilecen
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Nur Basak Ozer
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Berrin Yanikoglu
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey.,Center of Excellence in Data Analytics (VERIM), Sabanci University, Istanbul, Turkey
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Cooper E, Choi PJ, Hwang K, Nam KM, Kim CY, Shaban T, Schweder P, Mee E, Correia J, Turner C, Faull RLM, Denny WA, Noguchi K, Dragunow M, Jose J, Park TIH. Elucidating the cellular uptake mechanisms of heptamethine cyanine dye analogues for their use as an anticancer drug-carrier molecule for the treatment of glioblastoma. Chem Biol Drug Des 2023; 101:696-716. [PMID: 36323652 DOI: 10.1111/cbdd.14171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/03/2022] [Revised: 10/24/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
The development of chemotherapies for glioblastoma is hindered by their limited bioavailability and toxicity on normal brain function. To overcome these limitations, we investigated the structure-dependent activity of heptamethine cyanine dyes (HMCD), a group of tumour-specific and BBB permeable near-infrared fluorescent dyes, in both commercial (U87MG) and patient-derived GBM cell lines. HMCD analogues with strongly ionisable sulphonic acid groups were not taken up by patient-derived GBM cells, but were taken up by the U87MG cell line. HMCD uptake relies on a combination of transporter uptake through organic anion-transporting polypeptides (OATPs) and endocytosis into GBM cells. The uptake of HMCDs was not affected by p-glycoprotein efflux in GBM cells. Finally, we demonstrate structure-dependent cytotoxic activity at high concentrations (EC50 : 1-100 μM), likely due to mitochondrial damage-induced apoptosis. An in vivo orthotopic glioblastoma model highlights tumour-specific accumulation of our lead HMCD, MHI-148, for up to 7 days following a single intraperitoneal injection. These studies suggest that strongly ionisable groups like sulphonic acids hamper the cellular uptake of HMCDs in patient-derived GBM cell lines, highlighting cell line-specific differences in HMCD uptake. We envisage these findings will help in the design and structural modifications of HMCDs for drug-delivery applications for glioblastoma.
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Affiliation(s)
- Elizabeth Cooper
- Department of Pharmacology, University of Auckland, Auckland, New Zealand.,Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Auckland, New Zealand.,The Hugh Green Biobank, The Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Peter J Choi
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Kihwan Hwang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung M Nam
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Tina Shaban
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Patrick Schweder
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.,Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Edward Mee
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Jason Correia
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Clinton Turner
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,Department of Anatomical Pathology, Pathology and Laboratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Richard L M Faull
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - William A Denny
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Katsuya Noguchi
- Dojindo Laboratories Co., Ltd, Techno-Research Park, Kumamoto, Japan
| | - Mike Dragunow
- Department of Pharmacology, University of Auckland, Auckland, New Zealand.,Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,The Hugh Green Biobank, The Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Jiney Jose
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Thomas I-H Park
- Department of Pharmacology, University of Auckland, Auckland, New Zealand.,Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Auckland, New Zealand.,The Hugh Green Biobank, The Centre for Brain Research, University of Auckland, Auckland, New Zealand
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Chilaca-Rosas MF, Garcia-Lezama M, Moreno-Jimenez S, Roldan-Valadez E. Diagnostic Performance of Selected MRI-Derived Radiomics Able to Discriminate Progression-Free and Overall Survival in Patients with Midline Glioma and the H3F3AK27M Mutation. Diagnostics (Basel) 2023; 13. [PMID: 36899993 DOI: 10.3390/diagnostics13050849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Radiomics refers to a recent area of knowledge that studies features extracted from different imaging techniques and subsequently transformed into high-dimensional data that can be associated with biological events. Diffuse midline gliomas (DMG) are one of the most devastating types of cancer, with a median survival of approximately 11 months after diagnosis and 4-5 months after radiological and clinical progression. METHODS A retrospective study. From a database of 91 patients with DMG, only 12 had the H3.3K27M mutation and brain MRI DICOM files available. Radiomic features were extracted from MRI T1 and T2 sequences using LIFEx software. Statistical analysis included normal distribution tests and the Mann-Whitney U test, ROC analysis, and calculation of cut-off values. RESULTS A total of 5760 radiomic values were included in the analyses. AUROC demonstrated 13 radiomics with statistical significance for progression-free survival (PFS) and overall survival (OS). Diagnostic performance tests showed nine radiomics with specificity for PFS above 90% and one with a sensitivity of 97.2%. For OS, 3 out of 4 radiomics demonstrated between 80 and 90% sensitivity. CONCLUSIONS Several radiomic features demonstrated statistical significance and have the potential to further aid DMG diagnostic assessment non-invasively. The most significant radiomics were first- and second-order features with GLCM texture profile, GLZLM_GLNU, and NGLDM_Contrast.
