Glioblastoma multiforme (GBM) is a devastating disease without cure. It is also the most common primary brain tumor in adults. Although aggressive surgical resection is standard of care, these operations are limited by tumor infiltration of critical cortical and subcortical regions. A better understanding of how the brain can recover and reorganize function in response to GBM would provide valuable clinical data. This ability, termed neuroplasticity, is not well understood in the adult human brain. A better understanding of neuroplasticity in GBM could allow for improved extent of resection, even in areas classically thought to have critical, static function. The best evidence to date has demonstrated neuroplasticity only in slower growing tumors or through indirect measures such as functional MRI or transcranial magnetic stimulation. In this novel study, we utilize a unique experimental paradigm to show direct evidence of plasticity via serial direct electrocortical stimulation (DES) within primary motor (M1) and somatosensory (S1) cortices in GBM patients. Six patients with glioblastoma multiforme in or near the primary motor or somatosensory cortex were included in this retrospective observational study. These patients had two awake craniotomies with DES to map cortical motor and sensory sites in M1 and S1. Five of six patients exhibited at least one site of neuroplasticity within M1 or S1. Out of the 51 total sites stimulated, 32 (62.7%) demonstrated plasticity. Of these sites, 14 (43.7%) were in M1 and 18 (56.3%) were in S1. These data suggest that even in patients with GBM in or near primary brain regions, significant functional reorganization is possible. This is a new finding which may lead to a better understanding of the fundamental factors promoting or inhibiting plasticity. Further exploration may aid in treatment of patients with brain tumors and other neurologic disorders.

中文翻译：

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胶质母细胞瘤患者人类初级运动和躯体感觉皮层可塑性的直接证据

多形性胶质母细胞瘤 (GBM) 是一种无法治愈的毁灭性疾病。它也是成人中最常见的原发性脑肿瘤。尽管积极的手术切除是护理标准，但这些手术受到关键皮质和皮质下区域肿瘤浸润的限制。更好地了解大脑如何恢复和重组功能以响应 GBM 将提供有价值的临床数据。这种称为神经可塑性的能力在成人大脑中还不是很清楚。更好地了解 GBM 中的神经可塑性可以改进切除范围，即使在经典认为具有关键静态功能的区域也是如此。迄今为止最好的证据表明，神经可塑性仅在生长较慢的肿瘤中或通过功能性 MRI 或经颅磁刺激等间接措施进行。在这项新颖的研究中，我们利用独特的实验范式，通过在 GBM 患者的初级运动 (M1) 和体感 (S1) 皮层内连续直接皮层电刺激 (DES) 来显示可塑性的直接证据。这项回顾性观察研究包括了 6 名在初级运动或躯体感觉皮层内或附近患有多形性胶质母细胞瘤的患者。这些患者进行了两次清醒开颅手术，使用 DES 绘制 M1 和 S1 的皮质运动和感觉部位。6 名患者中有 5 名在 M1 或 S1 内表现出至少一个神经可塑性部位。在总共 51 个受刺激的部位中，32 个 (62.7%) 表现出可塑性。在这些站点中，14 个 (43.7%) 位于 M1，18 个 (56.3%) 位于 S1。这些数据表明，即使在初级大脑区域内或附近的 GBM 患者中，显着的功能重组也是可能的。这是一项新发现，可能有助于更好地了解促进或抑制可塑性的基本因素。进一步探索可能有助于治疗患有脑肿瘤和其他神经系统疾病的患者。