Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery : lessons from a case series
Boccuni, Leonardo (Universitat Autònoma de Barcelona)
Roca-Ventura, Alba (Universitat Autònoma de Barcelona. Departament de Medicina)
Buloz-Osorio, Edgar (Universitat Autònoma de Barcelona)
Leno-Colorado, David (Universitat Autònoma de Barcelona)
Delgado-Gallén, Selma (Universitat Autònoma de Barcelona)
Cabello-Toscano, María (Universitat de Barcelona)
Perellón-Alfonso, Ruben (Universitat Autònoma de Barcelona)
Villalba-Martínez, Gloria (Universitat Pompeu Fabra)
Martinez-Ricarte, Fran (Hospital Universitari Vall d'Hebron)
Martín-Fernández, Jesús (Universidad de La Laguna)
Buxeda-Rodriguez, Mònica (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Conesa-Bertrán, Gerardo (Centro Médico Teknon (Barcelona))
Illueca-Moreno, Mireia (HM Nou Delfos (Barcelona))
Lladó-Carbó, Estela (HM Nou Delfos (Barcelona))
Perla y Perla, Cristóbal (HM Nou Delfos (Barcelona))
Garrido, César (Universitat de Barcelona)
Pariente, José Carlos (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Laredo, Carlos (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Muñoz-Moreno, Emma (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Bargalló, Núria (Centro de Investigación Biomédica en Red de Salud Mental)
Trompetto, Carlo (IRCCS Ospedale Policlinico San Martino (Gènova, Itàlia))
Marinelli, Lucio (IRCCS Ospedale Policlinico San Martino (Gènova, Itàlia))
Bartrés-Faz, David (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Abellaneda Pérez, Kilian (Institut Germans Trias i Pujol)
Pascual Leone, Álvaro (Harvard Medical School)
Tormos, Jose M. (Institut Germans Trias i Pujol. Institut Guttmann)

Fecha:	2024
Resumen:	The objective of this prospective, single-centre case series was to investigate feasibility, clinical outcomes, and neural correlates of non-invasive Neuromodulation-Induced Cortical Prehabilitation (NICP) before brain tumor surgery. Previous studies have shown that gross total resection is paramount to increase life expectancy but is counterbalanced by the need of preserving critical functional areas. NICP aims at expanding functional margins for extensive tumor resection without functional sequelae. Invasive NICP (intracranial neuromodulation) was effective but characterized by elevated costs and high rate of adverse events. Non-invasive NICP (transcranial neuromodulation) may represent a more feasible alternative. Nonetheless, up to this point, non-invasive NICP has been examined in only two case reports, yielding inconclusive findings. Treatment sessions consisted of non-invasive neuromodulation, to transiently deactivate critical areas adjacent to the lesion, coupled with intensive functional training, to activate alternative nodes within the same functional network. Patients were evaluated pre-NICP, post-NICP, and at follow-up post-surgery. Ten patients performed the intervention. Feasibility criteria were met (retention, adherence, safety, and patient's satisfaction). Clinical outcomes showed overall stability and improvements in motor and executive function from pre- to post-NICP, and at follow-up. Relevant plasticity changes (increase in the distance between tumor and critical area) were observed when the neuromodulation target was guided by functional neuroimaging data. This is the first case series demonstrating feasibility of non-invasive NICP. Neural correlates indicate that neuroimaging-guided target selection may represent a valid strategy to leverage neuroplastic changes before neurosurgery. Further investigations are needed to confirm such preliminary findings. The online version contains supplementary material available at 10. 1007/s11060-024-04774-4.
Ayudas:	Ministerio de Economía y Competitividad IBPS15-EE-3688 Ministerio de Ciencia e Innovación FJC2021-047380-I
Nota:	Altres ajuts: Fundación Joan Ribas Araquistain 2020.330 ; Institut Català de Recerca i Estudis Avançats ICREA Academia 2019 award
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Brain tumor ; Prehabilitation ; Neurorehabilitation ; Neuromodulation ; Neurosurgery ; Case series
Publicado en:	Journal of Neuro-Oncology, Vol. 170 (july 2024) , p. 185-198, ISSN 1573-7373

DOI: 10.1007/s11060-024-04774-4
PMID: 39044115

14 p, 1.8 MB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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