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
Clinical Neurology
Alexander J. Schupper, Rebecca B. Baron, William Cheung, Jessica Rodriguez, Steven N. Kalkanis, Muhammad O. Chohan, Bruce J. Andersen, Roukoz Chamoun, Brian Nahed, Brad E. Zacharia, Jerone Kennedy, Hugh D. Moulding, Lloyd Zucker, Michael R. Chicoine, Jeffrey J. Olson, Randy L. Jensen, Jonathan H. Sherman, Xiangnan Zhang, Gabrielle Price, Mary Fowkes, Isabelle M. Germano, Bob S. Carter, Constantinos G. Hadjipanayis, Raymund L. Yong
Summary: 5-ALA can increase extent of resection in patients with high-grade gliomas. This study evaluated the diagnostic accuracy of 5-ALA-induced PPIX fluorescence for HGG histopathology and assessed the safety profile of 5-ALA FGS.
JOURNAL OF NEUROSURGERY
(2022)
Review
Clinical Neurology
Anant Naik, Emily J. Smith, Ariana Barreau, Mark Nyaeme, Samuel W. Cramer, Daniel Najafali, David T. Krist, Paul M. Arnold, Wael Hassaneen
Summary: A network meta-analysis comparing 5-ALA, IMRI, and FS as intraoperative navigation methods for high-grade glioma resection showed that IMRI, FS, and 5-ALA all led to higher rates of gross total resection and improved overall survival and progression-free survival.
JOURNAL OF CLINICAL NEUROSCIENCE
(2022)
Review
Clinical Neurology
Nathan J. Nordmann, Alex P. Michael
Summary: Radiodynamic therapy (RDT) involves the administration of a radiosensitizing agent activated by ionizing radiation for the destruction of neoplastic cells. Porphyrins like 5-ALA have shown potential in the treatment of high-grade gliomas (HGGs) as they selectively accumulate in tumor cells and act as radiosensitizers, increasing oxidative stress and enhancing the immune response. Further clinical trials are needed to evaluate the optimal timing, dosing, and effectiveness of 5-ALA RDT for HGGs.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2021)
Article
Clinical Neurology
Michael Muether, Mohammed Jaber, Timothy D. Johnson, Daniel A. Orringer, Walter Stummer
Summary: Using a logistic regression model, the study found a strong correlation between enhancement on preoperative MRI and the likelihood of visible fluorescence during surgery in patients with intermediate-grade glioma. The research provides a robust method for predicting 5-ALA-induced fluorescence in patients with grade II and grade III gliomas with high accuracy.
Article
Clinical Neurology
Ben A. Strickland, Michelle Wedemeyer, Jacob Ruzevick, Alexander Micko, Shane Shahrestani, Siamak Daneshmand, Mark S. Shiroishi, Darryl H. Hwang, Frank Attenello, Thomas Chen, Gabriel Zada
Summary: This study describes the surgical experience and patient outcomes of 5-ALA-enhanced fluorescence-guided resection of high-grade glioma using endoscopic blue light visualization. The authors found that the blue light endoscope is a feasible and ergonomically favorable platform for optimizing tumor fluorescence detection during HGG resection.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Asfand Baig Mirza, Jose Pedro Lavrador, Loannis Christodoulides, Timothy Martyn Boardman, Amisha Vastani, Qusai Al Banna, Irena C. F. Norman, Christopher Murphy, Sharmila Devi, Francesco Vergani, Richard Gullan, Ranjeev Bhangoo, Keyoumars Ashkan, Razna Ahmed, Anastasios Giamouriadis
Summary: This study investigated the use of 5-aminolevulinic acid (5-ALA) in assisting the resection of grade III gliomas. The results showed that 5-ALA did not have significant benefits in grade III tumors, except for a subgroup of patients who achieved gross total resection (GTR). Additionally, worse postoperative outcomes and 6-month performance status were observed in the 5-ALA group, mainly due to poorer outcomes in the subtotal resection subgroup.
OPERATIVE NEUROSURGERY
(2022)
Review
Clinical Neurology
Emily J. Smith, Kavita Gohil, Charee M. Thompson, Anant Naik, Wael Hassaneen
Summary: This meta-analysis demonstrates that fluorescein-guided surgery improves GTR rates of HGGs compared to non-fluorescence guided surgery, while showing similar GTR rates compared to reported 5-ALA-guided resection rates.
WORLD NEUROSURGERY
(2021)
Review
Oncology
Andrea Bianconi, Marta Bonada, Pietro Zeppa, Stefano Colonna, Fulvio Tartara, Antonio Melcarne, Diego Garbossa, Fabio Cofano, Andreas F. Hottinger, Nimish Mohile
Summary: This systematic review aimed to evaluate the reliability of fluorescence-guided surgery in low-grade gliomas and identify the best fluorophore for highlighting tumor boundaries. The current evidence does not support the routine use of 5-aminolevulinic acid or sodium fluorescein in low-grade glioma surgery. New molecules and techniques show promising results but require further clinical validation.
