Personalised, image-guided, noninvasive brain stimulation in gliomas: Rationale, challenges and opportunities

G, Sprugnoli; S, Rossi; A, Rotenberg; A, Pascual-Leone; G, El-Fakhri; A, J. Golby; E, Santarnecchi

Abstract:

Malignant brain tumours are among the most aggressive human cancers, and despite intensive efforts made over the last decades, patients’ survival has scarcely improved. Recently, high-grade gliomas (HGG) have been found to be electrically integrated with healthy brain tissue, a communication that facilitates tumour mitosis and invasion. This link to neuronal activity has provided new insights into HGG pathophysiology and opened prospects for therapeutic interventions based on electrical modulation of neural and synaptic activity in the proximity of tumour cells, which could potentially slow tumour growth. Noninvasive brain stimulation (NiBS), a group of techniques used in research and clinical settings to safely modulate brain activity and plasticity via electromagnetic or electrical stimulation, represents an appealing class of interventions to characterise and target the electrical properties of tumour-neuron interactions. Beyond neuronal activity, NiBS may also modulate function of a range of substrates and dynamics that locally interacts with HGG (e.g., vascular architecture, perfusion and blood-brain barrier permeability). Here we discuss emerging applications of NiBS in patients with brain tumours, covering potential mechanisms of action at both cellular, regional, network and whole-brain levels, also offering a conceptual roadmap for future research to prolong survival or promote wellbeing via personalised NiBS interventions.

Patologie/Applicazioni:

• Stimolazione Magnetica Transcranica (TMS)
• Stimolazione elettrica transcranica (TES)
• Plasticità cerebrale

Anno:

2021

Tipo di pubblicazione:

Articolo

Parola chiave:

Neurostimolazione; Glioma; HGG; NIBS; Brain tumors; tumori

Testata scientifica:

EBioMedicine

Nota:

Nonostante gli enormi sforzi compiuti negli ultimi anni, la sopravvivenza dei pazienti con tumori cerebrali maligni è appena migliorata. La recente scoperta dell'integrazione elettrica tra il tessuto cerebrale sano e i gliomi ad alto grado di malignità (HGG) apre nuovi scenari in questo campo. Questo collegamento all'attività neuronale ha fornito nuove informazioni sulla fisiopatologia dell'HGG e ha aperto prospettive per interventi terapeutici basati sulla modulazione elettrica dell'attività neurale e sinaptica in prossimità delle cellule tumorali, che potrebbero potenzialmente rallentare la crescita del tumore.

DOI:

https://doi.org/10.1016/j.ebiom.2021.103514