Assessment of Eloquent Function in Brain Tumor Patients

University of Nebraska75 enrolled

Overview

Purpose of the study: AIM 1: Prospectively collect pre-operative \[functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), magnetoencephalography (MEG)\] and intra-operative mapping data in patients with intra-axial brain tumors to assess how well each modality predicts the location of eloquent brain function. In addition, each modality will be compared with the other. AIM 2: Assess reorganization of eloquent brain function and plasticity in patients with intra-axial brain tumors. This will be accomplished by prospectively collecting post-operative mapping studies and neuropsychological tests to compare them to prior mapping studies as stated above.

Any patient with a primary or metastatic brain tumor in or near an eloquent area would be eligible for participation in the study assuming no contraindications to any of the studies or operative procedure. Pre-operative evaluation will include clinical evaluation, neuropsychological testing, magnetic resonance imaging (MRI) brain with and without contrast, fMRI, DTI tractograms, and MEG studies as well as standard pre-operative work-up. Intra-operative procedures include all non-invasive pre-operative mapping data being incorporated into the operative procedure with imaging tools that are routinely used during neurosurgical procedures. Participants will have awake mapping performed. Usual standards of care will be followed during craniotomy, mapping, and tumor resection or biopsy. Post-operative procedures include routine post-operative care and assessment consisting of clinical examinations and imaging obtained within 24 hours post-resection. Participants will have routine follow-up outpatient appointments after surgery which will include neurologic assessment and follow-up imaging (MRI with and without contrast) for their tumors as appropriate. The experimental portion of the protocol is incorporating repeat neuropsychological testing and mapping studies (fMRI, DTI, MEG) studies at 2 and 6 months post-surgery into their routine follow-up.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Primary Brain Tumor

Eligibility

Sex: ALLMin age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 19 years and older * Brain tumor in or near eloquent brain regions that is appropriate for attempted resection * Appropriate body habitus and mental status/capacity to participate with non-invasive or invasive mapping * Benign or malignant intra-axial brain tumor * Primary or metastatic intra-axial brain tumor Exclusion Criteria: * Any contraindication to MRI (i.e. implanted devices) * Inappropriate body habitus or mental status/capacity to participate with non-invasive or invasive mapping in a safe and reliable manner * Declining to participate * Lacks capacity to understand the study or consent for themselves * Neurologic status which precludes testing (poor function- not testable) * Positive pregnancy test * End stage renal disease or severe renal dysfunction

Outcomes

Primary Outcomes

Eloquent function

The location of the eloquent function of interest (motor, sensory, speech) will be assessed pre-operatively and intra-operatively and compared. Then, at 2 and 6 months post-operatively, repeat non-invasive mapping studies will be performed to compare to the subjects' prior studies. This will allow for assessment of reorganization and plasticity of function. Additionally, novel ways of identifying eloquent brain regions will be developed.

Time frame: 1 year

Assessment of Eloquent Function in Brain Tumor Patients

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Central Contacts