Background: Audiovisual integration is essential for daily functions such as speech comprehension. It relies on a temporal constraint whereby events from different sensory modalities are perceptually bound within a limited temporal window, the audiovisual temporal binding window, defining the range of stimulus onset asynchronies perceived as synchronous. While correlational neuroimaging studies (fMRI, EEG) have implicated a distributed network in audiovisual integration, the causal neural underpinnings of the temporal binding window remain largely unknown. Objective: To identify cortical regions causally supporting audiovisual simultaneity judgment. Methods: Direct electrical stimulation (DES) was prospectively applied to 62 cortical sites during awake brain surgery in 39 patients. Patients performed an audiovisual simultaneity judgment task with varying stimuli onset asynchronies alongside standard sensory-motor, language, and visuospatial tasks. Montreal Neurological Institute coordinates were obtained for all stimulated areas. Results: DES selectively impaired audiovisual simultaneity judgments while sparing other standard tasks, in 7 highly focal, right-hemispheric cortical sites (<1 cm2). Three sites were situated around the intraparietal sulcus, and four near the supplementary motor area. Stimulation of left-hemisphere sites produced non-selective impairments, also affecting language-related tasks. Conclusions: These findings provide causal evidence for a right-lateralized frontoparietal network, involving focal regions near the intraparietal sulcus and supplementary motor area, in audiovisual temporal integration. Given the established roles of these regions in attentional and decisional processes, this study refines their contribution to the temporal binding window network and underscores the clinical importance of preserving this network during awake brain surgery. ### Competing Interest Statement The authors have declared no competing interest.

PURPOSE:Chronic subdural hematoma (cSDH) is typically diagnosed on non-contrast brain CT. Embolization of the middle meningeal artery (MMA) has become an increasingly adopted treatment, but pre-procedural assessment of MMA anatomy remains essential because anatomical variations may affect procedural safety. This study evaluated whether three-dimensional (3D) reconstructions from routine non-contrast CT can depict MMA anatomy compared with digital subtraction angiography (DSA), the reference standard. MATERIALS AND METHODS:In this retrospective study, 76 patients (91 MMAs) who underwent both non-contrast CT and DSA were analyzed. The anterior, posterior, and middle branches were assessed. Branch dominance was categorized as Type I (anterior), Type II (posterior), or Type III (mixed), and posterior branch origin as proximal (A), intermediate (B), or distal (C). The Extended-Adachi classification was used for overall anatomical patterns. The foramen spinosum (FS) and MMA tortuosity were also evaluated. Concordance rates between CT and DSA were calculated. RESULTS:On CT, the anterior, posterior, and middle branches were visible in 100%, 94.5%, and 96.7% of cases, respectively. CT-DSA concordance was high for branch identification (91.1%, 85.7%, and 78.0%) and lower for dominance (45.5%) and posterior branch origin (39.3%). Absence of the FS on CT was strongly associated with anatomical variants (3/4 cases). CONCLUSION:3D reconstructions from non-contrast CT allow reliable visualization of the main MMA branches. Assessment of the FS may provide an additional indirect indicator of anatomical variation, although this finding requires confirmation in larger studies. Pre-procedural recognition of MMA variants may help optimize procedural planning and reduce the risk of non-target embolization.

The temporal binding window (TBW) refers to the time interval within which two stimuli, typically visual and auditory, are perceived as synchronous. Neural bases underlying this process consistently implicate a large-scale network with superior temporal sulcus (STS) as a central hub, alongside contributions from primary auditory and visual cortices and higher-order areas including prefrontal and posterior parietal cortex. This study aimed to provide causal evidence for the involvement of superior temporal gyrus (STG) and intraparietal sulcus (IPS) in the simultaneity judgment (SJ) task using MRI-guided transcranial magnetic stimulation (TMS). In particular, we aimed to clarify temporal dynamics of these regions in audiovisual synchrony perception. Forty adults performed an SJ task in which they had to determine whether stimuli were synchronous or asynchronous. Single-pulse TMS was applied over bilateral IPS, STG, or the vertex at different delays following stimulus offset. Early stimulation of left IPS and right STG increased the proportion of “synchronous” responses. In contrast, later stimulation of bilateral STG was associated with reduced synchrony perception. These findings provide causal evidence for a dynamic interplay between parietal and temporal regions in audiovisual temporal integration. Early IPS and STG involvement facilitates temporal integration, while later STG activity promotes perceptual segregation. ### Competing Interest Statement The authors have declared no competing interest. Tremplin Call for Proposals, University of Toulouse

