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Publications (74)
Background
The cognitive dysfunction associated with cerebellar tumors in adults is not well understood. We herein evaluated the effect of cerebellar tumors and surgery on cognitive function in adult patients before and after resection.
Methods
Eighteen patients who underwent resection of a cerebellar tumor at the study center between 2016 and 202...
The main treatment for metastatic brain tumors is radiation therapy or surgical removal. Since the pembrolizumab, an anti-PD1 monoclonal antibody, was revealed to be effective for brain metastases of lung cancer, it has been used as a therapeutic option. However, the predictive factors of its efficacy have been unclear. If the efficacy of pembroliz...
Glioblastoma (GBM) is the most common type of primary malignant brain tumor and has a poor prognosis. Identifying novel targets and stratification strategies is urgently needed to improve patient survival. The present study aimed to identify clinically relevant genomic alterations in IDH-wildtype GBM using data from comprehensive genomic profiling...
Purpose
Glioblastoma (GBM) is the most common type of primary malignant brain tumor and has a poor prognosis. Identifying novel targets and stratification strategies is urgently needed to improve patient survival. The present study aimed to identify clinically relevant genomic alterations in IDH-wildtype GBM using data from comprehensive genomic pr...
Purpose
Leptomeningeal metastasis (LM) is a complication of surgery for brain metastasis and is a risk factor of poor prognosis. The risk of LM is particularly high after surgery for a breast cancer metastasis to the brain. If the risk of LM after surgical resection for a brain metastasis were predictable, appropriate adjuvant therapy could be admi...
Intratumor heterogeneity has been analyzed in brain tumors, and it has revealed that clonal evolution results in the formation of genetically diverse cell populations, which is a major factor in treatment resistance and recurrence. However, intratumoral heterogeneity has not been analyzed in routine clinical practice and remains at the research lev...
Objectives
Hyper- and hyposensitivity in multiple modalities have been well-documented in subjects with autistic spectrum disorder (ASD) but not in subjects with acquired brain injury (ABI). The purpose of this study was to determine whether subjects with ABI experience altered sensory processing in multiple sensory modalities, and to examine the r...
Mismatch repair (MMR) gene deficiency is rarely observed in gliomas, a constitutional defect is associated with tumorigenesis in Lynch syndrome, and an acquired defect is associated with hypermutation after temozolomide treatment. However, the meaning of MMR gene deficiency in gliomas is unclear. Two cases of MMR-deficient glioblastomas are reporte...
Awake craniotomy is an established procedure for resecting brain tumors in eloquent lesions, and intraoperative seizure is one of the most important complications. Phenytoin is normally used to control intraoperative seizures. Recently, phenytoin was replaced with levetiracetam at our institution because the latter has fewer side effects. While the...
Background
Tumors trigger both depression and anxiety about death because they can be terminal. However, the relationship between depression and time perspective in patients with life-threatening diseases remains unclear. In this study, we examined the effects of depression on time perspective in patients with brain tumors using a projective method...
A 46-year-old female patient with glioblastoma multiforme (GBM), IDH wild type developed severe pancytopenia 5 months after postoperative chemoradiotherapy. Bone marrow aspirate showed normocellular marrow with 70.0% abnormal cells, which suggested the possibility of acute myeloid leukemia. Immunophenotypic analysis did not show any hematological l...
An out‐of‐body experience (OBE) is a phenomenon whereby an individual views his/her body and the world from a location outside the physical body. Previous studies have suggested that the temporoparietal junction (TPJ), the brain region responsible for integrating multisensory signals, is responsible for OBE development. Here, however, we first pres...
Lesion studies have shown that the right temporal lobe is crucial for recognition of facial expressions, particularly fear expressions. However, in previous studies, premorbid abilities of the patients were unknown and the effects of epileptic discharge could not be excluded. Herein, we report a case of a patient who underwent assessments of facial...
Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin's lymphoma, and its prognosis is still very poor despite the conventional therapy of high-dose methotrexate (HD-MTX) followed by whole-brain radiation therapy (WBRT). The purpose of the present study was to evaluate the survival benefit of continuous intrathecal inject...
Background
Preservation of cranial nerve function in patients with benign tumors such as meningiomas and vestibular schwannomas remains difficult following microsurgery.
Methods
In this study, awake surgery was performed in 22 consecutive patients with meningiomas or vestibular schwannomas that compressed cranial nerves (I–XII). Improved, unchange...
Recently, researchers have focused on the embodied sense of self (ESS), which consists of the minimal and narrative selves. Although a study demonstrated that the ESS is related to brain dysfunction empirically, the subjective aspects of the ESS, and a systematic approach to it, have not yet been examined in brain-damaged patients. To examine this,...