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Kuschel LP, Hench J, Frank S, Hench IB, Girard E, Blanluet M, Masliah-Planchon J, Misch M, Onken J, Czabanka M, Yuan D, Lukassen S, Karau P, Ishaque N, Hain EG, Heppner F, Idbaih A, Behr N, Harms C, Capper D, Euskirchen P. Robust methylation-based classification of brain tumours using nanopore sequencing. Neuropathol Appl Neurobiol 2023; 49:e12856. [PMID: 36269599 DOI: 10.1111/nan.12856] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 06/03/2021] [Revised: 08/28/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND DNA methylation-based classification of cancer provides a comprehensive molecular approach to diagnose tumours. In fact, DNA methylation profiling of human brain tumours already profoundly impacts clinical neuro-oncology. However, current implementation using hybridisation microarrays is time consuming and costly. We recently reported on shallow nanopore whole-genome sequencing for rapid and cost-effective generation of genome-wide 5-methylcytosine profiles as input to supervised classification. Here, we demonstrate that this approach allows us to discriminate a wide spectrum of primary brain tumours. RESULTS Using public reference data of 82 distinct tumour entities, we performed nanopore genome sequencing on 382 tissue samples covering 46 brain tumour (sub)types. Using bootstrap sampling in a cohort of 55 cases, we found that a minimum set of 1000 random CpG features is sufficient for high-confidence classification by ad hoc random forests. We implemented score recalibration as a confidence measure for interpretation in a clinical context and empirically determined a platform-specific threshold in a randomly sampled discovery cohort (N = 185). Applying this cut-off to an independent validation series (n = 184) yielded 148 classifiable cases (sensitivity 80.4%) and demonstrated 100% specificity. Cross-lab validation demonstrated robustness with concordant results across four laboratories in 10/11 (90.9%) cases. In a prospective benchmarking (N = 15), the median time to results was 21.1 h. CONCLUSIONS In conclusion, nanopore sequencing allows robust and rapid methylation-based classification across the full spectrum of brain tumours. Platform-specific confidence scores facilitate clinical implementation for which prospective evaluation is warranted and ongoing.
