Neural Basis of Language Processing (BNL)
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.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
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.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patients carry a grade glioma 2 functional area of language and presenting the information to receive surgical care provided in awake for the first time.
or Healthy volunteers will be selected using a matching age and sex of patients in the study (matched to a patient on two of the first forty patients).
Exclusion Criteria:
- Subject presenting cons-indications to MRI (ventricular shunt valve, ferromagnetic foreign bodies, pacemaker, implantable defibrillators, cochlear hearing implant, claustrophobia, ....)
- History of head trauma, ischemic stroke or intracerebral hematoma.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Other: grade 2 glioma
Patient with grade 2 glioma use a neuropsychological examination and brain imaging (fMRI and tractography)
|
Patient with grade 2 glioma and healthy volunteers use a brain imaging (fMRI)
Patient with grade 2 glioma and healthy volunteers use a brain imaging (tractography)
Patient with grade 2 glioma and healthy volunteers use a neuropsychological examination
|
|
Other: healthy volunteers
healthy volunteers use a neuropsychological examination and brain imaging (fMRI and tractography)
|
Patient with grade 2 glioma and healthy volunteers use a brain imaging (fMRI)
Patient with grade 2 glioma and healthy volunteers use a brain imaging (tractography)
Patient with grade 2 glioma and healthy volunteers use a neuropsychological examination
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
functional score
Time Frame: 1 day
|
The intraoperative testing is performed by an evaluator (speech / neuropsychologist), present in the operating room, the patient's side. Its role is to identify functional disturbances induced by direct electrical stimulation. To do this, two standardized tests are administered to the patient alternately for the duration of the awake period. These tests are presented on a computer screen in PowerPoint format, with a picture every four seconds. |
1 day
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Evaluation orthophonic
Time Frame: 1 day
|
|
1 day
|
|
Evaluation orthophonic
Time Frame: 5 day
|
|
5 day
|
|
Evaluation orthophonic
Time Frame: 3 month
|
|
3 month
|
|
Imagery Data
Time Frame: 1 day
|
Imagery Data
|
1 day
|
|
Imagery Data
Time Frame: 5 day
|
Imagery Data
|
5 day
|
|
Imagery Data
Time Frame: 6 month
|
Imagery Data
|
6 month
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 8674
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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