Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas

Abstract Background Correlating the human connectome with clinical responses elicited during intraoperative brain mapping helps understanding of the intrinsic organization of the human brain. Methods for locating eloquent sites on neuroimaging are not standardized. In the present study, we standardi...

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Main Authors: Angela Elia, Alexandre Roux, Clément Debacker, Sylvain Charron, Giorgia Simboli, Alessandro Moiraghi, Bénédicte Trancart, Edouard Dezamis, Jun Muto, Fabrice Chretien, Marc Zanello, Catherine Oppenheim, Johan Pallud
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00834-6
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author Angela Elia
Alexandre Roux
Clément Debacker
Sylvain Charron
Giorgia Simboli
Alessandro Moiraghi
Bénédicte Trancart
Edouard Dezamis
Jun Muto
Fabrice Chretien
Marc Zanello
Catherine Oppenheim
Johan Pallud
author_facet Angela Elia
Alexandre Roux
Clément Debacker
Sylvain Charron
Giorgia Simboli
Alessandro Moiraghi
Bénédicte Trancart
Edouard Dezamis
Jun Muto
Fabrice Chretien
Marc Zanello
Catherine Oppenheim
Johan Pallud
author_sort Angela Elia
collection DOAJ
description Abstract Background Correlating the human connectome with clinical responses elicited during intraoperative brain mapping helps understanding of the intrinsic organization of the human brain. Methods for locating eloquent sites on neuroimaging are not standardized. In the present study, we standardized a methodology for locating subcortical eloquent sites identified during intraoperative mapping for awake brain tumor resection on a reference brain template. Methods Subcortical eloquent sites were tagged by co-registration of intraoperative photographs with early postoperative MRI ( < 48 h). Neuroimaging data were normalized into MNI152 space. To assess whether the location of subcortical eloquent sites on the MNI template was concordant with the expected brain connectivity, we compared each subcortical eloquent site with the Human Connectome Project 1065 probabilistic tractography atlas. Results We analyze 290 subcortical eloquent sites identified during 69/90 awake surgeries. 2/290 (0.7%) subcortical eloquent sites identified intraoperatively do not intersect with a fiber tract according to the reference atlas. Among the other 288 that successfully intersect with, at least, one white matter tract, 255/288 (88.5%) have a clinical response elicited intraoperatively that is congruent with the intersected white matter tract. In the remaining 33/288 (11.5%) functional incongruent and the 2/290 (0.7%) anatomical incongruent subcortical sites, the minimal mean distance between the eloquent site and a congruent with matter tract is 3.6 ± 4.4 mm (range 1.0–23.9, median 3.6, interquartile range 2.5–5.4). Conclusions We propose a standardized methodology to locate with accuracy on a reference brain template subcortical eloquent sites identified intraoperatively during functional brain mapping using direct electrical stimulations under awake condition.
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spelling doaj-art-eba8ec19a0454e26bd11d66833691f4a2025-08-20T03:53:12ZengNature PortfolioCommunications Medicine2730-664X2025-05-015111410.1038/s43856-025-00834-6Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlasAngela Elia0Alexandre Roux1Clément Debacker2Sylvain Charron3Giorgia Simboli4Alessandro Moiraghi5Bénédicte Trancart6Edouard Dezamis7Jun Muto8Fabrice Chretien9Marc Zanello10Catherine Oppenheim11Johan Pallud12Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneService de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneService de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneService de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneService de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneDepartment of Neurosurgery, Fujita Health UniversityService de Neuropathologie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneService de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Site Sainte AnneAbstract Background Correlating the human connectome with clinical responses elicited during intraoperative brain mapping helps understanding of the intrinsic organization of the human brain. Methods for locating eloquent sites on neuroimaging are not standardized. In the present study, we standardized a methodology for locating subcortical eloquent sites identified during intraoperative mapping for awake brain tumor resection on a reference brain template. Methods Subcortical eloquent sites were tagged by co-registration of intraoperative photographs with early postoperative MRI ( < 48 h). Neuroimaging data were normalized into MNI152 space. To assess whether the location of subcortical eloquent sites on the MNI template was concordant with the expected brain connectivity, we compared each subcortical eloquent site with the Human Connectome Project 1065 probabilistic tractography atlas. Results We analyze 290 subcortical eloquent sites identified during 69/90 awake surgeries. 2/290 (0.7%) subcortical eloquent sites identified intraoperatively do not intersect with a fiber tract according to the reference atlas. Among the other 288 that successfully intersect with, at least, one white matter tract, 255/288 (88.5%) have a clinical response elicited intraoperatively that is congruent with the intersected white matter tract. In the remaining 33/288 (11.5%) functional incongruent and the 2/290 (0.7%) anatomical incongruent subcortical sites, the minimal mean distance between the eloquent site and a congruent with matter tract is 3.6 ± 4.4 mm (range 1.0–23.9, median 3.6, interquartile range 2.5–5.4). Conclusions We propose a standardized methodology to locate with accuracy on a reference brain template subcortical eloquent sites identified intraoperatively during functional brain mapping using direct electrical stimulations under awake condition.https://doi.org/10.1038/s43856-025-00834-6
spellingShingle Angela Elia
Alexandre Roux
Clément Debacker
Sylvain Charron
Giorgia Simboli
Alessandro Moiraghi
Bénédicte Trancart
Edouard Dezamis
Jun Muto
Fabrice Chretien
Marc Zanello
Catherine Oppenheim
Johan Pallud
Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
Communications Medicine
title Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
title_full Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
title_fullStr Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
title_full_unstemmed Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
title_short Locating eloquent sites identified during brain tumor intraoperative mapping on reference MRI atlas
title_sort locating eloquent sites identified during brain tumor intraoperative mapping on reference mri atlas
url https://doi.org/10.1038/s43856-025-00834-6
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