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Affiliation(s)
- Luis P Kuschel
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Hench
- Department of Pathology, Universitätsspital Basel, Basel, Switzerland
| | - Stephan Frank
- Department of Pathology, Universitätsspital Basel, Basel, Switzerland
| | | | | | | | | | - Martin Misch
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Onken
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dongsheng Yuan
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sören Lukassen
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Philipp Karau
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Naveed Ishaque
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elisabeth G Hain
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Heppner
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ahmed Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, F-75013, Paris, France
| | - Nikolaus Behr
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Harms
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Stroke Research, Berlin, Germany
| | - David Capper
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp Euskirchen
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Giorgia AF, Francesca M, Fabiana R, Jennifer M, Adriana B, Antonella A, Marco L, Andrea S, Andrea DC, Ilaria M, Manuela C. Brain tumours in the time of COVID-19: An online survey on patients' disease experience in one Italian region. Front Oncol 2023; 13:1002895. [PMID: 36776343 PMCID: PMC9909965 DOI: 10.3389/fonc.2023.1002895] [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: 07/25/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
Background Since the outbreak, in 2019, of COVID-19, the world has experienced marked changes in daily habits, partly reflecting the exceptional social restrictions and health measures adopted to contain the disease. All these measures significantly affected not only peoples's daily lives and psychological well-being but also the possibility for the healthcare system to function properly. In this setting, brain tumour patients were at risk due to their higher physical and mental fragility and their need for regular care. The aim of the present study was to assess, using a self-reported online questionnaire, the patients's perceptions regarding their disease experience. Materials and methods We developed an online anonymous self-report survey to assess patients's disease experience during the pandemic. We investigated the impact of the COVID-19 pandemic on patients's cancer care schedules, their psychological distress and emotions felt during the pandemic, their levels of worry about COVID-19, and their oncological conditions. Results 107 patients answered our survey, most of them suffering from a glioma. Less than one-third of the sample had their appointments cancelled, delayed or converted into online visits due to the pandemic. Of the patients who answered the survey, 95% declared they were satisfied with their Institute's oncological management. The feelings reported most often were peacefulness or anxiety/worry; the majority of the sample reported high levels of loneliness, which tended to increase with age, whilst the psychological distress was correlated with age and with having a recurrence of the disease. Half of the sample declared severe worry about their oncological condition, in particular subjects with a recurrence or who were receiving adjuvant therapies. Patients with recurrence tended to worry more about the possibility of contracting COVID-19, and its effects. Conclusion Our findings illustrate how fragile and in need of care patients with a brain tumour may be, especially those with more severe clinical conditions. These data may help boost healthcare professionals's knowledge about brain tumour patients's needs and fears, so as to be able to offer them a better hospital experience and improve their clinical management, while possibly also reducing the psychological burden on patients and their families.
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Affiliation(s)
- Abete-Fornara Giorgia
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mameli Francesca
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ruggiero Fabiana
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Meessen Jennifer
- Department of Cardiovascular Medicine, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Blanda Adriana
- Department of Cardiovascular Medicine, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Ampollini Antonella
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Locatelli Marco
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Salmaggi Andrea
- Department of Neurology, “A. Manzoni Hospital”, Lecco, Italy
| | - Di Cristofori Andrea
- Department of Mental Health, Neurosurgery Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Mauri Ilaria
- Neurology Unit, Ospedale San Gerardo, Monza, Italy,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Caroli Manuela
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,*Correspondence: Caroli Manuela,
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Dobra G, Gyukity-Sebestyén E, Bukva M, Harmati M, Nagy V, Szabó Z, Pankotai T, Klekner Á, Buzás K. MMP-9 as Prognostic Marker for Brain Tumours: A Comparative Study on Serum-Derived Small Extracellular Vesicles. Cancers (Basel) 2023; 15. [PMID: 36765669 DOI: 10.3390/cancers15030712] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Matrix metalloproteinase-9 (MMP-9) degrades the extracellular matrix, contributes to tumour cell invasion and metastasis, and its elevated level in brain tumour tissues indicates poor prognosis. High-risk tissue biopsy can be replaced by liquid biopsy; however, the blood-brain barrier (BBB) prevents tumour-associated components from entering the peripheral blood, making the development of blood-based biomarkers challenging. Therefore, we examined the MMP-9 content of small extracellular vesicles (sEVs)-which can cross the BBB and are stable in body fluids-to characterise tumours with different invasion capacity. From four patient groups (glioblastoma multiforme, brain metastases of lung cancer, meningioma, and lumbar disc herniation as controls), 222 serum-derived sEV samples were evaluated. After isolating and characterising sEVs, their MMP-9 content was measured by ELISA and assessed statistically (correlation, paired t-test, Welch's test, ANOVA, ROC). We found that the MMP-9 content of sEVs is independent of gender and age, but is affected by surgical intervention, treatment, and recurrence. We found a relation between low MMP-9 level in sEVs (<28 ppm) and improved survival (8-month advantage) of glioblastoma patients, and MMP-9 levels showed a positive correlation with aggressiveness. These findings suggest that vesicular MMP-9 level might be a useful prognostic marker for brain tumours.
