Advanced MRI, Radiomics and Radiogenomics in Unravelling Incidental Glioma Grading and Genetic Status: Where Are We?

The 2021 WHO classification of brain tumours revolutionised the oncological field by emphasising the role of molecular, genetic and pathogenetic advances in classifying brain tumours. In this context, incidental gliomas have been increasingly identified due to the widespread performance of standard and advanced MRI sequences and represent a diagnostic and therapeutic challenge. The impactful decision to perform a surgical procedure deeply relies on the non-invasive identification of features or parameters that may correlate with brain tumour genetic profile and grading.

Safety and Efficacy Evaluation of Ultrasound Aspirators in Intramedullary Spinal Cord Tumors Surgery: An Experimental Study on a Swine Model.

: Intradural extramedullary and intramedullary spinal tumors are rare, complex to treat, and require advanced surgical techniques. Ultrasonic aspirators, commonly used for tumor removal, can cause sensory and motor deficits, including loss of motor evoked potentials (MEPs). This study aims to evaluate the safety and efficacy of ultrasonic aspirators in intramedullary tumor surgery using a swine model, comparing different systems and techniques.

A Novel and Cost-Effective Technique for Quantitative Measurement of Endoscopic Photogrammetric Model.

Background And Objective: In skull base surgery, endoscopic endonasal approaches require precise evaluation of the area of exposure and the maneuverability provided by each approach. Current neuroanatomical methodologies for quantifying these parameters primarily rely on computed tomography (CT) scans and neuronavigation systems, which entail significant financial investment. The aim of this study was to develop and validate an innovative, cost-effective methodology using an endoscopic photogrammetric model to measure the exposure area and maneuverability in endoscopic endonasal approaches, offering an accessible alternative to existing techniques.

Tumor treating fields for glioblastoma: opportunities and drawbacks.

Introduction: Glioblastoma (GBM) stands as one of the most challenging malignancies to treat, with a prognosis that remains notably poor despite advancements in therapeutic strategies.

Areas Covered: TTFields therapy is a novel approach to targeting cancer cell proliferation through alternating electric fields. The mechanism of action, dielectrophoresis, selectively disrupts mitotic processes in replicating cells, offering a localized treatment option with minimal systemic side effects.

Recurrence prediction in chronic subdural hematomas: a risk stratification score based on 118 consecutive patients.

Background: Chronic subdural hematoma (CSDH) is a frequent neurosurgical condition with a significant recurrence rate. Identifying patients at risk of recurrence is a topic of great interest to intercept this population in which to implement further therapeutic strategies.

Objective: To develop and internally validate a risk-stratification score using preoperative radiological parameters to predict risk of CSDH recurrency.

Impact of surgical timing on chronic subdural hematoma outcomes: novel insights from a multicenter study.

Objective: Chronic Subdural Hematoma (CSDH) is one of the most frequently encountered conditions in the neurosurgical practice. The role of timing in CSDH surgery in mild symptomatic patients remains uncertain. The aim of this study was to analyze the prognostic role of surgical timing in patients with mild symptomatic CSDH.

The involvement of brain norepinephrine nuclei in eating disorders.

While many individuals with anorexia nervosa (AN) undergo remission of the disorder, a significant proportion will experience relapse and/or persistent symptoms. The persistence of AN is thought to be driven by changes in neural circuits that underline treatment-resistant symptoms (maladaptive plasticity). Recent evidence about the biology of AN suggests it extends beyond psychiatric symptoms to involve also systemic metabolic dysfunction, which is based on alterations of the mechanistic Target Of Rapamycin Complex 1 (mTORC1).

The brainstem reticular formation pivots abnormal neural transmission in the course of Anorexia Nervosa.

Anorexia nervosa (AN) represents an eating disorder, which features the highest rate of mortality among all psychiatric disorders. The disease prevalence is increasing steadily, and an effective cure is missing. The neurobiology of the disease is largely unknown, and only a few studies were designed to disclose specific brain areas, where altered neural transmission may occur.

Hemispheric asymmetry and its influence on cranioplasty complications after decompressive craniectomy.

To explore temporal dynamics of cerebral herniation through the calvarial defect after decompressive craniectomy. To investigate patterns of hemispheric asymmetry in ischemic stroke and traumatic brain injury after decompressive craniectomy.To assess clinical implications of hemispheric asymmetry evaluation in order to minimize cranioplasty complications.

Clinical and functional outcome for gliomas located in the primary and supplementary motor area. Surgical series and systematic Literature review.

Introduction: This retrospective study and review aim to investigate diffuse adult gliomas in the motor cortex (primary motor area, M1, and secondary motor area, M2, which includes the supplementary motor area and premotor cortex). It explores the relationships between the histologic and molecular profiles of the lesions, their location, and the type of resection performed, and correlates them with patients' outcomes post-surgery.

Material And Methods: An Institutional retrospective review was conducted on a consecutive series of 200 selected patients with histologically confirmed Glioblastomas (GBM) treated surgically between September 2018 and February 2022.

The Prognostic Impact of Progesteron-Receptor Expression in Surgical Intracranial Meningioma on Performance Status and Quality of Life: A Single-Center Observational Study.