BACKGROUND:Intracranial meningiomas are the most common benign central nervous system tumors, often managed with elective surgical resection. While outcomes are generally favorable, postoperative management remains variable, particularly regarding routine Intensive-Care Units (ICU) admission. Given increasing pressure on critical care resources, identifying patients who truly require ICU-level monitoring is essential. OBJECTIVE:To evaluate early postoperative complications after meningioma surgery and develop a practical risk-based score to guide ICU admission. METHODS:We performed a retrospective single-center study of 203 intracranial meningioma resections (2020-2022). Patients were included if they had scheduled surgery and at least one night of postoperative ICU monitoring. A composite endpoint defined ICU-relevant complications within 24 h, including seizures, new deficits, delayed awakening, reintubation, transfusion, intra-veinous (IV) antihypertensives, and urgent imaging or reoperation. Twenty-two clinical, radiological, and surgical factors were analyzed. RESULTS:Postoperative complications requiring ICU-level care occurred in 19.2% of cases, mostly neurological (13.8%). Two-thirds of events occurred upon awakening or in the post-anesthesia care unit (PACU). Univariate analysis identified seven significant predictors: intracranial hypertension, falcine location, motor cortex involvement, operative time ≥3 h, blood loss >500 mL, osmotherapy use, and transfusion. A 10-item risk score demonstrated high sensitivity (92.3%) and negative predictive value (95.9%) using a cut-off of 1 or more points. Using this model, in our population, 36.5% of patients could have safely avoided ICU admission. CONCLUSION:A risk-based approach to ICU admission after meningioma surgery appears both safe and feasible. Implementation of this score, combined with extended PACU monitoring, could optimize resource use without compromising patient safety. Prospective validation is warranted.

BACKGROUND:Since 2021, glioblastomas have been classified into two subgroups: classic glioblastomas (histGB), defined as IDH wild-type grade 4 astrocytomas with necrosis and vascular proliferation, showing contrast enhancement (CE) on MRI; and molecular glioblastomas (molGB), characterized by specific alterations (7+/10-, EGFR amplification, TERT mutation). Although not always the case, molGB often lack CE and may mimic low-grade gliomas (LGG), hence complicating the diagnosis. Survival outcomes remain debated. This study aimed to evaluate the response of molGB to standard treatment and assess the ability of machine learning and deep learning to differentiate molGB without CE from LGG on MRI. METHODS:We retrospectively studied 132 glioblastoma patients treated with radiotherapy and temozolomide, comparing the survival outcomes of histGB and molGB. Artificial intelligence (AI) models were trained using features from MRI FLAIR hypersignal segmentation to distinguish molGB without CE from LGG. RESULTS:No significant difference in median overall survival (OS) (20.6 vs 18.4 months, P = .2) or progression-free survival (10.1 vs 9.3 months, P = .183) was observed between molGB and histGB. However, molGB without CE demonstrated improved median OS (31.2 vs 18 months, hazard ratios 0.45). Artificial intelligence models distinguished molGB without CE from LGG, achieving a best-performing ROC AUC of 0.85. CONCLUSIONS:While patients with molGB and histGB have similar overall survival, patients with molGB without CE appear to have better outcomes. Artificial intelligence models effectively differentiate molGB from LGG, supporting their potential diagnostic utility.

We report a case of brain abscess caused by both Listeria monocytogenes and Toxoplasma gondii in an patient who is immunocompromised.

