Neural Basis of Language Processing
Condition: Oligoastrocytoma; Astrocytoma; Oligodendroglioma
MeSH terms: Astrocytoma; Oligodendroglioma
Study type: Interventional

Summary: 
      According to the O.M.S. Classification, grade 2 glioma is a pre-cancerous lesion, slowly
      progressive, infiltrating the central nervous system, mainly affecting young adults.

      This surgery should nevertheless be conducted in awake condition to achieve two conflicting
      goals: get maximum brain tissue infiltrated by the tumor while preserving the integrity of
      functional structures. So awake after opening the skull, the patient undergoes a series of
      preoperative tests, administered by a speech therapist present in the operating room. This
      procedure allows the neurosurgeon to establish an individual functional brain mapping in real
      time, through the observation by the SLP of the patient's answers to direct electrical
      stimulation applied to the cortical and sub-cortical. This support is based on the
      extraordinary plasticity demonstrated by the brain in the presence of a slowly progressive
      lesion. To ensure the patient the highest achievable load should increase our understanding
      of brain function, including the neural bases of language, glioma grade 2 is predominantly
      localized functional area of language.
    

Detailed description: 
      According to the O.M.S. Classification, grade 2 glioma is a pre-cancerous lesion, slowly
      progressive, infiltrating the central nervous system, mainly affecting young adults. Surgical
      excision of the tumor is the most appropriate care, with or without chemotherapy or
      radiotherapy.

      This surgery should nevertheless be conducted in awake condition to achieve two conflicting
      goals: get maximum brain tissue infiltrated by the tumor while preserving the integrity of
      functional structures. So awake after opening the skull, the patient undergoes a series of
      preoperative tests (motor, sensory and / or language), administered by a speech therapist
      present in the operating room. This procedure allows the neurosurgeon to establish an
      individual functional brain mapping in real time, through the observation by the SLP of the
      patient's answers to direct electrical stimulation applied to the cortical and sub-cortical.
      This support is based on the extraordinary plasticity demonstrated by the brain in the
      presence of a slowly progressive lesion. To ensure the patient the highest achievable load
      should increase our understanding of brain function, including the neural bases of language,
      glioma grade 2 is predominantly localized functional area of language. Many studies apply to
      highlight the cortical organization of language, but the study of subcortical beams involved
      in this function, especially in the semantic language processing, has so far received less
      attention .

      The use of electric direct intraoperative stimulation helps highlight the cortico-subcortical
      networks involved in language processing.

      The new imaging techniques allow us to better understand the functional brain anatomy: the
      Diffusion Tensor can view the white matter bundles based on the diffusion of water molecules,
      functional MRI to visualize areas cortical functional.
    

Intervention name(s): fMRI; tractography; neuropsychological examination
Intervention type(s): Device; Procedure; Other
Intervention description(s): Patient with grade 2 glioma and healthy volunteers use a brain imaging (fMRI); Patient with grade 2 glioma and healthy volunteers use a brain imaging (tractography); Patient with grade 2 glioma and healthy volunteers use a neuropsychological examination
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other