Background: The relationship between meningiomas and gonadal steroid hormones has been the subject of debate, and there is limited understanding of the connection between patient, tumor characteristics, and progesterone receptor (PGR) status.

Methods: This retrospective observational study aims to explore the prognostic correlation between PGR+ and PGR-meningiomas in terms of various clinical, radiological, and surgical predictors. The analysis included 270 patients, divided into 2 groups: group A (PGR-, 194 patients), and group B (PGR+, 76 patients).

Clinical, Radiologic, and Surgical Features of Brain Metastases in Colorectal Cancer. A Strong Correlation Between Surgical Patterns and Outcome.

Background: Brain metastases (BMs) from colorectal cancer (CRC) are a small percentage of metastatic patients and surgery is considered the best choice to improve survival. While most research has focused on the risk of CRC spreading to the brain, no studies have examined the characteristics of BMs in relation to surgery and outcome. In this study, we evaluate the clinical and radiologic features of BMs from CRC patients who underwent surgery and analyze their outcomes.

3-Dimensional Printed Model of the Temporal Bone for Neurosurgical Training.

Background And Objectives: The development of neurosurgical skills stands out as a paramount objective for neurosurgery residents during their formative years. Mastery of intricate and complex procedures is a time-intensive process marked by a gradually ascending learning curve. Consequently, the study and simulation on surgical models assume significant importance.

The Impact of the COVID-19 Pandemic and Lockdown on the Outcome of Glioblastoma.

Background:  Rapid spread of the SARS-CoV-2 pandemic in 2020 led to an indirect effect on non-COVID patients. Since neuro-oncology cases are unique and brain tumors need a specific therapeutic protocol at proper doses and at the right times, the effects of the pandemic on health care services for patients with glioblastomas (GBs) and their impact on overall survival (OS) and quality of life are not yet known.

Methods:  We conducted a retrospective study of 142 GB patients who underwent surgery, radiation, and chemotherapy before and after the lockdown period, aiming to determine the differences in access to care, treatment modality, and adjuvant therapies, and how the lockdown changed the prognosis.

Application of the NSE score (Neurology-Stability-Epidural compression assessment) to establish the need for surgery in spinal metastases of elderly patients: a multicenter investigation.

Purpose: This retropective multicentric study aims to investigate the clinical applicability of the NSE score in the elderly, to verify the role of this tool as an easy help for decision making also for this class of patients.

Methods: All elderly patients (> 65 years) suffering from spinal metastases undergoing surgical or non-surgical treatment at the authors' Institutions between 2015 and 2022 were recruited. An agreement group (AG) and non-agreement group (NAG) were identified accordingly to the agreement between the NSE score indication and the performed treatment.

Anamnestic radiological metastases outcome surgical score (ARMO-S). A purpose of a predictive surgical scoring system for brain metastases.

Background: Several risk stratification scores have been suggested to aid prognostication and guide treatment strategies for brain metastases (BMs). However, the current scores do not focus on the specific neurosurgical population, therefore not predicting short-term mortality and postoperative performance status.

Methods: This retrospective observational study of 362 consecutive patients treated with surgery for BMs aims to identify the factors associated with post-surgical outcomes and propose a surgery-specific prognostic score for patients with BMs candidate for open surgery.

Brain metastases: Comparing clinical radiological differences in patients with lung and breast cancers treated with surgery.

Purpose: Brain metastases (BMs) most frequently originate from the primary tumors of the lung and breast. Survival in patients with BM can improve if they are detected early. No studies attempt to consider all potential surgical predictive factors together by including clinical, radiological variables for their recognition.

Is There a Place for Lewy Bodies before and beyond Alpha-Synuclein Accumulation? Provocative Issues in Need of Solid Explanations.

In the last two decades, alpha-synuclein (alpha-syn) assumed a prominent role as a major component and seeding structure of Lewy bodies (LBs). This concept is driving ongoing research on the pathophysiology of Parkinson's disease (PD). In line with this, alpha-syn is considered to be the guilty protein in the disease process, and it may be targeted through precision medicine to modify disease progression.

Damage to the Locus Coeruleus Alters the Expression of Key Proteins in Limbic Neurodegeneration.

The present investigation was designed based on the evidence that, in neurodegenerative disorders, such as Alzheimer's dementia (AD) and Parkinson's disease (PD), damage to the locus coeruleus (LC) arising norepinephrine (NE) axons (LC-NE) is documented and hypothesized to foster the onset and progression of neurodegeneration within target regions. Specifically, the present experiments were designed to assess whether selective damage to LC-NE axons may alter key proteins involved in neurodegeneration within specific limbic regions, such as the hippocampus and piriform cortex, compared with the dorsal striatum. To achieve this, a loss of LC-NE axons was induced by the neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP4) in C57 Black mice, as assessed by a loss of NE and dopamine-beta-hydroxylase within target regions.

Combined light and electron microscopy (CLEM) to quantify methamphetamine-induced alpha-synuclein-related pathology.

Methamphetamine (METH) produces a cytopathology, which is rather specific within catecholamine neurons both in vitro and ex vivo, in animal models and chronic METH abusers. This led some authors to postulate a sort of parallelism between METH cytopathology and cell damage in Parkinson's disease (PD). In fact, METH increases and aggregates alpha-syn proto-fibrils along with producing spreading of alpha-syn.