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Rahman AU, Saeed M, Saeed MH, Zebari DA, Albahar M, Abdulkareem KH, Al-Waisy AS, Mohammed MA. A Framework for Susceptibility Analysis of Brain Tumours Based on Uncertain Analytical Cum Algorithmic Modeling. Bioengineering (Basel) 2023; 10:bioengineering10020147. [PMID: 36829641 PMCID: PMC9952481 DOI: 10.3390/bioengineering10020147] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Susceptibility analysis is an intelligent technique that not only assists decision makers in assessing the suspected severity of any sort of brain tumour in a patient but also helps them diagnose and cure these tumours. This technique has been proven more useful in those developing countries where the available health-based and funding-based resources are limited. By employing set-based operations of an arithmetical model, namely fuzzy parameterised complex intuitionistic fuzzy hypersoft set (FPCIFHSS), this study seeks to develop a robust multi-attribute decision support mechanism for appraising patients' susceptibility to brain tumours. The FPCIFHSS is regarded as more reliable and generalised for handling information-based uncertainties because its complex components and fuzzy parameterisation are designed to deal with the periodic nature of the data and dubious parameters (sub-parameters), respectively. In the proposed FPCIFHSS-susceptibility model, some suitable types of brain tumours are approximated with respect to the most relevant symptoms (parameters) based on the expert opinions of decision makers in terms of complex intuitionistic fuzzy numbers (CIFNs). After determining the fuzzy parameterised values of multi-argument-based tuples and converting the CIFNs into fuzzy values, the scores for such types of tumours are computed based on a core matrix which relates them with fuzzy parameterised multi-argument-based tuples. The sub-intervals within [0, 1] denote the susceptibility degrees of patients corresponding to these types of brain tumours. The susceptibility of patients is examined by observing the membership of score values in the sub-intervals.
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Affiliation(s)
- Atiqe Ur Rahman
- Department of Mathematics, University of Management and Technology, Lahore 54000, Pakistan
| | - Muhammad Saeed
- Department of Mathematics, University of Management and Technology, Lahore 54000, Pakistan
| | - Muhammad Haris Saeed
- Department of Chemistry, University of Management and Technology, Lahore 54000, Pakistan
| | - Dilovan Asaad Zebari
- Department of Computer Science, College of Science, Nawroz University, Duhok 42001, Iraq
| | - Marwan Albahar
- School of Computer Science, Umm Al Qura University, Mecca 24211, Saudi Arabia
- Correspondence: (M.A.); (M.A.M.)
| | | | - Alaa S. Al-Waisy
- Computer Technologies Engineering Department, Information Technology College, Imam Ja’afar Al-Sadiq University, Baghdad 10001, Iraq
| | - Mazin Abed Mohammed
- College of Computer Science and Information Technology, University of Anbar, Anbar 31001, Iraq
- Correspondence: (M.A.); (M.A.M.)
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Żwierełło W, Maruszewska A, Skórka-Majewicz M, Gutowska I. Fluoride in the Central Nervous System and Its Potential Influence on the Development and Invasiveness of Brain Tumours-A Research Hypothesis. Int J Mol Sci 2023; 24. [PMID: 36675073 DOI: 10.3390/ijms24021558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
The purpose of this review is to attempt to outline the potential role of fluoride in the pathogenesis of brain tumours, including glioblastoma (GBM). In this paper, we show for the first time that fluoride can potentially affect the generally accepted signalling pathways implicated in the formation and clinical course of GBM. Fluorine compounds easily cross the blood-brain barrier. Enhanced oxidative stress, disruption of multiple cellular pathways, and microglial activation are just a few examples of recent reports on the role of fluoride in the central nervous system (CNS). We sought to present the key mechanisms underlying the development and invasiveness of GBM, as well as evidence on the current state of knowledge about the pleiotropic, direct, or indirect involvement of fluoride in the regulation of these mechanisms in various tissues, including neural and tumour tissue. The effects of fluoride on the human body are still a matter of controversy. However, given the growing incidence of brain tumours, especially in children, and numerous reports on the effects of fluoride on the CNS, it is worth taking a closer look at these mechanisms in the context of brain tumours, including gliomas.
