Editorial Material
Clinical Neurology
Ben A. Strickland, Gabriel Zada
Summary: Glioblastoma multiforme is the most common primary brain tumor in adults, often treated with maximal safe resection, chemotherapy, and radiation. Intraoperative use of blue light endoscopy can enhance tumor fluorescence visualization, aiding in achieving a more accurate resection.
WORLD NEUROSURGERY
(2021)
Article
Oncology
Simone Pacioni, Quintino Giorgio D'Alessandris, Stefano Giannetti, Giuseppe Maria Della Pepa, Martina Offi, Martina Giordano, Valerio Maria Caccavella, Maria Laura Falchetti, Liverana Lauretti, Roberto Pallini
Summary: In this study, fluorescence microscopy analysis was used to assess the number of fluorescence-positive tumor cells induced by 5-aminolevulinic acid (5-ALA) in both low-grade and high-grade gliomas. The ability of 5-ALA to cross the blood-brain barrier (BBB) was also investigated. It was found that 32.7-75.5 percent of cells in high-grade gliomas displayed 5-ALA induced fluorescence, while low-grade gliomas did not show fluorescence following 5-ALA. Immunofluorescence analysis suggested that 5-ALA does not cross the BBB. These findings have important implications for the neurosurgical resection of gliomas.
Article
Neurosciences
Pietro Zeppa, Raffaele De Marco, Matteo Monticelli, Armando Massara, Andrea Bianconi, Giuseppe Di Perna, Stefania Greco Crasto, Fabio Cofano, Antonio Melcarne, Michele Maria Lanotte, Diego Garbossa
Summary: This study compared the use of 5-ALA and SF in GBM patients and found no significant differences in terms of resection extent and postoperative functional status. However, the concomitant use of both fluorophores may improve overall survival.
Article
Oncology
Stefanie Lietke, Michael Schmutzer, Christoph Schwartz, Jonathan Weller, Sebastian Siller, Maximilian Aumiller, Christian Heckl, Robert Forbrig, Maximilian Niyazi, Rupert Egensperger, Herbert Stepp, Ronald Sroka, Jorg-Christian Tonn, Adrian Ruhm, Niklas Thon
Summary: Malignant glioma, especially in recurrent situations, has a poor prognosis. Interstitial photodynamic therapy (iPDT) using 5-aminolevulinic acid-induced protoporphyrin IX as a cytotoxic photosensitizer shows promising results in treating recurrent malignant gliomas. Heterogeneous treatment response was observed without significant association with patient characteristics, treatment-related factors, or molecular markers. Further prospective evaluation is needed to identify mechanisms and prognostic factors of favorable treatment response.
Review
Biochemistry & Molecular Biology
Marek Mazurek, Dariusz Szczepanek, Anna Orzylowska, Radoslaw Rola
Summary: This article summarizes the current knowledge on the differences in the level of emitted fluorescence in glial tumors. It discusses how the level of fluorescence may depend on the histological type and genetic profile of the tumor, as well as the activity and expression of enzymes involved in the intracellular metabolism of fluorescent dyes.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Cell Biology
Leire Pedrosa, Carmen Bedia, Dioulde Diao, Alejandra Mosteiro, Abel Ferres, Elisabetta Stanzani, Fina Martinez-Soler, Avelina Tortosa, Estela Pineda, Iban Aldecoa, Marc Centellas, Marta Munoz-Tuduri, Ana Sevilla, Angels Sierra, Jose Juan Gonzalez Sanchez
Summary: This study investigated the effects of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) on glioblastoma (GB) treatment and determined the optimal conditions for PDT efficacy without causing phototoxic injury to normal brain tissue. The results showed that 5-ALA/PDT effectively inhibited cancer cell proliferation and promoted apoptosis without significant effects on normal cells.
Review
Clinical Neurology
Danielle Golub, Jonathan Hyde, Siddhant Dogra, Joseph Nicholson, Katherine A. Kirkwood, Paulomi Gohel, Stephen Loftus, Theodore H. Schwartz
Summary: The study compared the efficacy of 5-ALA and IMRI in optimizing EOR in HGG, finding both to be superior to conventional neuronavigation. However, no clear difference in effectiveness was found between IMRI and 5-ALA.