Diffuse midline glioma, H3 K27M mutant, is newly recognized as a distinct category, which usually arises in the brain stem, thalamus or spinal cord of children, and young adults. The oncogenic H3 K27M mutation involves H3.3 (encoded by H3F3A) or H3.1 (encoded by HIST1H3B/HIST1H3C), and the incidence of each mutation differs among the primary sites....
Background:
Hearing preservation in patients with vestibular schwannomas remains difficult by microsurgery or radiosurgery.
Method:
In this study, awake surgery via the retrosigmoid approach was performed for vestibular schwannomas (volume, 11.6 ± 11.2 ml; range, 1.3-26.4 ml) in eight consecutive patients with preoperative quartering of pure ton...
Introduction We analyzed factors associated with worsened paresis at 1-month follow-up in patients with brain tumors located in the primary motor area (M1) to establish protocols for safe awake craniotomy for M1 lesions.
Methods Patients with M1 brain tumors who underwent awake surgery in our hospital (n = 61) were evaluated before, during, and imm...
Epithelioid glioblastomas (E-GBMs) are rare, highly aggressive tumors consisting of closely packed tumor cells with smooth, round cell borders and abundant eosinophilic cytoplasm. They tend to affect younger patients compared with conventional GBM. BRAF V600E mutation is characteristically found in approximately 50 % of all E-GBMs, compared with a...
Objective:
An awake craniotomy is a safe neurological surgical technique that minimizes the risk of brain damage. During the course of this surgery, the patient is asked to perform motor or cognitive tasks, but some patients exhibit severe sleepiness. Thus, the present study investigated the predictive value of a patient's preoperative neuropsycho...
We analyzed factors associated with worsened paresis in a large series of patients with brain lesions located within or near the primary motor area (M1) to establish protocols for safe, awake craniotomy of eloquent lesions.
We studied patients with brain lesions involving M1, the premotor area (PMA) and the primary sensory area (S1), who underwent...
Recent investigation suggests that the dorsal anterior cingulate cortex (ACC) is involved in the interplay between cognition and emotion. The present study described three patients who underwent removal of brain tumors just above the right dorsal ACC. These patients had residual tumor following surgery and showed anxiety disorder (AD) both before a...
ABSTRACT The anatomic localization of brain functions can be characterized via diffusion tensor imaging (DTI) in patients with brain tumors and neurologic symptoms. The goal of the present study was to evaluate the function of the ventral, arcuate fasciculus (AF) and the superior longitudinal fasciculus (SLF)-related language pathways using these t...
Functional neurological changes after surgery combined with diffusion tensor imaging (DTI) tractography can directly provide evidence of anatomical localization of brain function. Using these techniques, a patient with dysgraphia before surgery was analyzed at our hospital in 2011. The patient showed omission of kana within sentences before surgery...
Functional neurological changes after surgery combined with diffusion tensor imaging (DTI) tractography can directly provide evidence of anatomical localization of brain function. Using these techniques, a patient with dysgraphia before surgery was analyzed at our hospital in 2011. The patient showed omission of kana within sentences before surgery...
Comparison of preoperative and postoperative neurological functions in patients undergoing resection of brain tumors, in combination with data from diffusion tensor imaging (DTI) studies, can provide direct evidence of anatomical localization of brain function. The goal of the present study was to use these techniques to characterize memory functio...
Brain imaging studies suggest that panic disorder (PD) is mediated by several brain regions, including the anterior cingulate cortex (ACC). In the present report we describe a patient who experienced a panic attack during awake surgery (case 1) and another patient who developed PD after surgery and radiotherapy (case 2). In case 1, the patient expe...
Patients undergoing awake surgery for resection of brain tumours in the primary motor cortex (M1) are at high risk of developing new motor deficits. Thus, use of this procedure requires consideration of several important points, including the optimal modality to localise M1 on the affected side and the overall advantages and disadvantages of the pr...
Objective: Some patients with temporal lobe brain tumours show aggressive or escape behaviour during awake surgery. As the amygdala plays a critical role in coping with stress, we evaluated whether the left or right amygdala was involved in aggressive or escape behaviour in six patients undergoing awake surgery for temporal lobe brain tumours.
Met...
Analysis of lesions and symptoms in patients with brain tumors combined with information from diffusion tensor imaging provides direct evidence of the anatomical localization of brain function. Using these methods, we evaluated 8 patients who underwent surgery for metastatic brain tumors located in the left occipital lobes between 2007 and 2009. Pr...