An observer willing to cross a street must first estimate if the approaching cars offer enough time to safely complete the task. The brain areas supporting this perception, known as Time‐To‐Contact (TTC) perception, have been mainly studied through noninvasive correlational approaches. We carried out an experiment in which patients were tested during an awake brain surgery electrostimulation mapping to examine the causal implication of various brain areas in the street‐crossing decision process. Forty patients were tested in a gap acceptance task before their surgery to establish a baseline performance. The task was individually adapted upon this baseline level and carried out during their surgery. We acquired and normalized to MNI space the coordinates of the functional areas that influenced task performance. A total of 103 stimulation sites were tested, allowing to establish a large map of the areas involved in the street‐crossing decision. Multiple sites were found to impact the gap acceptance decision. A direct implication was however found mostly for sites within the right parietal lobe, while indirect implication was found for sites within the language, motor, or attentional networks. The right parietal lobe can be considered as causally influencing the gap acceptance decision. Other positive sites were all accompanied with dysfunction in other cognitive functions, and therefore should probably not be considered as the site of TTC estimation.

BACKGROUND:Glioblastoma (GBM) systematically recurs after a standard 60 Gy radio-chemotherapy regimen. Since magnetic resonance spectroscopic imaging (MRSI) has been shown to predict the site of relapse, we analyzed the effect of MRSI-guided dose escalation on overall survival (OS) of patients with newly diagnosed GBM. METHODS:In this multicentric prospective phase III trial, patients who had undergone biopsy or surgery for a GBM were randomly assigned to a standard dose (SD) of 60 Gy or a high dose (HD) of 60 Gy with an additional simultaneous integrated boost totaling 72 Gy to MRSI metabolic abnormalities, the tumor bed and residual contrast enhancements. Temozolomide was administered concomitantly and maintained for 6 months thereafter. RESULTS:One hundred and eighty patients were included in the study between March 2011 and March 2018. After a median follow-up of 43.9 months (95% CI [42.5; 45.5]), median OS was 22.6 months (95% CI [18.9; 25.4]) versus 22.2 months (95% CI [18.3; 27.8]) for HD, and median progression-free survival was 8.6 (95% CI [6.8; 10.8]) versus 7.8 months (95% CI [6.3; 8.6]), in SD versus HD, respectively. No increase in toxicity rate was observed in the study arm. The pseudoprogression rate was similar across the SD (14.4%) and HD (16.7%) groups. For O(6)-methylguanine-DNA methyltransferase (MGMT) methylated patients, the median OS was 38 months (95% CI [23.2; NR]) for HD patients versus 28.5 months (95% CI [21.1; 35.7]) for SD patients. CONCLUSION:The additional MRSI-guided irradiation dose totaling 72 Gy was well tolerated but did not improve OS in newly diagnosed GBM. TRIAL REGISTRATION:NCT01507506; registration date: December 20, 2011. https://clinicaltrials.gov/ct2/show/NCT01507506?cond=NCT01507506&rank=1.

Sincipital meningoencephaloceles (MECs) are rare congenital malformations characterized by the herniation of brain or meningeal tissue through an opening in the anterior floor of the skull base. These malformations always affect the frontal bone, specifically the glabellar region and the naso-frontal angle. A collaboration between M & eacute;decins du Monde and the Children's Surgical Center in Phnom Penh has enabled the treatment of over four hundred cases over twenty years. Patients typically have not undergone radiological examinations, with surgical strategies based on clinical and intraoperative observations. There are several clinical forms of MECs: naso-frontal, naso-ethmoidal, and naso-orbital. The 1972 classification by Suwanwela remains the most relevant. Naso-frontal MECs are often associated with significant skin expansion without major bone deformity, unlike naso-ethmoidal MECs, which lead to significant deformities and are the most common. Naso-orbital MECs, being rarer, most frequently result in an increased orbital volume. The nature of the herniated tissue and the volume of the hernia are critical in determining the surgical strategy. Canthopexy, a key element of reconstruction, must be precise and adhere to strict rules to ensure an aesthetic result. The fronto-nasal remodeling completes the repair. The surgery for MECs follows well-codified principles. The humanitarian context influences management, with an emphasis on surgical safety and skill transmission. Treatment relies more on clinical assessment than radiological, although imaging advancements are now available in Cambodia. Long-term follow-up, especially in children, remains a challenge to document in order to evaluate the impacts on growth and the stability of surgical outcomes. (c) 2024 Published by Elsevier Masson SAS.