JOURNAL OF NEUROSURGERY
(2021)
Article
Oncology
Kazuhide Shimizu, Kaoru Tamura, Shoko Hara, Motoki Inaji, Yoji Tanaka, Daisuke Kobayashi, Takashi Sugawara, Hiroaki Wakimoto, Tadashi Nariai, Kenji Ishii, Ichiro Sakuma, Taketoshi Maehara
Summary: This study aimed to investigate the correlation between preoperative MET-PET signals and intraoperative 5-ALA-induced fluorescence in malignant brain tumor surgery. The results showed that strong tumor fluorescence correlated with high MET-PET uptake and cellular proliferation, providing valuable tumor biology information for surgery in situations where MET-PET is not accessible.
Article
Clinical Neurology
Sadahiro Kaneko, Eric Suero Molina, Peter Sporns, Stephanie Schipmann, David Black, Walter Stummer
Summary: This study investigates the real-time kinetics of protoporphyrin IX (PpIX) in low-grade glioma (LGG) using hyperspectral fluorescence-based measurements and identifies factors that predict fluorescence. The results show that fluorescence in LGG peaks between 7 and 8 hours after 5-ALA application, and it is related to 18F-FET PET uptake and Ki-67/MIB-1.
JOURNAL OF NEUROSURGERY
(2022)
Article
Biochemistry & Molecular Biology
Joao Basso, Marco G. Paggi, Ana Fortuna, Carla Vitorino, Rui Vitorino
Summary: This study identified dysregulated miRNAs in glioblastoma using integrative analysis of microarray data. They found 21 miRNAs commonly dysregulated in glioblastoma, which were associated with tumor progression, invasion, and patient survival. Additionally, they identified 5 miRNAs specifically associated with glioblastoma, suggesting them as potential therapeutic targets. These miRNAs modulate several signaling pathways including MAPK/ERK, calcium, PI3K/AKT, mTOR, and Wnt.
MOLECULAR GENETICS AND GENOMICS
(2022)
Article
Clinical Neurology
Laurent J. Livermore, Martin Isabelle, Ian M. Bell, Oliver Edgar, Natalie L. Voets, Richard Stacey, Olaf Ansorge, Claire Vallance, Puneet Plaha
Summary: Raman spectroscopy can accurately differentiate between tumor and normal brain tissue in fresh samples and performs better than 5-ALA-induced fluorescence, showing potential as an intraoperative tool for guiding glioma surgery.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Laurent J. Livermore, Martin Isabelle, Ian M. Bell, Oliver Edgar, Natalie L. Voets, Richard Stacey, Olaf Ansorge, Claire Vallance, Puneet Plaha
Summary: The study demonstrates the superior performance of Raman spectroscopy in distinguishing between tumor and normal brain tissue, making it a crucial intraoperative tool for glioma surgery guidance. When used in conjunction with 5-ALA-induced fluorescence, Raman spectroscopy outperforms the latter and shows better predictive value.
JOURNAL OF NEUROSURGERY
(2021)
Article
Oncology
Abel Ferres, Alberto Di Somma, Alejandra Mosteiro, Thomaz Eduardo Topczewski, Pedro Roldan, Leire Pedrosa, Dioulde Diao, Estela Pineda, Angels Sierra, Joaquim Ensenat, Jose Juan Gonzalez-Sanchez
Summary: In this study, an inadvertent effect of 5-ALA-mediated photodynamic therapy has been detected in vivo. This finding opens up possibilities for further research on this promising therapeutic tool.
FRONTIERS IN ONCOLOGY
(2022)
Article
Clinical Neurology
Alexandra M. Giantini-Larsen, Natasha Kharas, David Pisapia, Theodore H. Schwartz
Summary: The headlamp/loupe device is a useful tool for performing fluorescence-guided resection of high-grade gliomas. The degree of fluorescence can provide information about histology, cell density, and necrosis, and is significant in predicting the type of tumor. Safe complete resection of fluorescence has a high positive predictive value for radiographic extent of resection.
ACTA NEUROCHIRURGICA
(2023)
Article
Clinical Neurology
Johannes Herta, Anna Cho, Thomas Roetzer-Pejrimovsky, Romana Hoeftberger, Wolfgang Marik, Gernot Kronreif, Tanja Peilnsteiner, Karl Roessler, Stefan Wolfsberger
Summary: The potential of 5-aminolevulinic acid (5-ALA) and Raman spectroscopy (RS) in detecting tumor-infiltrated brain in glioblastoma patients was assessed and compared. The study found that RS has higher sensitivity and 5-ALA has higher specificity in detecting tumor-infiltrated brain. Combining the two methods can increase the accuracy of tumor detection by about 10%.
