TY - JOUR
T1 - Neuromodulation-induced prehabilitation to leverage neuroplasticity before brain tumor surgery :
T2 - a single-cohort feasibility trial protocol
AU - Boccuni, Leonardo
AU - Abellaneda‑Pérez, Kilian
AU - Martín-Fernández, Jesús
AU - Leno-Colorado, David
AU - Roca-Ventura, Alba
AU - Prats Bisbe, Alba
AU - Buloz Osorio, Edgar
AU - Bartrés-Faz, David
AU - Bargalló, Núria
AU - Cabello-Toscano, María del Rocío
AU - Pariente, José Carlos
AU - Muñoz-Moreno, Emma
AU - Trompetto, Carlo
AU - Marinelli, Lucio
AU - Villalba-Martinez, Gloria
AU - Duffau, Hugues
AU - Pascual Leone, Álvaro
AU - Tormos, Jose M
PY - 2023
Y1 - 2023
N2 - Neurosurgery for brain tumors needs to find a complex balance between the effective removal of targeted tissue and the preservation of surrounding brain areas. Neuromodulation-induced cortical prehabilitation (NICP) is a promising strategy that combines temporary inhibition of critical areas (virtual lesion) with intensive behavioral training to foster the activation of alternative brain resources. By progressively reducing the functional relevance of targeted areas, the goal is to facilitate resection with reduced risks of neurological sequelae. However, it is still unclear which modality (invasive vs. non-invasive neuromodulation) and volume of therapy (behavioral training) may be optimal in terms of feasibility and efficacy. Patients undertake between 10 and 20 daily sessions consisting of neuromodulation coupled with intensive task training, individualized based on the target site and neurological functions at risk of being compromised. The primary outcome of the proposed pilot, single-cohort trial is to investigate the feasibility and potential effectiveness of a non-invasive NICP protocol on neuroplasticity and post-surgical outcomes. Secondary outcomes investigating longitudinal changes (neuroimaging, neurophysiology, and clinical) are measured pre-NICP, post-NICP, and post-surgery. Ethics approval was obtained from the Research Ethical Committee of Fundació Unió Catalana d'Hospitals (approval number: CEI 21/65, version 1, 13/07/2021). The results of the study will be submitted to a peer-reviewed journal and presented at scientific congresses. , identifier NCT05844605.
AB - Neurosurgery for brain tumors needs to find a complex balance between the effective removal of targeted tissue and the preservation of surrounding brain areas. Neuromodulation-induced cortical prehabilitation (NICP) is a promising strategy that combines temporary inhibition of critical areas (virtual lesion) with intensive behavioral training to foster the activation of alternative brain resources. By progressively reducing the functional relevance of targeted areas, the goal is to facilitate resection with reduced risks of neurological sequelae. However, it is still unclear which modality (invasive vs. non-invasive neuromodulation) and volume of therapy (behavioral training) may be optimal in terms of feasibility and efficacy. Patients undertake between 10 and 20 daily sessions consisting of neuromodulation coupled with intensive task training, individualized based on the target site and neurological functions at risk of being compromised. The primary outcome of the proposed pilot, single-cohort trial is to investigate the feasibility and potential effectiveness of a non-invasive NICP protocol on neuroplasticity and post-surgical outcomes. Secondary outcomes investigating longitudinal changes (neuroimaging, neurophysiology, and clinical) are measured pre-NICP, post-NICP, and post-surgery. Ethics approval was obtained from the Research Ethical Committee of Fundació Unió Catalana d'Hospitals (approval number: CEI 21/65, version 1, 13/07/2021). The results of the study will be submitted to a peer-reviewed journal and presented at scientific congresses. , identifier NCT05844605.
KW - Brain tumor
KW - Neuro-oncology
KW - Prehabilitation
KW - Neuromodulation
KW - Neurorehabilitation
KW - Neurosurgery
KW - Neuroplasticity
KW - Clinical trial
U2 - 10.3389/fneur.2023.1243857
DO - 10.3389/fneur.2023.1243857
M3 - Article
C2 - 37849833
SN - 1664-2295
VL - 14
JO - Frontiers in Neurology
JF - Frontiers in Neurology
ER -