Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery: lessons from a case series

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• dc.contributor.author Boccuni, Leonardo
• dc.contributor.author Villalba Martínez, Gloria
• dc.contributor.author Tormos Muñoz, Josep María
• dc.date.accessioned 2025-06-30T11:46:04Z
• dc.date.available 2025-06-30T11:46:04Z
• dc.date.issued 2024
• dc.description.abstract Purpose: The objective of this prospective, single-centre case series was to investigate feasibility, clinical outcomes, and neural correlates of non-invasive Neuromodulation-Induced Cortical Prehabilitation (NICP) before brain tumor surgery. Previous studies have shown that gross total resection is paramount to increase life expectancy but is counterbalanced by the need of preserving critical functional areas. NICP aims at expanding functional margins for extensive tumor resection without functional sequelae. Invasive NICP (intracranial neuromodulation) was effective but characterized by elevated costs and high rate of adverse events. Non-invasive NICP (transcranial neuromodulation) may represent a more feasible alternative. Nonetheless, up to this point, non-invasive NICP has been examined in only two case reports, yielding inconclusive findings. Methods: Treatment sessions consisted of non-invasive neuromodulation, to transiently deactivate critical areas adjacent to the lesion, coupled with intensive functional training, to activate alternative nodes within the same functional network. Patients were evaluated pre-NICP, post-NICP, and at follow-up post-surgery. Results: Ten patients performed the intervention. Feasibility criteria were met (retention, adherence, safety, and patient's satisfaction). Clinical outcomes showed overall stability and improvements in motor and executive function from pre- to post-NICP, and at follow-up. Relevant plasticity changes (increase in the distance between tumor and critical area) were observed when the neuromodulation target was guided by functional neuroimaging data. Conclusion: This is the first case series demonstrating feasibility of non-invasive NICP. Neural correlates indicate that neuroimaging-guided target selection may represent a valid strategy to leverage neuroplastic changes before neurosurgery. Further investigations are needed to confirm such preliminary findings.
• dc.format.mimetype application/pdf
• dc.identifier.citation Boccuni L, Roca-Ventura A, Buloz-Osorio E, Leno-Colorado D, Delgado-Gallén S, Cabello-Toscano M, et al. Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery: lessons from a case series. J Neurooncol. 2024 Oct;170(1):185-98. DOI: 10.1007/s11060-024-04774-4
• dc.identifier.doi http://dx.doi.org/10.1007/s11060-024-04774-4
• dc.identifier.issn 0167-594X
• dc.identifier.uri http://hdl.handle.net/10230/70793
• dc.language.iso eng
• dc.publisher Springer
• dc.relation.ispartof J Neurooncol. 2024 Oct;170(1):185-98
• dc.rights © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Brain tumor
• dc.subject.keyword Case series
• dc.subject.keyword Neuromodulation
• dc.subject.keyword Neurorehabilitation
• dc.subject.keyword Neurosurgery
• dc.subject.keyword Prehabilitation
• dc.title Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery: lessons from a case series
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion