Surg-38. direct evidence of plasticity within primary motor and sensory cortices via direct electrical stimulation in glioblastoma patients undergoing repeat awake craniotomy

In this study, we examine plasticity within primary sensory (S1) and motor (M1) cortices in glioblastoma patients undergoing repeat intra-operative direct electrical stimulation (DES) under awake conditions.METHODS:This retrospective analysis included five patients with glioblastoma in/near M1/S1 that underwent two awake surgeries, each with DES-based sensory and motor mapping. Inter-surgery interval was 216 ± 41 days. Plasticity was defined as a change in mapping result (gain, loss, or change of function) within M1/S1 at second operation or absence of typical mapping result without a change in the patient’s sensory/motor exam.RESULTS:Four of five patients (80%) exhibited at least one site of plasticity within M1 or S1. Out of 41 total sites stimulated in both surgeries, 9 S1 (22%) and 11 M1 (27%) sites demonstrated plasticity, with gain of function (negative->positive) and loss of function (positive->negative) equally distributed. Change of function (e.g. hand motor to forearm motor) and cross-modal (e.g. motor->sensory) plasticity sites were also observed (10% of total sites).DISCUSSION:The current study provides direct evidence of multiple patterns of plasticity within the primary sensorimotor cortices of the adult brain over a relatively short time scale (months). Further, these data suggest that even in patients with high-grade gliomas near primary brain regions, significant functional reorganization is possible. A better fundamental under...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: SURGICAL THERAPY Source Type: research