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Related Experiment Video

Updated: May 25, 2026

A Protocol for Explant Cultures of IDH1-mutant Diffuse Low-grade Gliomas
06:27

A Protocol for Explant Cultures of IDH1-mutant Diffuse Low-grade Gliomas

Published on: May 9, 2025

The challenge to remove diffuse low-grade gliomas while preserving brain functions.

Hugues Duffau1

  • 1Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier University Medical Center, France. h-duffau@chu-montpellier.fr

Acta Neurochirurgica
|January 27, 2012
PubMed
Summary

Early surgery for diffuse low-grade gliomas is key. Resection guided by brain function, not just tumor size, improves survival and quality of life by preserving neural networks.

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Correlation between resumption of employment and overall survival following awake mapping-based surgery for IDH-mutant grade 2 glioma: a consecutive series with 515 patients.

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What is the actual role of intraoperative MRI on long-term onco-functional outcome of surgery for low-grade glioma? A systematic review.

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Intractable epilepsy before and/or after awake functional mapping-based surgery for IDH-mutant grade 2 glioma: a consecutive series of 105 patients.

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Molecular oncology·2026

Area of Science:

  • Neurosurgery
  • Neuro-oncology
  • Neuroscience

Background:

  • WHO grade II glioma (diffuse low-grade glioma) is a pre-malignant tumor often presenting in young patients.
  • Tumor growth is constant, inevitably leading to malignant transformation.
  • Surgical resection improves survival by delaying anaplastic transformation, but balancing extent of resection with quality of life is crucial.

Purpose of the Study:

  • To propose a new concept for surgical resection of diffuse low-grade gliomas based on functional, not oncological, boundaries.
  • To emphasize understanding individual cerebral anatomo-functional organization to preserve quality of life.
  • To highlight the importance of mapping both horizontal and vertical brain connectivity.

Main Methods:

  • Preoperative functional neuroimaging.

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  • Intraoperative electrical cortical mapping in awake patients.
  • Mapping of horizontal cortico-cortical and vertical cortico-subcortical connectivity to preserve essential brain networks.

    • Main Results:

    • A 'hodotopical' framework, studying cortical epicenters and subcortical pathways, aids functional reshaping.
    • Advances in hodotopical and plastic brain processing have improved the benefit-to-risk ratio of surgery.
    • Enhanced oncological and functional outcomes are achievable through this approach.

    Conclusions:

    • The time is right to advance towards 'functional neurooncology' and 'preventive neurosurgery' for low-grade gliomas.
    • Increased collaboration with fundamental neurosciences is needed to develop updated models of cognition and plasticity.
    • Biomathematical models and in silico studies are crucial for understanding glioma growth and optimizing individualized treatment strategies.