Les méningo-encéphalocèles (MEC) sincipitaux sont des malformations congénitales rares qui se manifestent par une hernie de tissu cérébral ou méningé à travers une ouverture dans l’étage antérieur de la base du crâne. Ces malformations touchent toujours l’os frontal, plus précisément la région glabellaire et l’angle naso-frontal. Une collaboration entre Médecins du Monde et le Children's Surgical Center de Phnom Penh a permis de prendre en charge plus de quatre cents cas sur vingt ans. Les patients n’ont généralement pas eu d’examens radiologiques, les stratégies chirurgicales étant basées sur les observations cliniques et peropératoires. Il existe plusieurs formes cliniques de MEC : naso-frontales, naso-ethmoïdales, et naso-orbitaires. La classification de Suwanwela de 1972 reste la plus pertinente. Les MEC naso-frontales sont souvent associés à une importante expansion cutanée sans déformation osseuse majeure, contrairement aux MEC naso-ethmoïdales, qui entraînent des déformations significatives et sont les plus fréquentes. Les MEC naso-orbitaires, plus rares, provoquent le plus souvent une augmentation du volume orbitaire. La nature du tissu hernié et le volume de la hernie sont déterminants pour la stratégie chirurgicale. La canthopexie, un élément clé de la reconstruction, doit être précise et répond à des règles strictes pour assurer un résultat esthétique. Le remodelage fronto-nasal finalise la réparation. La chirurgie des MEC suit des principes bien codifiés. Le contexte humanitaire influence la prise en charge, avec un accent sur la sécurité chirurgicale et la transmission des compétences. Le traitement repose sur une vision clinique plus que radiologique, même si les avancées en imagerie sont aujourd’hui disponibles au Cambodge. Le suivi à long terme, surtout chez les enfants, reste un défi à documenter pour évaluer les impacts sur la croissance et la stabilité des résultats chirurgicaux.

OBJECTIVES:Vaccine-induced immune thrombotic thrombocytopenia (VITT), a recently described entity characterized by thrombosis at unusual locations such as cerebral venous sinus and splanchnic vein, has been rarely described after adenoviral-encoded COVID-19 vaccines. In this study, we report the immunohistological correlates in 3 fatal cases of cerebral venous thrombosis related to VITT analyzed at an academic medical center.METHODS:Detailed neuropathologic studies were performed in 3 cases of cerebral venous thrombosis related to VITT after adenoviral COVID-19 vaccination.RESULTS:Autopsy revealed extensive cerebral vein thrombosis in all 3 cases. Polarized thrombi were observed with a high density of neutrophils in the core and a low density in the tail. Endothelial cells adjacent to the thrombus were largely destroyed. Markers of neutrophil extracellular trap and complement activation were present at the border and within the cerebral vein thrombi. SARS-CoV-2 spike protein was detected within the thrombus and in the adjacent vessel wall.DISCUSSION:Data indicate that neutrophils and complement activation associated with antispike immunity triggered by the vaccine is probably involved in the disease process.

