Astrocytoma Clinical Trial
Official title:
The Neural Basis of Language: A New Lighting. Study of Semantic Processing in MRI Mutimodale and Direct Electrical Stimulation
According to the O.M.S. Classification, grade 2 glioma is a pre-cancerous lesion, slowly
progressive, infiltrating the central nervous system, mainly affecting young adults.
This surgery should nevertheless be conducted in awake condition to achieve two conflicting
goals: get maximum brain tissue infiltrated by the tumor while preserving the integrity of
functional structures. So awake after opening the skull, the patient undergoes a series of
preoperative tests, administered by a speech therapist present in the operating room. This
procedure allows the neurosurgeon to establish an individual functional brain mapping in real
time, through the observation by the SLP of the patient's answers to direct electrical
stimulation applied to the cortical and sub-cortical. This support is based on the
extraordinary plasticity demonstrated by the brain in the presence of a slowly progressive
lesion. To ensure the patient the highest achievable load should increase our understanding
of brain function, including the neural bases of language, glioma grade 2 is predominantly
localized functional area of language.
According to the O.M.S. Classification, grade 2 glioma is a pre-cancerous lesion, slowly
progressive, infiltrating the central nervous system, mainly affecting young adults. Surgical
excision of the tumor is the most appropriate care, with or without chemotherapy or
radiotherapy.
This surgery should nevertheless be conducted in awake condition to achieve two conflicting
goals: get maximum brain tissue infiltrated by the tumor while preserving the integrity of
functional structures. So awake after opening the skull, the patient undergoes a series of
preoperative tests (motor, sensory and / or language), administered by a speech therapist
present in the operating room. This procedure allows the neurosurgeon to establish an
individual functional brain mapping in real time, through the observation by the SLP of the
patient's answers to direct electrical stimulation applied to the cortical and sub-cortical.
This support is based on the extraordinary plasticity demonstrated by the brain in the
presence of a slowly progressive lesion. To ensure the patient the highest achievable load
should increase our understanding of brain function, including the neural bases of language,
glioma grade 2 is predominantly localized functional area of language. Many studies apply to
highlight the cortical organization of language, but the study of subcortical beams involved
in this function, especially in the semantic language processing, has so far received less
attention .
The use of electric direct intraoperative stimulation helps highlight the cortico-subcortical
networks involved in language processing.
The new imaging techniques allow us to better understand the functional brain anatomy: the
Diffusion Tensor can view the white matter bundles based on the diffusion of water molecules,
functional MRI to visualize areas cortical functional.
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