Article
Oncology
David J. McCracken, Alexander J. Schupper, Nikita Lakomkin, James Malcolm, David Painton Bray, Constantinos G. Hadjipanayis
Summary: To aid in the resection of brain tumors, adjuvant technologies such as fluorescence-guided surgery have been developed. 5-aminolevulinic acid (5-ALA) is a fluorescent substance that accumulates in tumor cells, improving visualization. 5-ALA fluorescence-guided surgery can increase the extent of tumor resection and improve patient survival.
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
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)
Article
Clinical Neurology
Eric Suero Molina, David Black, Sadahiro Kaneko, Michael Muther, Walter Stummer
Summary: The administration of higher doses of 5-aminolevulinic acid can lead to increased conversion into protoporphyrin IX in low-grade glioma, indicating a relationship between plasma concentration and brain movement of 5-ALA.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Arthur Hosmann, Mohammed Jaber, Thomas Roetzer-Pejrimovsky, Gerald Timelthaler, Martin Borkovec, Barbara Kiesel, Lisa I. Wadiura, Matthias Millesi, Petra A. Mercea, Joanna Phillips, Shawn Hervey-Jumper, Anna S. Berghoff, Johannes A. Hainfellner, Mitchel S. Berger, Walter Stummer, Georg Widhalm
Summary: This study found a correlation between visible 5-aminolevulinic acid (5-ALA) fluorescence and CD34 microvascularity in patients with low-grade gliomas (LGGs). Visible fluorescence during LGG surgery may indicate increased CD34 microvascularity, serving as an early prognostic marker for unfavorable patient outcomes.
JOURNAL OF NEUROSURGERY
(2023)
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
Neurosciences
Luca Zanin, Giorgio Saraceno, Giulia Renisi, Liana Signorini, Luigi Battaglia, Marco Ferrara, Francesco Antonio Rasulo, Pier Paolo Panciani, Marco Maria Fontanella
Summary: This case report describes the delayed onset cell-mediated encephalitis caused by COVID-19 virus, which is the first recorded case occurring more than 40 days after the diagnosis. The patient experienced intense headache, fever, and subsequent generalized epileptic seizures before being diagnosed with brain death.
INTERNATIONAL JOURNAL OF NEUROSCIENCE
(2023)
Review
Neurosciences
Edoardo Agosti, Simona Serioli, Kanwaljeet Garg, Alberto Pietrantoni, Pietro Luigi Poliani, Marco Maria Fontanella
Summary: This study reported a rare case of multiple vertebral metastases from anal squamous cell carcinoma (SCC) and aimed to define a treatment strategy. Through case presentation and literature review, it was found that there is currently no universally accepted treatment strategy for vertebral metastases from anal SCC. Prompt and aggressive, local and systemic, and multimodal treatment of the vertebral lesions may be crucial for improving patient outcomes.
INTERNATIONAL JOURNAL OF NEUROSCIENCE
(2023)
Review
Biochemistry & Molecular Biology
Fulvio Tartara, Andrea Montalbetti, Emanuela Crobeddu, Daniele Armocida, Eleonora Tavazzi, Andrea Cardia, Marco Cenzato, Davide Boeris, Diego Garbossa, Fabio Cofano
Summary: This paper provides a practical review of the pathophysiological events following subarachnoid hemorrhage (SAH). The complex cascade of pathophysiological events involves various interconnected but distinct pathways. The use of heparin, with its anticoagulant effect and ability to interfere with secondary events, may be an interesting therapeutic strategy for SAH management.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Medicine, General & Internal
Palma Ciaramitaro, Giuseppe Migliaretti, Marilena Ferraris, Andrea Garnero, Giovanni Morana, Paolo Carucci, Ilaria Stura, Fulvio Massaro, Diego Garbossa
Summary: This study investigated presurgery hydrodynamic markers in patients with syringomyelia and Chiari 1 malformation to evaluate their association with clinical and radiological improvement after surgery. The results showed that presurgical cerebrospinal fluid flow at the craniocervical junction predicted post-surgical pain relief and prognoses. Changes in the fourth ventricle area before surgery could provide useful information for evaluating long-term surgical outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Daniele Armocida, Alessandro Pesce, Mauro Palmieri, Fabio Cofano, Giuseppe Palmieri, Paola Cassoni, Carla Letizia Busceti, Francesca Biagioni, Diego Garbossa, Francesco Fornai, Antonio Santoro, Alessandro Frati
Summary: This study investigated the relationship between EGFR mutation and the disease course, prognosis, and diagnostic imaging of brain metastases (BMs) from non-small-cell lung cancer (NSCLC). The results showed a significant correlation between EGFR mutation and the size and edema volume of BMs, as well as the incidence of seizures.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Neurosciences
Alessandro Frati, Daniele Armocida, Fulvio Tartara, Fabio Cofano, Sergio Corvino, Sergio Paolini, Antonio Santoro, Diego Garbossa
Summary: This study reviewed 47 cases of posterior reversible encephalopathy syndrome (PRES) that occurred after surgery to identify the clinical features, timing of symptom onset, and treatment of this rare surgical complication. The results showed that postoperative PRES can occur in both pediatric and adult patients, with cardiovascular disease being the most common comorbidity. PRES typically occurs within the first 3 weeks after surgery, and prompt recognition and treatment can lead to complete reversal of symptoms in most cases.
