Can the knight capture the queen? The role of supramarginal gyrus in chess rule-retrieval as evidenced by a novel combined awake brain mapping and fMRI protocol.

Brain tumours represent a burden for society, not only due to the risks they entail but also because of the possibility of losing relevant cognitive functions for the patient's life after their resection. In the present study, we report how we monitored chess performance through a multimodal Electrical Stimulation Mapping (ESM) - functional Magnetic Resonance Imaging (fMRI) combined protocol. The ESM was performed under a left parietal lobe tumour resection surgery on a patient that expressed the desire to preserve his chess playing ability post-operative.

Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles.

Objective: Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. This research aims to provide a comprehensive understanding of each tumor's DSC-PWI signatures, evaluate the discriminative capacity of cerebral blood volume (CBV) and percentage of signal recovery (PSR) percentile values, and explore the synergy of CBV and PSR combination for pre-surgical differentiation.

Methods: Patients diagnosed with grade 2 and 3 IDH-mutant astrocytomas and IDH-mutant 1p19q-codeleted oligodendrogliomas were retrospectively retrieved (2010-2022).

Understanding language and cognition after brain surgery - Tumour grade, fine-grained assessment tools and, most of all, individualized approach.

Cognitive performance influences the quality of life and survival of people with glioma. Thus, a detailed neuropsychological and language evaluation is essential. In this work, we tested if an analysis of errors in naming can indicate semantic and/or phonological impairments in 87 awake brain surgery patients.

Eating-induced seizures: A semiological sign of the right temporal pole.

Objective: Eating-induced seizures (EIS) are a rare form of reflex seizures. The objective of this study was to report a series of cases of EIS involving patients admitted to our epilepsy unit, and to analyze the clinical characteristics, etiology, and treatment response of this type of infrequent seizure.

Methods: We performed a single-center retrospective analysis of all consecutive patients diagnosed with epilepsy with eating-induced seizures between 2008 and 2020.

Deeply 3D-T1-TFE hypointense voxels are characteristic of phase-rim lesions in multiple sclerosis.

Objectives: The development of new drugs for the treatment of progressive multiple sclerosis (MS) highlights the need for new prognostic biomarkers. Phase-rim lesions (PRLs) have been proposed as markers of progressive disease but are difficult to identify and quantify. Previous studies have identified T1-hypointensity in PRLs.

The role of the anterior insular cortex in self-monitoring: A novel study protocol with electrical stimulation mapping and functional magnetic resonance imaging.

Becoming aware of one's own states is a fundamental aspect for self-monitoring, allowing us to adjust our beliefs of the world to the changing context. Previous evidence points out to the key role of the anterior insular cortex (aIC) in evaluating the consequences of our own actions, especially whenever an error has occurred. In the present study, we propose a new multimodal protocol combining electrical stimulation mapping (ESM) and functional magnetic resonance imaging (fMRI) to explore the functional role of the aIC for self-monitoring in patients undergoing awake brain surgery.

Inferior fronto-occipital fascicle displacement in temporoinsular gliomas using diffusion tensor imaging.

Background And Purpose: Brain tumors can result in displacement or destruction of important white matter tracts such as the inferior fronto-occipital fascicle (IFOF). Diffusion tensor imaging (DTI) can assess the extent of this effect and potentially provide neurosurgeons with an accurate map to guide tumor resection; analyze IFOF displacement patterns in temporoinsular gliomas based on tumor grading and topography in the temporal lobe; and assess whether these patterns follow a predictable pattern, to assist in maximal tumor resection while preserving IFOF function.

Methods: Thirty-four patients with temporal gliomas and available presurgical MRI were recruited.

New-onset non-lesional aphasic status epilepticus. Clinical description, diagnostic clues, and treatment algorithm.

Objectives: De novo aphasic status epilepticus (ASE) in patients without a previous history of epilepsy and without cerebral lesions (aphasic NOSE) is rare. The aim of the study is to describe its clinical characteristics, etiologies, and outcome.

Materials & Methods: Single-center study including consecutive patients presenting to the emergency department between 2011 and 2019 with acute aphasia, which was finally diagnosed as aphasic NOSE.

Primary extraosseous dural chondrosarcoma: a case report.

Background: Dural chondrosarcoma is a very rare intracranial tumor, given that meninges do not normally contain cartilaginous tissue from which it can originate. We present a case of primary extraosseous dural chondrosarcoma.

Case Presentation: A 48-year-old woman presented to our tertiary center neurosurgery consultation with progressive headache, vomiting, vertigo, and gait instability of 5 months' duration.

Risk of Developing Epilepsy after Autoimmune Encephalitis.

Background: Acute symptomatic seizures (ASS) are a common manifestation of autoimmune encephalitis (AE), but the risk of developing epilepsy as a sequela of AE remains unknown, and factors predisposing the development of epilepsy have not been fully identified.

Objective: To assess the risk of developing epilepsy in AE and study related risk factors.

Materials And Methods: This was a retrospective single centre study including patients diagnosed with AE according to criteria described by Graus et al.

Lower Locus Coeruleus MRI intensity in patients with late-life major depression.

