The impact of high grade glial neoplasms on human cortical electrophysiology.
OBJECTIVE
The brain's functional architecture of interconnected network-related oscillatory patterns in discrete cortical regions has been well established with functional magnetic resonance imaging (fMRI) studies or direct cortical electrophysiology from electrodes placed on the surface of the brain, or electrocorticography (ECoG). These resting state networks exhibit a robust functional architecture that persists through all stages of sleep and under anesthesia. While the stability of these networks provides a fundamental understanding of the organization of the brain, understanding how these regions can be perturbed is also critical in defining the brain's ability to adapt while learning and recovering from injury.


METHODS
Patients undergoing an awake craniotomy for resection of a tumor were studied as a unique model of an evolving injury to help define how the cortical physiology and the associated networks were altered by the presence of an invasive brain tumor.


RESULTS
This study demonstrates that there is a distinct pattern of alteration of cortical physiology in the setting of a malignant glioma. These changes lead to a physiologic sequestration and progressive synaptic homogeneity suggesting that a de-learning phenomenon occurs within the tumoral tissue compared to its surroundings.


CONCLUSIONS
These findings provide insight into how the brain accommodates a region of "defunctionalized" cortex. Additionally, these findings may have important implications for emerging techniques in brain mapping using endogenous cortical physiology.
Department of Neurological Surgery, Yale University School of Medicine, New Haven, Connecticut, United States of America.
S Kathleen
SK
Bandt
Department of Neurological Surgery, Washington University, St. Louis, Missouri, United States of America.
Jarod L
JL
Roland
Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
Mrinal
M
Pahwa
Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.|Washington University School of Medicine, St. Louis, Missouri, United States of America.
Carl D
CD
Hacker
Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas, United States of America.
David T
DT
Bundy
Department of Neurological Surgery, University of California San Francisco, San Francisco, California, United States of America.
Jonathan D
JD
Breshears
Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
Mohit
M
Sharma
Washington University School of Medicine, St. Louis, Missouri, United States of America.|Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America.
Joshua S
JS
Shimony
Department of Neurological Surgery, Washington University, St. Louis, Missouri, United States of America.|Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.|Washington University School of Medicine, St. Louis, Missouri, United States of America.|Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri, United States of America.|Brain Laser Center, Washington University School of Medicine, St. Louis, Missouri, United States of America.
Eric C
EC
Leuthardt
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D003399:Craniotomy; D000069280:Electrocorticography; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted; D014851:Wakefulness