Diffusion tensor tractography provides useful information regarding the surgical strategy for brain tumors. The goal of the present study was to analyze relationships between visual field deficits and the locations of brain tumors compared with optic tracts as visualized by tractography, and compared with the calcarine fissure.
Subjects comprised 1...
The present study describes a case of a right-handed 74-year-old woman with a brain tumor who showed conversion of speech to Sutra, a Buddhist prayer, which was stored in the right hemisphere according to the Wada test. After surgery, relative improvement in the speech disorder was observed, and frequency of speech production of simple normal words...
Direct evidence of the anatomical localization of brain function is provided by functional neurological changes during awake surgery combined with data from preoperative functional magnetic resonance imaging and diffusion tensor imaging studies. The goal of the present study was to analyze the etiology and mechanism of motor hemineglect using these...
Awake surgery provides accurate localization of brain function based on rapid reversible neurological changes during surgical manipulation. In this study, hand clenching rapidly deteriorated due to surgical manipulation during awake surgery and instantly recovered not by hand clenching alone but by combined movement of hand clenching and elbow flex...
The functional characteristics of the left inferior longitudinal fasciculus (ILF) remain unclear. The present study describes a case of a right-handed 74-year-old woman with a brain tumor who showed marked deterioration in object naming ability after invasion of the tumor into the medial region of the left posterior (middle and inferior) temporal l...
Anatomical localization of brain function can be achieved by functional changes during awake surgery combined with tractography constructed by diffusion tensor imaging studies. We aimed to use these techniques to characterize the sensory tract in the corona radiata in patients with closely associated brain tumors. Of nine patients who had brain tum...
Functional neurological changes after surgery combined with data from diffusion tensor imaging (DTI) studies can provide direct evidence of anatomical localization of brain function. The goal of the present study was to characterize mechanisms of spatial neglect using these techniques by analyzing two patients with development or worsening of left...
Changes in motor function in response to lesions in the premotor area (PM) and the primary motor area (M1) are difficult to predict. The goal of the present study was to use awake surgery to characterize the functional property of the PM or the M1 in patients with brain tumors. Neurological change before, during and after awake surgery was compared...
Cortical mapping during awake surgery assesses intraoperative neurological change in response to electrical stimulation to provide direct information regarding the anatomical localization of the primary motor area (M1). The goal of the present study was to analyze the reliability of the identification of the precentral knob in the axial image of ma...
Resection of brain tumors in the primary motor area (M1) is difficult to achieve without adversely affecting motor function. Between November 2003 and November 2006, 16 patients with 18 brain tumors involving the M1 (11 metastatic, 6 gliomas, 1 cavernous angioma) underwent craniotomy and awake surgery with continuous motor testing at our hospital....
The optimal treatment strategy for cervicogenic headache (CeH) remains controversial, possibly because the pathophysiology of this disease entity is unclear. The present study describes a case of alleviation of severe CeH that was alleviated after cervical open-door laminoplasty and reviews magnetic resonance imaging (MRI) data from a series of pat...
Awake surgery has been reported to play a role in the safe removal of brain tumors and detection of the functional localization of the cortex or neuronal tracts. In our hospital, from November 2004 to May 2007, we performed awake surgery with continuous tasks in 33 cases of brain tumors within or near the primary motor area (M1). The relationship b...
Use of intrathecal (IT) chemotherapy combined with radiotherapy can extend survival of patients with untreated leptomeningeal dissemination of malignant tumors from one month to two to six months. The goal of the present study was to determine the effect of continuous IT (CIT) via a subcutaneous port that was placed using a neuronavigation system....
The oral alkylating agent, temozolomide (Temodal: TMZ), is the only anticancer drug that has been shown in a phase III study to improve survival in glioblastoma (GBM) when administered with concomitant radiotherapy. Pharmacokinetic studies have documented relatively high concentrations of TMZ in brain tumors and cerebrospinal fluid (20-40% of the a...
Mirror therapy is effective in the rehabilitation of patients with hemiparesis, but its mechanism is not clear. In this study, a patient with brain tumor (patient 1) who underwent mirror therapy after surgery and showed drastic recovery of hand paresis, a patient with visual memory disturbance (patient 2), and five normal volunteers performed tasks...
Ommaya reservoirs are commonly used in the diagnosis and management of leptomeningeal metastases (LM) from malignant tumors. The present study investigates the utility of an intraoperative navigation-guided technique for Ommaya reservoir placement. Between March 2004 and December 2005, 85 navigation-guided Ommaya reservoir placements were performed...
