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The insular lobe and brain plasticity: Lessons from tumor surgery
Hugues Duffau1, Luc Taillandier, Peggy Gatignol
1Departments of Neurosurgery and Inserm U678, Hôpital Salpêtrière, 47-83 Bd de l'hôpital, 75651 Paris Cedex 13, France. hugues.duffau@psl.ap-hop-paris.fr
Clinical Neurology and Neurosurgery
|October 11, 2005
Summary
The insula, a complex brain region, demonstrates significant functional compensation after glioma surgery. This highlights the brain
Area of Science:
- Neurosurgery
- Neuroscience
- Brain Anatomy
Background:
- The insula's role in brain function is not fully understood.
- Its essentiality versus compensability remains debated.
- Recent literature suggests the insula is involved in numerous functions.
Purpose of the Study:
- To investigate the functional role and plasticity of the insula.
- To determine if the insula plays an essential or compensable role in brain function.
- To assess the impact of insular glioma resection on neurological status.
Main Methods:
- Surgical resection of insular low-grade gliomas in 42 patients with seizures.
- Intraoperative electrical stimulation for functional mapping.
- Resection guided by cortico-subcortical functional boundaries under local anesthesia.
Main Results:
- Intraoperative mapping elicited transient language, pain, and vertigo.
- Post-operative deficits included hemiparesis, language disorders, and other syndromes.
- All patients, except three with stroke, recovered preoperative neurological status within 3 months.
Conclusions:
- The insula exhibits significant functional compensation and plasticity.
- This compensatory potential has implications for fundamental neuroscience.
- Findings are particularly relevant for oncological neurosurgery involving the insula.