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Unnisa A, Greig NH, Kamal MA. Nanotechnology: A Promising Targeted Drug Delivery System for Brain Tumours and Alzheimer's Disease. Curr Med Chem 2023; 30:255-270. [PMID: 35345990 DOI: 10.2174/0929867329666220328125206] [Citation(s) in RCA: 1] [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: 11/16/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 02/08/2023]
Abstract
Nanotechnology is the process of modulating shape and size at the nanoscale to design and manufacture structures, devices, and systems. Nanotechnology's prospective breakthroughs are incredible, and some cannot even be comprehended right now. The blood-brain barrier, which is a prominent physiological barrier in the brain, limits the adequate elimination of malignant cells by changing the concentration of therapeutic agents at the target tissue. Nanotechnology has sparked interest in recent years as a way to solve these issues and improve drug delivery. Inorganic and organic nanomaterials have been found to be beneficial for bioimaging approaches and controlled drug delivery systems. Brain cancer (BC) and Alzheimer's disease (AD) are two of the prominent disorders of the brain. Even though the pathophysiology and pathways for both disorders are different, nanotechnology with common features can deliver drugs over the BBB, advancing the treatment of both disorders. This innovative technology could provide a foundation for combining diagnostics, treatments, and delivery of targeted drugs to the tumour site, further supervising the response and designing and delivering materials by employing atomic and molecular elements. There is currently limited treatment for Alzheimer's disease, and reversing further progression is difficult. Recently, various nanocarriers have been investigated to improve the bioavailability and efficacy of many AD treatment drugs. Nanotechnology-assisted drugs can penetrate the BBB and reach the target tissue. However, further research is required in this field to ensure the safety and efficacy of drug-loaded nanoparticles. The application of nanotechnology in the diagnosis and treatment of brain tumours and Alzheimer's disease is briefly discussed in this review.
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Affiliation(s)
- Aziz Unnisa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Hail, Hail, KSA
| | - Nigel H Greig
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Mohammad A Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.,King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia.,Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh.,Novel Global Community Educational Foundation, Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia
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Staub-Bartelt F, Steinmann J, Radtke O, Hänggi D, Sabel M, Rapp M. Impact of COVID-19 Epidemic on Psycho-Oncological Distress in Neuro-Oncological Patients. Curr Oncol 2022; 30:358-369. [PMID: 36661678 PMCID: PMC9857307 DOI: 10.3390/curroncol30010029] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Up to 40% of neuro-oncological patients already deal with high levels of distress under conventional circumstances. Due to COVID-19, pandemic hospital visitor rules have been restricted and patients did not receive the same level of supporting caregiver network as before COVID. The aim of the present study was to analyse the impact of the COVID pandemic on the prevalence of distress, anxiety and depression in neuro-oncological patients. Patients admitted for brain tumour surgery were screened regarding distress, anxiety and depression. Furthermore, aspects of patients' quality of life and clinical data were covered. Retrospectively available data of patients treated pre-pandemic (group A) and throughout the COVID-19 pandemic (group B) were statistically analysed using Chi-square tests and independent-sample t-tests, and regression analysis was performed to support statistical findings. Data from 110 patients were available. In all, 48 patients were included pre-COVID-19 and 62 during the COVID-19 pandemic. The authors found no significant difference between pre-COVID-19 prevalence of distress (p = 0.112), anxiety (p = 0.385) or depression (p = 0.084). Regression analyses additionally did not show any significant influence of COVID-19 on the above analysed parameter. Analyses of our cohort's data could not underline the negative impact of COVID-19 restrictions, shortcuts of professional and remodelled caregiver support on psycho-oncological outcomes.