Review
Cell Biology
Luca Zanin, Alexandra Sachkova, Pier Paolo Panciani, Veit Rohde, Marco Maria Fontanella, Bawarjan Schatlo
Summary: Liquid biopsy research on Low-Grade gliomas (LGG) has remained less conspicuous than that on other malignant brain tumors. Reliable serum markers would be precious for diagnosis, follow-up and treatment. Micro-RNA (miRs) appears to have the highest clinical utility.
CELLULAR AND MOLECULAR NEUROBIOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Simona Serioli, Ludovico Agostini, Alberto Pietrantoni, Federico Valeri, Flavia Costanza, Sabrina Chiloiro, Barbara Buffoli, Amedeo Piazza, Pietro Luigi Poliani, Maria Peris-Celda, Federica Iavarone, Simona Gaudino, Marco Gessi, Giovanni Schinzari, Pier Paolo Mattogno, Antonella Giampietro, Laura De Marinis, Alfredo Pontecorvi, Marco Maria Fontanella, Liverana Lauretti, Guido Rindi, Alessandro Olivi, Antonio Bianchi, Francesco Doglietto
Summary: This article comprehensively reviews the principal pathways and potential target therapies for aggressive PitNETs. Through a search and analysis of English papers, the current understanding and future prospects of the molecular mechanisms and treatment methods for PitNETs are discussed.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Biochemistry & Molecular Biology
Edoardo Agosti, Marco Zeppieri, Lucio De Maria, Camilla Tedeschi, Marco Maria Fontanella, Pier Paolo Panciani, Tamara Ius
Summary: This systematic review evaluates the current strategies and future perspectives of immunotherapy for glioblastoma (GBM). The review found that immunotherapy is a promising treatment option for recurrent GBM, with immune checkpoint inhibitors, personalized cancer vaccines, oncolytic viruses, and CAR T-cell therapy being the main focuses of current research.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Clinical Neurology
Erika Ferrari, Claudio Cornali, Alessandro Fiorindi, Edoardo Agosti, Salvatore Gallone, Elisa Rubino, Francesco Ponzio, Marco Maria Fontanella, Lucio De Maria
Summary: This study investigated the associations between specific single-nucleotide polymorphisms (SNPs) in the CYP2A6 gene and the presence and rupture of intracranial aneurysms (IAs) in Italian patients. The results showed that the frequency of aSAH was significantly higher in current smokers, regardless of the pattern of CYP2A6 SNPs. There was a correlation between IA rupture and cigarette smoking in patients with the heterozygous CYP2A6 *1B2 allele.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Mauro Palmieri, Daniele Armocida, Raffaella De Pietro, Giuseppina Chiarello, Francesca Rizzo, Diego Garbossa, Francesco Marampon, Antonio Santoro, Alessandro Frati
Summary: Surgical resection is the main treatment for grade II meningiomas, and the use of radiotherapy is still controversial. The study found that grade II meningiomas have a higher recurrence rate compared to grade I, and adjuvant radiotherapy can improve recurrence control but also increase the risk of seizures and decrease performance status.
WORLD NEUROSURGERY
(2023)
Article
Medicine, General & Internal
Luca Zanin, Edoardo Agosti, Florian Ebner, Lucio de Maria, Francesco Belotti, Barbara Buffoli, Rita Rezzani, Bernard Hirt, Marco Ravanelli, Tamara Ius, Marco Zeppieri, Marcos Soares Tatagiba, Marco Maria Fontanella, Francesco Doglietto
Summary: This study compared the surgical volumes and exposure areas of different surgical approaches to Meckel's cave and found that endoscopic approaches can provide adequate exposure, especially for the medial portions, while microsurgical transcranial approaches still seem to be the gold standard for optimal exposure and surgical volumes in the most lateral portion of Meckel's cave.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Neurosciences
Marta Pertichetti, Daniele Corbo, Francesco Belotti, Francesca Saviola, Roberto Gasparotti, Marco Maria Fontanella, Pier Paolo Panciani
Summary: This study systematically reviewed the scientific literature on the topic of preoperative neuropsychological tests and fMRI tasks. The results showed a strong correlation between neuropsychological and fMRI results, with language being the most commonly evaluated cognitive function. The study also suggested that selecting well-adjusted and individualized neuropsychological tasks may enable the development of personalized and more efficient protocols. Furthermore, fMRI findings may help identify plasticity phenomena to avoid unintentional damage during neurosurgery.
Review
Oncology
Raffaele De Marco, Alessandro Pesaresi, Andrea Bianconi, Michela Zotta, Desiree Deandreis, Giovanni Morana, Pietro Zeppa, Antonio Melcarne, Diego Garbossa, Fabio Cofano
Summary: A systematic review of the literature was performed to investigate the integration of amino acid PET imaging in surgical practice for gliomas. Although there is limited evidence, targeting the biologically active area can assist neurosurgeons in achieving better tumor resection and provide additional information for the management of brain gliomas.