Poster No:
1098
Submission Type:
Abstract Submission
Authors:
Alba Roca-Ventura1, Leonardo Boccuni1, David Leno-Colorado1, Edgar Buloz-Osorio1, Selma Delgado-Gallen1, María Cabello-Toscano2, David Bartrés-Faz2, Alvaro Pascual-Leone3, Jose M. Tormos4, Kilian Abellaneda-Pérez1
Institutions:
1Institut Guttmann, Barcelona, Spain, 2University of Barcelona, Barcelona, Spain, 3Harvard Medical School, Boston, MA, 4Universidad Católica de Valencia, Valencia, Spain
First Author:
Co-Author(s):
Introduction:
Optimizing tumor excision while limiting harm to healthy brain tissue is the main objective of brain tumor surgery. However, the use of invasive prehabilitation techniques come with a higher risk of consequences. Recent research has demonstrated the brain's ability for change plastically, allowing functional activity to be transferred between different brain regions. However, it remains unclear whether this externally-triggered reorganization of cognitive brain networks could temporarily and adversely affect cognitive functioning in patients awaiting brain surgery.
Methods:
Twelve patients (4 women, 8 men; mean age: 52.67 ± 13.4) diagnosed with brain tumors were admitted for prehabilitation. Patients were categorized into two equivalent groups based on the tumor's location and its potential risk to either language or motor functionality. Pre- and post-prehabilitation assessments encompassed functional magnetic resonance imaging (fMRI) and a comprehensive neuropsychological assessment. Prehabilitation involved non-invasive brain stimulation targeting networks relevant to the function at-risk, combined with intensive language or motor training, tailored to each individual's specific case. Language performance and fMRI-derived language brain networks were explored as the main variables, with their metrics compared to those of the motor group, employed as a control. Two Way Repeated Measures Anova, post hocs and Wilcoxon test were used for the statistical analyses.
Results:
A significant interaction between groups (language vs. motor) and time (pre vs. post-PRH) was found for the fMRI language brain networks modulation (F = 5.007; p = 0.049). Pairwise post-hoc analyses revealed a significant decrease in the language group (p= 0.047) but not in the motor control group (p= 0.495). These statistically significant changes in brain network arrangement were not associated with language performance in any of the groups (all p-values > 0.05).
Conclusions:
Non-invasive prehabilitation induced distinct brain network changes for language and motor groups and these changes showed no association with cognitive impact, and hence, without generating an impact on cognitive function. Therefore, the relocation of brain activity from its initial site does not seem to result in any potential crowding effects. In this context, these results suggests that non-invasive prehabilitation before brain tumor surgery opens a safe neuroplasticity window where brain configuration is temporarily modified, but cognitive performance is preserved. Notwithstanding, more research is necessary to confirm and explore deeper into these findings, which lies on the horizon (ClinicalTrials.gov: NCT05844605).
Brain Stimulation:
Non-invasive Electrical/tDCS/tACS/tRNS
Non-invasive Magnetic/TMS 2
Language:
Language Comprehension and Semantics
Learning and Memory:
Neural Plasticity and Recovery of Function 1
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling
Keywords:
Cognition
Language
MRI
Plasticity
Transcranial Magnetic Stimulation (TMS)
Other - non-invasive stimulation, neurosurgery
1|2Indicates the priority used for review
Provide references using author date format
Boccuni, L. (2023). ‘Neuromodulation-induced prehabilitation to leverage neuroplasticity before brain tumor surgery: a single-cohort feasibility trial protocol’, Frontiers in neurology vol. 14 1243857.
Barcia, J. (2012b). ‘rTMS stimulation to induce plastic changes at the language motor area in a patient with a left recidivant brain tumor affecting Broca's area’, Neurocase vol. 18,2, pp. 132-138.
François, C (2019). Right Structural and Functional Reorganization in Four-Year-Old Children with Perinatal Arterial Ischemic Stroke Predict Language Production. eNeuro vol. 6,4