METHODS: Treatment sessions consisted of non-invasive neuromodulation, to transiently deactivate critical areas adjacent to the lesion, coupled with intensive functional training, to activate alternative nodes within the same functional network. Patients were evaluated pre-NICP, post-NICP, and at follow-up post-surgery.
RESULTS: Ten patients performed the intervention. Feasibility criteria were met (retention, adherence, safety, and patient\'s satisfaction). Clinical outcomes showed overall stability and improvements in motor and executive function from pre- to post-NICP, and at follow-up. Relevant plasticity changes (increase in the distance between tumor and critical area) were observed when the neuromodulation target was guided by functional neuroimaging data.
CONCLUSIONS: This is the first case series demonstrating feasibility of non-invasive NICP. Neural correlates indicate that neuroimaging-guided target selection may represent a valid strategy to leverage neuroplastic changes before neurosurgery. Further investigations are needed to confirm such preliminary findings.
方法:治疗包括非侵入性神经调节,暂时停用病变附近的关键区域,加上强化的功能训练,激活同一功能网络中的替代节点。患者在NICP前进行了评估,NICP后,以及术后随访。
结果:10名患者进行了干预。符合可行性标准(保留,坚持,安全,和患者的满意度)。临床结果显示,从NICP之前到之后,运动和执行功能的总体稳定性和改善。在后续。当神经调节目标由功能神经影像学数据指导时,观察到相关的可塑性变化(肿瘤与临界区域之间的距离增加)。
结论:这是第一个证明非侵入性NICP可行性的病例系列。神经相关性表明,神经影像学引导的目标选择可能代表了在神经外科手术前利用神经可塑性变化的有效策略。需要进一步调查以确认这些初步发现。