JOURNAL OF NEUROSURGERY
(2023)
Review
Clinical Neurology
Karanbir Brar, Shervin Taslimi, Yosef Ellenbogen, Jiawen Deng, Winston Hou, Fabio Y. Moraes, Michael Glantz, Brad E. Zacharia, Aaron Tan, Manmeet S. Ahluwalia, Mustafa Khasraw, Gelareh Zadeh, Alireza Mansouri
Summary: This study quantitatively compares the efficacy of various treatment regimens for NSCLC brain metastases without a targetable epidermal growth factor receptor mutation/ALK rearrangement. The results demonstrate promising survival benefits with the use of checkpoint inhibitor-based regimens.
WORLD NEUROSURGERY
(2022)
Article
Oncology
Jurgen Germann, Gelareh Zadeh, Alireza Mansouri, Walter Kucharczyk, Andres M. Lozano, Alexandre Boutet
Summary: Brain imaging, particularly MRI, is essential in neuro-oncology for diagnosis and treatment. Neuroimaging techniques allow the transformation of brain MRI into an average brain for group analyses. Normative analyses using MRI data are uncommon in neuro-oncology research but offer a wide range of possibilities for understanding tumor behavior.
Article
Oncology
Debarati Bhanja, Djibril Ba, Kyle Tuohy, Hannah Wilding, Mara Trifoi, Varun Padmanaban, Guodong Liu, Michael Sughrue, Brad Zacharia, Douglas Leslie, Alireza Mansouri
Summary: Low-grade gliomas (LGGs) account for 13-16% of glial tumors. The incidence, prevalence, and risk factors of mental health disorders (MHD) in LGG patients were investigated in this retrospective cohort study. Among 20,432 LGG patients, 60.9% had MHD, with 16.9% of patients developing new-onset MHD within 12 months of LGG diagnosis. Risk factors included female gender, ages 35-54, presence of seizures, and first-line surgical treatment. Proactive surveillance and counseling for MHDs are recommended, as well as consideration of the impact of surgery on brain networks affecting mood.
Article
Clinical Neurology
Debarati Bhanja, Jeffrey Neighbors, James Connor, Gelareh Zadeh, Alireza Mansouri
Summary: This study aims to evaluate the therapeutic effects of repurposed posaconazole (PCZ) in patients with glioblastoma (GBM). The study will analyze the tumor penetrance, neuropharmacokinetics, and the impact of PCZ on tumor cell metabolism. Successful trial results will contribute to finding more effective treatment options for GBM.
Article
Oncology
Jeffrey A. Zuccato, Vikas Patil, Sheila Mansouri, Mathew Voisin, Ankur Chakravarthy, Shu Yi Shen, Farshad Nassiri, Nicholas Mikolajewicz, Mara Trifoi, Anna Skakodub, Brad Zacharia, Michael Glantz, Daniel D. De Carvalho, Alireza Mansouri, Gelareh Zadeh
Summary: By using methylomes obtained from cerebrospinal fluid, it is possible to accurately classify brain metastases, glioblastomas, and central nervous system lymphomas, which eliminates the risks associated with invasive diagnostic surgical biopsies and provides a classification basis for non-biopsiable tumors. This has significant implications for guiding surgical planning and avoiding surgical risks.
Review
Clinical Neurology
Nebras M. Warsi, Amro H. Mohammad, Frederick Zhang, Simeon M. M. Wong, Han Yan, Alireza Mansouri, George M. Ibrahim
Summary: A systematic review and meta-analysis of 31 studies showed that ECoG-guided surgery can improve postoperative seizure control in cases of low-grade cerebral neoplasms. However, this effect may be attenuated in the presence of concomitant cortical dysplasia, highlighting the need for improved monitoring.
Article
Surgery
Kyle Tuohy, Djibril M. Ba, Debarati Bhanja, Douglas Leslie, Guodong Liu, Alireza Mansouri
Summary: This study compared the complication rates and costs associated with different surgical interventions for DLGG. The results showed that maximal safe resection did not increase the complication rate, but it was associated with higher total costs and drug costs.
