Lessons from brain mapping in surgery for low-grade glioma: insights into associations between tumour and brain plasticity

Lancet Neurol. 2005 Aug;4(8):476-86. doi: 10.1016/S1474-4422(05)70140-X.


Surgical treatment of low-grade gliomas (LGGs) aims to maximise the amount of tumour tissue resected, while minimising the risk of functional sequelae. In this review I address the issue of how to reconcile these two conflicting goals. First, I review the natural history of LGG-growth, invasion, and anaplastic transformation. Second, I discuss the contribution of new techniques, such as functional mapping, to our understanding of brain reorganisation in response to progressive growth of LGG. Third, I consider the clinical implications of interactions between tumour progression and brain plasticity. In particular, I show how longitudinal studies (preoperative, intraoperative, and postoperative) could allow us to optimise the surgical risk-to-benefit ratios. I will also discuss controversial issues such as defining surgical indications for LGGs, predicting the risk of postoperative deficit, aspects of operative surgical neuro-oncology (eg, preoperative planning and preservation of functional areas and tracts), and postoperative functional recovery.

Publication types

  • Review

MeSH terms

  • Brain / physiology*
  • Brain / physiopathology
  • Brain / surgery
  • Brain Mapping*
  • Brain Neoplasms / physiopathology
  • Brain Neoplasms / surgery*
  • Electroencephalography
  • Glioma / physiopathology
  • Glioma / surgery*
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Magnetoencephalography
  • Monitoring, Intraoperative*
  • Neuronal Plasticity*
  • Positron-Emission Tomography