Background: The locus coeruleus (LC) is the major noradrenergic source in the central nervous system. Structural alterations in the LC contribute to the pathophysiology of different neuropsychiatric disorders, which may increase to a variable extent the likelihood of developing neurodegenerative conditions. The characterization of such alterations may therefore help to predict progression to neurodegenerative disorders.

The black box of global aphasia: Neuroanatomical underpinnings of remission from acute global aphasia with preserved inner language function.

Objective: We studied an unusual case of global aphasia (GA) occurring after brain tumor removal and remitting one-month after surgery. After recovering, the patient reported on her experience during the episode, which suggested a partial preservation of language abilities (such as semantic processing) and the presence of inner speech (IS) despite a failure in overt speech production. Thus, we explored the role of IS and preserved language functions in the acute phase and investigated the neuroanatomical underpinnings of this severe breakdown in language processing.

White-matter pathways and semantic processing: intrasurgical and lesion-symptom mapping evidence.

In the present study, we aimed to test the association between the correct function of the left ventral white matter pathways and semantic processing (dual stream models for language processing, Hickok & Poeppel, 2004), using a new set of language tasks during intraoperative electrical stimulation at white matter level. Additionally, we evaluated brain regions needed for correct performance on the different semantic tasks using lesion-symptom analyses (voxel lesion-symptom mapping and track-wise lesion analysis) in a sample of 62 candidates for the awake brain surgery. We found that electrical stimulation in the vicinity of the inferior longitudinal and inferior fronto-occipital fasciculi disturbed performance on semantic processing tasks.

Magnetic resonance spectroscopy in posterior fossa tumours: the tumour spectroscopic signature may improve discrimination in adults among haemangioblastoma, ependymal tumours, medulloblastoma, and metastasis.

Objectives: Assessing a posterior fossa tumour in an adult can be challenging. Metastasis, haemangioblastoma, ependymal tumours, and medulloblastoma are the most common diagnostic possibilities. Our aim was to evaluate the contribution of magnetic resonance spectroscopy (MRS) in the diagnosis of these entities.

Involvement of the middle frontal gyrus in language switching as revealed by electrical stimulation mapping and functional magnetic resonance imaging in bilingual brain tumor patients.

Neural basis of language switching and the cognitive models of bilingualism remain controversial. We explored the functional neuroanatomy of language switching implementing a new multimodal protocol assessing neuropsychological, functional magnetic resonance and intraoperative electrical stimulation mapping results. A prospective series of 9 Spanish-Catalan bilingual candidates for awake brain surgery underwent a specific language switching paradigm implemented both before and after surgery, throughout the electrical stimulation procedure and during functional magnetic resonance both pre- and postoperatively.

Brain metastasis of carcinoma ex pleomorphic adenoma of the parotid gland: case report and review of the literature.

We present an extremely infrequent case of brain metastasis of a parotid tumor. To our knowledge, this is the second case reported of a brain metastasis of a malignant parotid tumor, carcinoma ex pleomorphic adenoma. Pleomorphic adenoma represents 60% of tumors of the parotid gland, and although it is a benign tumor, it can transform into carcinoma ex pleomorphic adenoma in 5% of cases, one of the most aggressive neoplasms of the salivary glands.

Words are not enough: nonword repetition as an indicator of arcuate fasciculus integrity during brain tumor resection.

OBJECTIVE Subcortical electrical stimulation during brain surgery may allow localization of functionally crucial white matter fibers and thus tailoring of the tumor resection according to its functional limits. The arcuate fasciculus (AF) is a white matter bundle connecting frontal, temporal, and parietal cortical areas that is often disrupted by left brain lesions. It plays a critical role in several cognitive functions related to phonological processing, but current intraoperative monitoring methods do not yet allow mapping of this tract with sufficient precision.

Morphological derivation overflow as a result of disruption of the left frontal aslant white matter tract.

The frontal aslant tract (FAT) is a recently described major connection between the preSMA and Broca's area, whose functional role remains undefined. In this study we examined a patient presenting a morphological overregularization strategy in a verb generation task during awake surgery. This specific language deficit coincided with brain tumor resection at the level of the left FAT.

Multicentre evaluation of the INTERPRET decision support system 2.0 for brain tumour classification.

In a previous study, we have shown the added value of (1) H MRS for the neuroradiological characterisation of adult human brain tumours. In that study, several methods of MRS analysis were used, and a software program, the International Network for Pattern Recognition of Tumours Using Magnetic Resonance Decision Support System 1.0 (INTERPRET DSS 1.

Intraoperative electrical stimulation of language switching in two bilingual patients.

Background: Language switching (LS) is an important phenomena usually observed in some bilingual communities. The ability to switch languages is a very fast, efficient and flexible process, being a fundamental aspect of bilingual efficient language communication. The aim of the present study was to characterize the specific role of non-language specific prefrontal regions in the neural network involved in LS in bilingual patients, during awake brain surgery and using electrical stimulation mapping (ESM).

Painful os sustentaculi: imaging findings of another symptomatic skeletal variant.

The os sustentaculi is a rare accessory bone of the ankle and foot region. We describe the imaging findings of a symptomatic os sustentaculi in a 49-year-old man. Its clinical significance and associated conditions are also briefly discussed.