Enhancing Neurosurgical Outcomes with Quicktome: A New Perspective on Cognitive Brain Networks

The landscape of neurosurgery is rapidly evolving with technological advancements that allow for more precise and informed surgical interventions. One such innovation is the use of Quicktome, a platform that leverages machine learning to map non-traditional cognitive brain networks. This tool offers a new perspective on understanding and preserving cognitive functions during the surgical resection of insulo-Sylvian gliomas.

The Challenge of Insulo-Sylvian Gliomas

Insulo-Sylvian gliomas present a significant challenge due to their proximity to both traditional and non-traditional brain networks involved in cognition. Traditional approaches focus on avoiding damage to eloquent areas such as the motor cortex and language regions. However, recent research highlights the importance of non-traditional networks like the salience network (SN) and central executive network (CEN), which are crucial for maintaining cognitive functions.

Understanding Non-Traditional Brain Networks

The study "Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas" reveals that 98% of patients with these gliomas show involvement with non-traditionally eloquent networks. These include the SN, CEN, default mode network (DMN), dorsal attention network (DAN), and ventral attention network (VAN). Damage to these networks can lead to significant cognitive morbidity post-surgery.

The Role of Quicktome in Surgical Planning

Quicktome provides a detailed map of these non-traditional networks using diffusion tensor imaging tractography and a personalized brain atlas. This allows neurosurgeons to visualize critical networks and make informed decisions about surgical approaches. In two reported cases, Quicktome was used to adjust surgical plans, resulting in better preservation of cognitive functions.

Case Studies: Optimizing Surgical Approaches

• Case 1: A patient with a left insula glioma had their surgical approach altered to protect the SN and sensorimotor areas. Post-surgery, the patient retained normal cognitive function.
• Case 2: For a patient with extensive tumor infiltration, Quicktome guided the surgical path to avoid critical networks like the SN and VAN, resulting in preserved cognitive functions despite inevitable damage to some areas.

Encouraging Further Research

This study underscores the potential of integrating tools like Quicktome into standard neurosurgical practices. By providing insights into complex brain network architectures, surgeons can minimize cognitive deficits post-surgery. Practitioners are encouraged to explore further research in this area to enhance surgical outcomes and patient quality of life.

To read the original research paper, please follow this link: Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas: a case series study and clinical experience using Quicktome.