Function of the inferior longitudinal fasciculus (ILF), which connects the anterior temporal and occipital lobes, has not been clearly demonstrated in the human brain. A 47-year-old woman with visual memory disturbance as demonstrated by the Wechsler Memory Scale-Revised presented with possible brain tumor in the right temporal lobe. Diffusion tens...
The accurate localization of the primary motor cortex (M1) is critical for the preservation of motor function during resection of brain tumors in and around the M1. The goal of the present study was to determine which technique provided the most accurate localization of M1. The accuracy of preoperative functional magnetic resonance imaging (fMRI),...
The Tc-99m MIBI uptake index of 27 metastatic brain tumors was assessed by setting ROIs over the tumor and contralateral normal brain areas. The mean Tc-99m MIBI uptake index among the 27 tumors was very high (28.3 ± 23.8) with wide variability in individual measurements (range, 3.3-85). In one case, use of these high uptake values helped delineate...
Purpose:
Sonography has been employed for real-time intraoperative delineation of tumor boundaries during resection of brain tumors. However, the variably hyperechoic appearance of brain edema or gliosis surrounding the brain may interfere with accurate depiction of tumor margins. The goal of the present study was to use sononavigation, which prov...
Resection of tumors involving the motor area frequently results in postoperative motor deficits. In an attempt to prevent poor motor outcomes, our institution has utilized preoperative fMRI and tractography as well as intraoperative cortical mapping and continuous motor tasks during awake surgery in patients with motor area tumors. In one case, a p...
Doppler sonography can be used for real-time intraoperative localization of arteries within or near brain tumors but is less useful for distinguishing between arteries with similar diameters, such as the main trunk and branches of the anterior cerebral artery (ACA). By contrast, sononavigation provides real-time information in alignment with magnet...
Reorganization of brain function may result in preservation of motor function in patients with brain tumors. The goal of the present study was to investigate whether function of the primary motor area (M1) was restored and whether motor function improved after brain tumor resection.
Five patients with metastatic brain tumors located within or near...
Several studies have reported changes in cerebrovascular reactivity during the interictal period of migraine. To characterize mechanisms of migraine, we compared changes in total haemoglobin (THbl) and regional oxygen saturation (rSO(2)) of the right and left frontal lobes in response to intracranial pressure changes during the interictal period of...
Autonomic nerve dysregulation produces a sense of impaired well-being and interferes with work performance in affected individuals. In this study, we characterized the pathophysiology of this condition.
Six patients with high symptom scores for orthostatic intolerance (OI) along with age- and sex-matched normal volunteers were directed to perform a...
The goal of the present study was to determine the efficacy of preoperative fMRI, tractography, and intraoperative continuous task during awake surgery in preserving postoperative motor function in patients undergoing resection of metastatic brain tumors in or near the primary motor area. Three patients with metastatic brain tumors in the primary m...
The goal of this study was to evaluate the function of fibers that connect the hand area of the primary motor and sensory cortices. A 63-year-old male with a metastatic brain tumor located in the left primary motor area underwent awake surgery. During removal of the tumor, the posterior end of the primary motor cortex, including the fibers between...
Six patients with brain tumors within or near the primary motor cortex underwent preoperative functional magnetic resonance imaging (fMRI) and intraoperative cortical mapping, and the accuracy of those techniques for localization of the primary motor cortex and motor function beside the tumor were determined by comparison against neuroanatomical co...
To investigate the vasoreactivity of cerebral hemisphere in patients with dizziness and syncope, we compared changes in total haemoglobin (THbl) and regional oxygen saturation (rSO2) of the right and left frontal lobes in response to head-down manoeuvre. Ninety-six right-handed subjects (aged 59 +/- 19 years) were asked to perform a head-down or a...
Reliably predicting infection soon after craniotomies would prevent infection and reduce treatment costs and hospitalization expenses. Therefore we analysed potential risk factors and blood count data after craniotomies for brain tumours in order to predict infection as soon as possible after surgery. We analysed 139 patients who underwent cranioto...
In this study, we compared the recurrence of metastatic brain tumors after radiosurgery versus after surgery plus radiation, and analyzed the factors associated with the recurrence of brain metastases. Twenty-eight and 35 patients with metastatic brain tumors underwent radiosurgery (52 lesions) and surgery plus radiation (46 lesions), respectively,...
BACKGROUND AND PURPOSE: Reorganization of brain function may result in preservation of motor function in patients with brain tumors. The goal of the present study was to investigate whether function of the primary motor area (M1) was restored and whether motor function improved after brain tumor resection. METHODS: Five patients with metastatic bra...