OBJECTIVE:The authors analyzed the current-intensity thresholds for electrostimulation of language fasciculi and the possible consequences of threshold variability on brain mapping. METHODS:A prospective protocol of subcortical electrostimulation was used in 50 patients undergoing brain mapping, directly stimulating presumed language fasciculi identified by diffusion tensor imaging. RESULTS:The stimulation-intensity thresholds for identification of language fasciculi varied among patients (mean minimum current intensity of 4.4 mA, range = 1.5-10 mA, standard deviation = 1.1 mA), and 23% of fascicular interferences were detected only above 5 mA. Repeated stimulation of the same site with the same intensity led to different types of interferences in 20% of patients, and a higher current intensity led to changes in the type of response in 27%. The mean minimum stimulation intensities did not differ significantly between different fasciculi, between the different types of interference obtained, or with age, sex, or type of tumor. Positive results on cortical mapping were significantly associated with positive results on subcortical mapping (P < 0.001). Subcortical intensity thresholds were slightly lower than cortical ones (mean = 4.43 vs. 5.25 mA, P = 0.034). In 23 of 50 subcortical mappings, fascicular stimulation produced no language interference. CONCLUSIONS:Individual variability of minimum stimulation-intensity thresholds for identification of language fasciculi is frequent. Nevertheless, even when a high current intensity was used, many stimulations on language fasciculi remained negative for various hypothetic reasons. Finding the optimal current intensity for identifying language fasciculi is of paramount importance to refine the clinical results and scientific data derived from brain mapping.

AIM: To present one-step customized cranioplasty for intraosseous meningiomas. CASE DESCRIPTION: The authors report the case of a 54-year-old woman with a consequent frontal intraosseous meningioma invading the superior sagittal sinus. The patient only suffered from local pain and cosmetic damage. A complete resection was scheduled with a one-step reconstruction of the frontal bone by a polyetheretherketone (PEEK) specific implant. This implant was computer-assisted designed and manufactured and verified by the surgeon before the intervention. During surgery, the resection was guided by a computer designed resection template and by the classic neuronavigation system. Cranioplasty has been considered optimal intraoperatively by surgeons. The patient, a few weeks after surgery, underwent a subcutaneous fluid collection, rapidly resolutive with a circumferential pressure bandage. Six months after surgery, the patient considered the surgery a success with a very good cosmetic result and a total regression of her local pain. CONCLUSION: One-step computer-assisted cranioplasty is a safe and effective procedure for large skull defects. PEEK specific implant for cranioplasty offer advantages compared to other materials that will be discussed under the scope of the one-step reconstruction.

Souvent traitées par ostéosynthèse, les fractures du rachis thoraco lombaire peuvent avoir des conséquences à long terme sur le plan clinique, mais aussi social et familial. Peu de données sont disponibles dans la littérature à ce sujet. Le but de cette étude était d’évaluer ces conséquences à très long terme (> 12 ans) chez des patients opérés d’une fracture par ostéosynthèse ouverte du rachis thoraco-lombaire. Deux groupes, un composé de 30 patients opérés pour une fracture thoraco-lombaire par fixation postérieure et un autre composé de 30 témoins (n’ayant jamais eu de fracture vertébrale) appariés selon l’âge, le sexe, le statut professionnel et la durée du suivi ont été étudiés. 3 questionnaires ont été envoyés à l’ensemble de la cohorte, patients et témoins : un sur les aspects cliniques, familiaux et socioprofessionnels et 2 échelles évaluant le retentissement de la lombalgie sur plusieurs domaines (Dallas et Eifel). Le suivi moyen des patients était de 14,5 ans (de 12 à 18 ans, s :2,3). La majorité (56 %) des fractures sont survenues au niveau T12/L1. Au dernier suivi, la lombalgie chronique concernait 20 (66,7 %) patients contre 11 (36,7 %) des témoins (p = 0,03). La consommation d’antalgique est supérieure dans le groupe patient (13 patients–43,3 %) par rapport au groupe témoin non opéré (5 personnes–16,6 %) (p = 0,04). Une grande majorité (13 patients, 57 %) ont bénéficié d’arrêts de travail dépassant 6 mois. Une diminution de salaire (après le traumatisme) est significativement plus souvent retrouvée (p = 0,002) chez les patients opérés par rapport aux témoins appariés sur la même période. Au suivi final, le score Eifel moyen pour l’ensemble de la cohorte de patients était significativement supérieur à celui du groupe témoin (4,7 [s :3,75] contre 2,6 [s : 4,2], p = 0,008). Le score de Dallas est supérieur dans le groupe de patients pour les items répercussion quotidienne, travail-loisirs et sociabilité (p < 0,05). Pourvoyeur de lombalgie chronique, d’arrêt de travail long, de répercussion dans la vie professionnelle et familiale, les suites postopératoires à très long terme des patients opérés d’une fracture rachidienne pourrait être plus difficiles que prévu chez une majorité de patients. Cette étude a permis de mieux les identifier et propose quelques solutions pour faciliter le retour au travail et ainsi réduire ces conséquences à long terme, avec notamment une sollicitation rapide du service de médecine du travail. III ; étude rétrospective de contrôle de cas.

