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Eloquent brain definition11/11/2023 ![]() ![]() The regions included in our voxel-based definition of eloquence showed a high degree of association with performing biopsy compared to resection.Ĭonclusion: We present a simple, robust, unbiased, and clinically relevant method for assessing tumor location and eloquence in lower-grade gliomas. Eloquent regions are found slightly more frequently in the proximity of IDH-mutated astrocytomas compared to oligodendrogliomas. Results: Exploring the differences between patients with oligodendrogliomas, isocitrate dehydrogenase (IDH) mutated astrocytomas, and patients with IDH wild-type astrocytomas, we found that the latter were older, more often had lower Karnofsky performance status, and that these tumors were more often found in the proximity of eloquent regions. Tumor segmentations were registered to a standardized space where two anatomical atlases were used to perform a voxel-based comparison of the proximity of segmentations to brain regions of traditional clinical interest. Methods: A multi-institutional population-based dataset of adult patients (≥18 years) histologically diagnosed with lower-grade glioma was analyzed. Objective: To report on a voxel-based method for assessing anatomical distribution and proximity to eloquent regions in diffuse lower-grade gliomas (World Health Organization grades 2 and 3). An unbiased and reproducible method to determine tumor location and eloquence is desirable, both for clinical use and for research purposes. Studies often report tumor location based on anatomical taxonomy alone since the estimation of eloquent regions requires considerable knowledge of functional neuroanatomy and is, to some degree, a subjective measure. Olavs Hospital, Trondheim University Hospital, Trondheim, Norwayīackground: Glioma is the most common intra-axial tumor, and its location relative to critical areas of the brain is important for treatment decision-making. 8Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.7Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.6Department of Health Research, SINTEF Digital, Trondheim, Norway.5Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.4Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.3Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. ![]() ![]() 2Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.Thus, DWI emerges as a valuable diagnostic method for the monitoring of periprocedural ischaemic events in the brain, and could be a surrogate parameter for optimising diagnostic and therapeutic vascular procedures in the future.Tomás Gómez Vecchio 1* Alice Neimantaite 1 Alba Corell 1,2 Jiri Bartek Jr 3,4,5 Margret Jensdottir 3 Ingerid Reinertsen 6,7 Ole Solheim 8,9 Asgeir S. There is increasing evidence, however, that cumulative burden of ischaemic brain injury causes neuropsychological deficits or aggravates vascular dementia. The clinical impact of these "silent" ischaemic lesions within brain areas without primary motor, sensory, or linguistic function ("non-eloquent" brain areas) is debated. Diffusion-weighted MRI (DWI) has shown new ischaemic lesions in a substantial number of patients undergoing cardiac or carotid-artery surgery, and coronary or cerebral-angiographic interventions. Although clinical examinations suggest a relatively low risk for ischaemic complications affecting the brain, new magnetic resonance techniques have led to the awareness of much higher numbers of clinically silent ischaemic brain lesions. Improved diagnostic and therapeutic options for these diseases have led to increasing numbers of invasive procedures such as angiography, stent placement, and operations exceeding 4 million each year in the USA. Cardiovascular and cerebrovascular disorders are the main cause of death and permanent disability worldwide.
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