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Dobran M, di Somma LGM, Paracino R. Haemostatic technique in malignant gliomas. Neurol Neurochir Pol 2022; 56:499-502. [PMID: 36458803 DOI: 10.5603/pjnns.a2022.0074] [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: 08/05/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Haemostasis in brain surgery is mandatory to avoid postoperative re-bleeding and a poor outcome. Postoperative intra-cavity haemorrhage is a frequent complication, especially in surgery of malignant gliomas because of the fragility of pathological vessels. MATERIAL AND METHODS In this technical note, we describe our 'compression' technique used to achieve haemostasis in adult patients who underwent surgery for supratentorial malignant gliomas (GBM) at our Institute from January 2019 to January 2022. Peri-operative work-up included clinical status, laboratory data and contrast brain CT, performed at 24 hours after surgery, or earlier for patients with neurological worsening. RESULTS A total of 82 patients was included in this study, 46 males (57%) and 36 females (43%). A post-operative intra-cavity haemorrhage was documented by postoperative CT-scan in 3/82 patients (3.65%), and the mean surgical time was 3.66 hours. No late bleeding was observed 48 hours after surgery. CONCLUSIONS We have documented the good results of our technique to achieve haemostasis in patients operated for malignant glioma (GBM). The technique described in this study seems to be safe and useful to avoid post-operative bleeding in the surgery of cerebral GBM.
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Affiliation(s)
- Mauro Dobran
- Department of Neurosurgey, Ospedali Riuniti di Ancona, Via Cona, Ancona, Italy
| | | | - Riccardo Paracino
- Department of Neurosurgery, Azienda Ospedaliera di Perugia, Perugia, Italy.
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Satoer D, De Witte E, Bulté B, Bastiaanse R, Smits M, Vincent A, Mariën P, Visch-Brink E. Dutch Diagnostic Instrument for Mild Aphasia (DIMA): standardisation and a first clinical application in two brain tumour patients. Clin Linguist Phon 2022; 36:929-953. [PMID: 35899484 DOI: 10.1080/02699206.2021.1992797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/17/2021] [Accepted: 10/06/2021] [Indexed: 06/15/2023]
Abstract
Brain tumour patients with mild language disturbances are typically underdiagnosed due to lack of sensitive tests leading to negative effects in daily communicative and social life. We aim to develop a Dutch standardised test-battery, the Diagnostic Instrument for Mild Aphasia (DIMA) to detect characteristics of mild aphasia at the main linguistic levels phonology, semantics and (morpho-)syntax in production and comprehension. We designed 4 DIMA subtests: 1) repetition (words, non-words, compounds and sentences), 2) semantic odd-picture-out (objects and actions), 3) sentence completion and 4) sentence judgment (accuracy and reaction time). A normative study was carried out in a healthy Dutch-speaking population (N = 211) divided into groups of gender, age and education. Clinical application of DIMA was demonstrated in two brain tumour patients (glioma and meningioma). Standard language tests were also administered: object naming, verbal fluency (category and letter), and Token Test. Performance was at ceiling on all sub-tests, except semantic odd-picture-out actions, with an effect of age and education on most subtests. Clinical application DIMA: repetition was impaired in both cases. Reaction time in the sentence judgment test (phonology and syntax) was impaired (not accuracy) in one patient. Standard language tests: category fluency was impaired in both cases and object naming in one patient. The Token Test was not able to detect language disturbances in both cases. DIMA seems to be sensitive to capture mild aphasic deficits. DIMA is expected to be of great potential for standard assessment of language functions in patients with also other neurological diseases than brain tumours.
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Affiliation(s)
- Djaina Satoer
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Elke De Witte
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
- Department of Clinical and Experimental Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bram Bulté
- Centre for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Marion Smits
- Department of Nuclear Medicine and Radiology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | | | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Jeker S, Beck MJ, Erb TO. Special Anaesthetic Considerations for Brain Tumour Surgery in Children. Children (Basel) 2022; 9:children9101539. [PMID: 36291476 PMCID: PMC9600674 DOI: 10.3390/children9101539] [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] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
Brain tumours are among the most common neoplasm in children. Therefore, paediatric anaesthesiologists face the challenge of neurosurgical interventions in all age groups. To minimize perioperative mortality and morbidity, a comprehensive understanding of age-dependent differences in anatomy and cerebrovascular physiology is a mandatory prerequisite. Advances in subspeciality training in paediatric neurosurgery and paediatric anaesthesia may improve clinical outcomes and advance communication between the teams.