Background: The existence of cerebral area specifically involved in coding for writing movements in the left middle frontal gyrus is a matter of debate. We present a rare case of pure agraphia associated with a left frontal meningioma. The location of the lesion associated with this disorder could help to feed this debate. Method: We report a case of pure agraphia in a 69-year-old man. The patient had a writing disorder evolving over several months with a dominant, left frontal lesion. On neuropsychological evaluation, the writing difficulties were present whatever the nature of the writing (spontaneous, dictation, coping). The writing disorder was isolated, with no features of aphasia, alexia or limb apraxia. Phonological and lexical processing was preserved. The imaging showed a probable frontal meningioma restricted to the foot of the first and second left frontal circumvolutions (MNI coordinates /barycenter of the lesion: x=-19.8, y=1.5, z=52.2). Results: The patient was operated and the whole lesion was removed. After surgical resection, the patient’s writing disorder improved. Other components of language assessed were the same as before the surgery and showed no disturbances. The pathological study concluded on an OMS grade II atypical meningioma. Conclusion: We think that the disorder presented by our patient was related to the disturbance of the frontal graphemic center located in the Exner area. Here, we describe and analyze his condition through a neuro-anatomical and a cognitive approach.

OBJECTIVE:The purpose of this study was to investigate the possible benefit of repeat surgery on overall survival for patients with recurrent glioblastoma multiforme (GBM).METHODS:We performed a retrospective analysis of data from patients who presented with recurrent GBM over a 5-year period (n = 157), comparing baseline characteristics and survival for patients who had at least 1 new tumor resection followed by chemotherapy (reoperation group, n = 59) and those who received medical treatment only (no-reoperation group, n = 98) for recurrence.RESULTS:The baseline characteristics of the two groups differed in terms of WHO performance status (better in the reoperation group), mean age (60 years in the reoperation group vs. 65 years in the no-reoperation group), mean interval to recurrence (3 months later in the reoperation group than in the no-reoperation group) and more gross total resections in the reoperation group. Nevertheless, the patients in the reoperation group had a higher rate [32.8%] of sensorimotor deficits than those of the no-reoperation group [14.2]. There was no significant difference in sex; tumor localization, side, or extent; MGMT status; MIB-1 labeling index; or Karnofsky Performance Status [KPS] score. After adjustment for age, the WHO performance status, interval of recurrence, and extent of resection at the first operation, multivariate analysis showed that median survival was significantly better in the reoperation group than in the no-reoperation group (22.9 vs. 14.61 months, P < 0.05). After a total of 69 repeat operations in 59 patients (10 had 2 repeat surgeries), we noted 13 temporary and 20 permanent adverse postoperative events, yielding a permanent complication rate of 28.99% (20/69). There was also a statistically significant (P = 0.029, Student's t-test) decrease in the mean KPS score after reoperation (mean preoperative KPS score of 89.34 vs. mean postoperative score of 84.91).CONCLUSION:Our retrospective study suggests that repeat surgery may be beneficial for patients with GBM recurrence who have good functional status (WHO performance status 0 and 1), although the potential benefits must be weighed against the risk of permanent complications, which occurred in almost 30% of the patients who underwent repeat resection in this series.

