Frontiers in Oncology (May 2024)

Exploring the neural basis of non-invasive prehabilitation in brain tumour patients: An fMRI-based case report of language network plasticity

  • Leonardo Boccuni,
  • Leonardo Boccuni,
  • Leonardo Boccuni,
  • Alba Roca-Ventura,
  • Alba Roca-Ventura,
  • Alba Roca-Ventura,
  • Edgar Buloz-Osorio,
  • Edgar Buloz-Osorio,
  • Edgar Buloz-Osorio,
  • David Leno-Colorado,
  • David Leno-Colorado,
  • David Leno-Colorado,
  • Jesús Martín-Fernández,
  • Jesús Martín-Fernández,
  • Jesús Martín-Fernández,
  • María Cabello-Toscano,
  • María Cabello-Toscano,
  • Ruben Perellón-Alfonso,
  • Ruben Perellón-Alfonso,
  • Ruben Perellón-Alfonso,
  • Ruben Perellón-Alfonso,
  • Ruben Perellón-Alfonso,
  • Jose Carlos Pariente Zorrilla,
  • Jose Carlos Pariente Zorrilla,
  • Carlos Laredo,
  • Carlos Laredo,
  • Cesar Garrido,
  • Cesar Garrido,
  • Cesar Garrido,
  • Emma Muñoz-Moreno,
  • Emma Muñoz-Moreno,
  • Nuria Bargalló,
  • Nuria Bargalló,
  • Nuria Bargalló,
  • Nuria Bargalló,
  • Nuria Bargalló,
  • Gloria Villalba,
  • Francisco Martínez-Ricarte,
  • Carlo Trompetto,
  • Carlo Trompetto,
  • Lucio Marinelli,
  • Lucio Marinelli,
  • Matthew D. Sacchet,
  • Matthew D. Sacchet,
  • David Bartrés-Faz,
  • David Bartrés-Faz,
  • David Bartrés-Faz,
  • Kilian Abellaneda-Pérez,
  • Kilian Abellaneda-Pérez,
  • Kilian Abellaneda-Pérez,
  • Alvaro Pascual-Leone,
  • Alvaro Pascual-Leone,
  • Alvaro Pascual-Leone,
  • Josep María Tormos Muñoz,
  • Josep María Tormos Muñoz

DOI
https://doi.org/10.3389/fonc.2024.1390542
Journal volume & issue
Vol. 14

Abstract

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Primary brain neoplasms are associated with elevated mortality and morbidity rates. Brain tumour surgery aims to achieve maximal tumour resection while minimizing damage to healthy brain tissue. Research on Neuromodulation Induced Cortical Prehabilitation (NICP) has highlighted the potential, before neurosurgery, of establishing new brain connections and transfer functional activity from one area of the brain to another. Nonetheless, the neural mechanisms underlying these processes, particularly in the context of space-occupying lesions, remain unclear. A patient with a left frontotemporoinsular tumour underwent a prehabilitation protocol providing 20 sessions of inhibitory non-invasive neuromodulation (rTMS and multichannel tDCS) over a language network coupled with intensive task training. Prehabilitation resulted in an increment of the distance between the tumour and the language network. Furthermore, enhanced functional connectivity within the language circuit was observed. The present innovative case-study exposed that inhibition of the functional network area surrounding the space-occupying lesion promotes a plastic change in the network’s spatial organization, presumably through the establishment of novel functional pathways away from the lesion’s site. While these outcomes are promising, prudence dictates the need for larger studies to confirm and generalize these findings.

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