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Affiliation(s)
- Sandra Jeker
- Department of Pediatric Anesthesia, University Children’s Hospital Basel (UKBB), 4056 Basel, Switzerland
- Correspondence:
| | - Maria Julia Beck
- Department of Pediatric Anesthesia, University Children’s Hospital Basel (UKBB), 4056 Basel, Switzerland
| | - Thomas O. Erb
- Department of Pediatric Anesthesia, University Children’s Hospital Basel (UKBB), 4056 Basel, Switzerland
- Department of Pediatric Anesthesia, University of Basel, 4001 Basel, Switzerland
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Adegboyega G, Jordan C, Kawka M, Chisvo N, Toescu SM, Hill C. Quality of life reporting in the management of posterior fossa tumours: A systematic review. Front Surg 2022; 9:970889. [PMID: 36303860 PMCID: PMC9594859 DOI: 10.3389/fsurg.2022.970889] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Survival amongst posterior fossa tumour (PFT) patients is improving. Clinical endpoints such as overall survival fail to depict QoL. There is yet to be a review of current QoL instruments used for adult PFTs. Aim of this review is to outline the QoL reporting in the management of PFTs and measure participation level. Methods This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A search strategy to identify adult patients with PFTs who took part in QoL metrics was conducted. Observational and experimental studies published from 1990 to date were included. Studies with a sample size less than 10 and performance measures such as Karnofsky Performance Status were not considered. Results A total of 116 studies were included in the final analysis. Vestibular schwannomas were the most common tumour pathology (n = 23,886, 92.6%) followed by pilocytic astrocytomas (n = 657, 2.5%) and meningiomas (n = 437, 1.7%) Twenty-five different QoL measures were used in the study pool. SF-36 was the most common (n = 55, 17 47.4%) QoL metric in the whole study pool, followed by the Penn Acoustic Neuroma QoL scale (n = 24, 20.7%) and Dizziness Handicap Inventory (n = 16, 13.8%). Seventy-two studies reported less-than 100% participation in QoL evaluation. The commonest reason for non-participation was a lack of response (n = 1,718, 60.8%), incomplete questionnaires (n = 268, 9.4%) and cognitive dysfunction (n = 258, 9.1%). Conclusion Informed clinical decision-making in PFT patients requires the development of specific QoL outcomes. Core outcome sets, and minimal clinically important differences (MCID) are essential for these metrics to show clinically significant improvements in patient QoL.
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Affiliation(s)
- Gideon Adegboyega
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chloe Jordan
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Michal Kawka
- Imperial College London School of Medicine, London, United Kingdom
| | - Nathan Chisvo
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Ciaran Hill
- Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
- University College London Cancer Institute, London, United Kingdom
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Jarmuzek P, Kot M, Defort P, Stawicki J, Komorzycka J, Nowak K, Tylutka A, Zembron-Lacny A. Prognostic Values of Combined Ratios of White Blood Cells in Glioblastoma: A Retrospective Study. J Clin Med 2022; 11:3397. [PMID: 35743468 DOI: 10.3390/jcm11123397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/20/2022] Open
Abstract
In some malignant tumours, the changes in neutrophil counts in relation to other blood cells are connected with unfavourable prognosis. Nevertheless, the prognostic value of the combinations of the haematological components in glioblastoma (GBM) remains under dispute. The clinical significance of the neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) was investigated in our study. We retrospectively studied 358 patients (males n = 195; females n = 163) aged 59.9 ± 13.5 yrs with newly diagnosed glioma and admitted to the Neurosurgery Centre. Routine blood tests and clinical characteristics were recorded within the first hour of hospital admission. The inflammatory variables: NLR, SII and SIRI exceeded the reference values and were significantly elevated in Grade 3 and Grade 4 tumour. The Cox model analysis showed that the age ≥ 63 years, NLR ≥ 4.56 × 103/µL, SII ≥ 2003 × 103/µL and SIRI ≥ 3.03 × 103/µL significantly increased the risk of death in Grade 4 tumour patients. In the inflammatory variables, NLR demonstrated the highest impact on the survival time (HR 1.56; 95% CI 1.145–2.127; p = 0.005). In the first Polish study including GBM patients, the age in relation to simple parameters derived from complete blood cell count were found to have prognostic implications in the survival rate.
