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Resumen Introduccion Los tumores neuroepiteliales disembrioplasicos (DNET) son un tipo de neoplasia glioneuronal benigna de localizacion tipicamente temporal que producen crisis epilepticas resistentes al tratamiento farmacologico en ninos y adultos jovenes. Objetivo Se muestran 4 casos valorando la utilidad de la resonancia magnetica funcional en el estudio prequirurgico de pacientes con tumores neuroepiteliales disembrionarios. Para la obtencion de imagenes se utilizo un equipo de resonancia magnetica Philipps Intera de 3.0 Tesla y la tecnica Blood Oxygenation Level-Dependent, permitiendo localizar las areas elocuentes de lenguaje y motora mediante la aplicacion de paradigmas especificos. Resultados En un caso el tumor se encontraba adyacente al area de Broca, en 2 casos coincidia con Wernicke, en un paciente estaba menos de 1 cm del area motora de la mano y en otro proximo a la memoria. Solo 2 de los pacientes fueron operados, no produciendose deficit funcional postoperatorio. Se observo activacion hemisferica contralateral al tumor sugestivo de neuroplasticidad en uno de los pacientes. Conclusiones La resonancia magnetica funcional supone un metodo no invasivo que permite evaluar la proximidad de las lesiones a las areas elocuentes, clave en la evaluacion del riesgo quirurgico. Ademas, ha permitido detectar probable neuroplasticidad en un caso, la cual ha garantizado el exito de la cirugia.

Objective Cognitive effects in acromegaly patients are poorly understood and the mechanisms involved are still unclear. The aim of this study was to evaluate the cognitive function, depression, and quality of life of acromegaly patients treated with pegvisomant versus somatostatin analogues (SRLs) and to analyze the effect of the different treatments on cognition and possible structural brain changes. Methods This cross-sectional study involved 23 acromegaly patients divided into two groups according to treatment modality: One group of 9 patients treated with pegvisomant and another group of 14 patients treated with SRLs. All participants underwent blood analysis, neuropsychological tests, depression tests, quality of life assessment, and 3-Tesla magnetic resonance imaging. Results We found no significant differences between groups in the neuropsychological tests, depression or quality of life; nor in the whole-brain cortical thickness. In the SRL group, the volume of the thalamus correlated positively with executive function, a correlation not found in the pegvisomant group. In addition, the pegvisomant group had significantly higher levels of insulin than the SRL group. Conclusions In conclusion, in this pilot study, the type of pharmacological treatment in patients with acromegaly and good glycemic control did not influence the cognitive function and cortical brain thickness. However, pegvisomant could play a neuroprotective role on the thalamus that will have to be demonstrated with larger samples in future studies.