FRONTIERS IN SURGERY
(2023)
Article
Clinical Neurology
Alireza Mansouri, Sufyan Ibrahim, Lorenzo Bello, Juan Martino, Carlos Velasquez
Summary: Cortical and subcortical motor mapping has become an important technique for maximal safe resection of intra-axial brain tumors. However, there is a lack of standardized protocols for motor mapping due to variation in strategies and techniques. In this survey of 51 neurosurgeons, preliminary data was obtained on patient selection and the approach to motor mapping for brain tumors.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2023)
Review
Immunology
Mohammadmahdi Sabahi, Arash Salehipour, Mohammad Sajjad Yavari Bazl, Nima Rezaei, Alireza Mansouri, Hamid Borghei-Razavi
Summary: Despite poor prognosis of GBM, immunotherapy, especially CAR T cells, shows promising potential in improving outcomes. Local immunotherapy targeting tumor microenvironment, such as TLS incorporation into a scaffold, can reduce CAR T cell exhaustion and enhance the immune response. Combining TLS, STING agonists, GSCs, and CAR T cells in an implantable scaffold offers a multifaceted approach for GBM treatment.
JOURNAL OF NEUROIMMUNOLOGY
(2023)
Review
Oncology
Debarati Bhanja, Hannah Wilding, Angel Baroz, Mara Trifoi, Ganesh Shenoy, Becky Slagle-Webb, Daniel Hayes, Yasaman Soudagar, James Connor, Alireza Mansouri
Summary: This review focuses on summarizing the potential and shortcomings of photodynamic therapy (PDT) in the treatment of glioblastoma (GBM), analyzing the current challenges that hinder its effectiveness, and highlighting novel investigations in this field. By addressing these barriers and proposing solutions, this review provides a path for optimizing PDT as a paradigm-shifting treatment for GBM.
Review
Oncology
Mohammad Mofatteh, Mohammad Sadegh Mashayekhi, Saman Arfaie, Yimin Chen, Armaan K. Malhotra, Mohammed Ali Alvi, Nicholas Sader, Violet Antonick, Mostafa Fatehi Hassanabad, Alireza Mansouri, Sunit Das, Xuxing Liao, Roger S. McIntyre, Rolando Del Maestro, Gustavo Turecki, Aaron A. Cohen-Gadol, Gelareh Zadeh, Keyoumars Ashkan
Summary: After a diagnosis of a brain tumor, psychological distress has been found to have negative effects on mental health and suicidal tendencies. However, the extent of this impact has not been thoroughly studied. This systematic review examined the impact of brain tumors on suicidality. The results showed that brain tumor patients had higher rates of suicidal ideation and attempts compared to the general population. Factors such as anxiety, depression, pain severity, physical impairment, glioblastoma diagnosis, male sex, and older age were identified as the primary risk factors for increased suicidality.
NEURO-ONCOLOGY ADVANCES
(2023)
Correction
Oncology
Nicholas Mikolajewicz, Shahbaz Khan, Mara Trifoi, Anna Skakdoub, Vladmir Ignatchenko, Sheila Mansouri, Jeffrey Zuccato, Brad E. Zacharia, Michael Glantz, Gelareh Zadeh, Jason Moffat, Thomas Kislinger, Alireza Mansouri
NEURO-ONCOLOGY ADVANCES
(2023)
Article
Oncology
Nicholas Mikolajewicz, Shahbaz Khan, Mara Trifoi, Anna Skakdoub, Vladmir Ignatchenko, Sheila Mansouri, Jeffrey Zuccatto, Brad E. Zacharia, Michael Glantz, Gelareh Zadeh, Jason Moffat, Thomas Kislinger, Alireza Mansouri
Summary: This study successfully identified diagnostic and prognostic biomarkers for glioblastoma, brain metastases, and primary central nervous system lymphoma through proteomic analysis of cerebrospinal fluid samples. Novel biomarkers were discovered, and the classification of tumors using low CSF volumes was found to be feasible for longitudinal tumor surveillance.
NEURO-ONCOLOGY ADVANCES
(2022)
Meeting Abstract
Oncology
Angel Baroz, Caleb Stahl, Debarati Bhanja, Hannah Wilding, Alireza Mansouri
Meeting Abstract
Oncology
Debarati Bhanja, Djibril Ba, Kyle Tuohy, Hannah Wilding, Mara Trifoi, Varun Padmanaban, Guodong Liu, Michael Sughrue, Brad Zacharia, Douglas Leslie, Alireza Mansouri