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Rasool M, Ismail NA, Boulila W, Ammar A, Samma H, Yafooz WMS, Emara AM. A Hybrid Deep Learning Model for Brain Tumour Classification. Entropy (Basel) 2022; 24:799. [PMID: 35741521 DOI: 10.3390/e24060799] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/16/2022]
Abstract
A brain tumour is one of the major reasons for death in humans, and it is the tenth most common type of tumour that affects people of all ages. However, if detected early, it is one of the most treatable types of tumours. Brain tumours are classified using biopsy, which is not usually performed before definitive brain surgery. An image classification technique for tumour diseases is important for accelerating the treatment process and avoiding surgery and errors from manual diagnosis by radiologists. The advancement of technology and machine learning (ML) can assist radiologists in tumour diagnostics using magnetic resonance imaging (MRI) images without invasive procedures. This work introduced a new hybrid CNN-based architecture to classify three brain tumour types through MRI images. The method suggested in this paper uses hybrid deep learning classification based on CNN with two methods. The first method combines a pre-trained Google-Net model of the CNN algorithm for feature extraction with SVM for pattern classification. The second method integrates a finely tuned Google-Net with a soft-max classifier. The proposed approach was evaluated using MRI brain images that contain a total of 1426 glioma images, 708 meningioma images, 930 pituitary tumour images, and 396 normal brain images. The reported results showed that an accuracy of 93.1% was achieved from the finely tuned Google-Net model. However, the synergy of Google-Net as a feature extractor with an SVM classifier improved recognition accuracy to 98.1%.
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Mehan S, Arora N, Bhalla S, Khan A, U Rehman M, Alghamdi BS, Zughaibi TA, Ashraf GM. Involvement of Phytochemical-Encapsulated Nanoparticles' Interaction with Cellular Signalling in the Amelioration of Benign and Malignant Brain Tumours. Molecules 2022; 27:3561. [PMID: 35684498 DOI: 10.3390/molecules27113561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022]
Abstract
Brain tumours have unresolved challenges that include delay prognosis and lower patient survival rate. The increased understanding of the molecular pathways underlying cancer progression has aided in developing various anticancer medications. Brain cancer is the most malignant and invasive type of cancer, with several subtypes. According to the WHO, they are classified as ependymal tumours, chordomas, gangliocytomas, medulloblastomas, oligodendroglial tumours, diffuse astrocytomas, and other astrocytic tumours on the basis of their heterogeneity and molecular mechanisms. The present study is based on the most recent research trends, emphasising glioblastoma cells classified as astrocytoma. Brain cancer treatment is hindered by the failure of drugs to cross the blood–brain barrier (BBB), which is highly impregnableto foreign molecule entry. Moreover, currently available medications frequently fail to cross the BBB, whereas chemotherapy and radiotherapy are too expensive to be afforded by an average incomeperson and have many associated side effects. When compared to our current understanding of molecularly targeted chemotherapeutic agents, it appears that investigating the efficacy of specific phytochemicals in cancer treatment may be beneficial. Plants and their derivatives are game changers because they are efficacious, affordable, environmentally friendly, faster, and less toxic for the treatment of benign and malignant tumours. Over the past few years, nanotechnology has made a steady progress in diagnosing and treating cancers, particularly brain tumours. This article discusses the effects of phytochemicals encapsulated in nanoparticles on molecular targets in brain tumours, along with their limitations and potential challenges.
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