Objective To evaluate the role and possible complications of tumor resection in the management of glioblastoma (GBM) in a series of patients 80 years of age and older with review of literature. Methods The authors retrospectively analyzed cases involving patients 80 years or older who underwent biopsy or initial resection of GBM at their hospital between 2007 and 2018. A total of 117 patients (mean age 82 years) met the inclusion criteria; 57 had resection (group A) and 60 had biopsy (group B). Functional outcomes and survival at follow-up were analyzed. Results Group A differed significantly from group B at baseline in having better WHO performance status, better ASA scores, more right-sided tumors, and no basal ganglia or “butterfly” gliomas. Nevertheless, 56% of group A patients had an ASA score of 3. Median survival was 9.5 months (95% CI 8–17 months) in group A, 4 months (95% CI 3.5–6 months) in group B, and 17.5 months (95% CI 12–24 months) in the 56% of group A patients treated with resection and Stupp protocol. Rates of postoperative neurologic and medical complications were almost identical in the 2 groups, but the rate of surgical site complications was substantially greater in group A (12% vs 5%). There was no significant difference in mean preoperative and postoperative KPS scores (group A). Conclusions In selected patients 80 years or older, radical removal of GBM was associated with acceptable survival and a low perioperative complication rate which is comparable to that of a biopsy. Although the median survival of the whole group was lower than reported for younger patients, a subgroup amenable to radical surgery and Stupp protocol achieved a median survival of 17.5 months.

Time‐to‐contact (TTC) perception refers to the ability of an observer to estimate the remaining time before an object reaches a point in the environment, and is of crucial importance in daily life. Noninvasive correlational approaches have identified several brain areas sensitive to TTC information. Here we report the results of two studies, including one during an awake brain surgery, that aimed to identify the specific areas causally engaged in the TTC estimation process. In Study 1, we tested 40 patients with brain tumor in a TTC estimation task. The results showed that four of the six patients with impaired performance had tumors in right upper parietal cortex, although this tumoral location represented only six over 40 patients. In Study 2, 15 patients underwent awake brain surgery electrostimulation mapping to examine the implication of various brain areas in the TTC estimation process. We acquired and normalized to MNI space the coordinates of the functional areas that influenced task performance. Our results seem to demonstrate that the early stage of the TTC estimation process involved specific cortical territories in the ventral region of the right intraparietal sulcus. Downstream processing of TTC could also involve the frontal eye field (middle frontal gyrus) related to ocular search. We also found that deactivating language areas in the left hemisphere interfered with the TTC estimation process. These findings demonstrate a fine grained, cortical representation of TTC processing close to the ventral right intraparietal sulcus and complement those described in other human studies.

Objectives: Establishing an overall survival prognosis for resected glioblastoma during routine postoperative management remains a challenge. The aim of our single-center study was to assess the usefulness of basing survival analyses on preradiotherapy MRI (PRMR) rather than on postoperative MRI (POMR). Patients and methods: A retrospective review was undertaken of 75 patients with glioblastoma treated at our institute. We collected overall survival and MRI volumetric data. We analyzed two types of volumetric data: residual tumor volume and extent of resection. Overall survival rates were compared according to these two types of volumetric data, calculated on either POMR or PRMR and according to the presence or absence of residual enhancement. Results: Analysis of volumetric data revealed progression of some residual tumors between POMR and PRMR. Kaplan-Meier analysis of the correlations between extent of resection, residual tumor volume, and overall survival revealed significant differences between POMR and PRMR data. Both MRI scans indicated a difference between the complete resection subgroup and the incomplete resection subgroup, as median overall survival was longer in patients with complete resection. However, differences were significant for PRMR (25.3 vs. 15.5, p = 0.012), but not for POMR (21.3 vs. 15.8 months, p = 0.145). With a residual tumor volume cut-off value of 3 cm(3), Kaplan-Meier survival analysis revealed non-significant differences on POMR (p = 0.323) compared with PRMR (p = 0.007). Conclusion: Survival in patients with resected glioblastoma was more accurately predicted by volumetric data acquired with PRMR. Differences in predicted survival between the POMR and PRMR groups can be attributed to changes in tumor behavior before adjuvant therapy.

Additional file 2: Table S2. List of the 517 childhood cancer genes in the dragon targeted gene sequencing panel (Illumina_TruSeq Custom Amplicon).