Longitudinal language mapping in surgical LGG patients
Research type
Research Study
Full title
Longitudinal assessment of language function using navigated transcranial magnetic stimulation (nTMS) and diffusion MRI in patients with low-grade gliomas (LGG)
IRAS ID
222379
Contact name
Neil Kitchen
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
The study investigates the presence of essential language-related brain areas situated next to tumours, with the aim of increasing our existing understanding of how the brain reorganises itself in response to tumours and surgery.
Aims: 1/ To map brain areas next to tumours that are essential for speech and language function, using navigated transcranial magnetic stimulation (nTMS), together with magnetic resonance (MR) tractography 2/ To examine to what extent tumour evolution and surgery produce changes in the location of brain function, by using repeat mapping at 6 weeks and 6 months post-operatively; this will provide a measure of the brain’s dynamic ability to reorganise the locations of its functional areas – a process called plasticity. Changes in the patient group will be compared with age-matched healthy controls.
Purpose: Surgery, the mainstay of treatment for low-grade gliomas (LGGs), must balance maximum tumour removal with maintaining speech and language function. By measuring plasticity caused by the tumour and surgery, we aim to establish a ‘functionally-guided’ approach to glioma surgery.
Relevance: LGGs most commonly occur in speech-related areas. The quality of life for patients and their carers is greatly improved by maintaining these essential functions. Language mapping performed before surgery will provide information about how their brain function has adapted to the tumour, allowing patients to consider their individual requirements for preserving brain function versus maximum tumour removal. Repeat language mapping following surgery will track reorganisation of brain function in relation to surgery and tumour recurrence, potentially offering new opportunities for therapeutic shaping of plasticity.
Novelty: This study provides a significant innovation in LGG treatment. By directly and non-invasively measuring brain plasticity in relation to speech function, a staged functionally guided surgery approach might be envisioned, with surgery taking place at intervals to allow brain function to optimally recover and reorganise between operations.
REC name
London - Queen Square Research Ethics Committee
REC reference
17/LO/0291
Date of REC Opinion
6 Apr 2017
REC opinion
Further Information Favourable Opinion