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Meningeosis neoplastica is a rare manifestation of high-grade gliomas and is usually associated with a devastating outcome. The aim of this bicenter series was to investigate the clinical course and outcome of patients with meningiosis neoplastica.This case series included patients in whom surgery was performed for World Health Organization grade IV primary and secondary glioblastoma (GBM) at the University Medical Center Göttingen, Göttingen, Germany between 2009 and 2021 and Burdenko Institute of Neurosurgery, Moscow, Russia between 2012 and 2018. Inclusion criteria were manifestation of clinical and neuroradiologic signs of leptomeningeal, ependymal, or spinal dissemination of GBM at various time points during the course of the disease.Meningeosis neoplastica was found in 36 patients. Nine patients developed spinal metastases and 12 ependymal dissemination and 15 patients had a leptomeningeal manifestation of high-grade glioma. The median age of patients at first diagnosis of primary tumor was 56 years. Typical symptoms were headache, nausea, vomiting, and acute paraplegia. The median overall survival was 11 months and progression-free survival was 8 months. Meningeosis neoplastica developed a median 2 months after the initial tumor diagnosis. Salvage therapies included ventriculoperitoneal shunting, decompression of spinal metastases, and spinal radiation therapy. The median time between meningeosis manifestation and death was 3 months.Meningeosis neoplastica is a rare manifestation of GBM. It has a poor prognosis. The overall survival after the manifestation of meningeosis was barely longer than 3 months. Salvage therapies did not improve the outcome in our patient cohort.

Purpose The aim of the study was to evaluate the role of pseudo-continuous ASL-perfusion (pCASL-perfusion) in preoperative assessing of cerebral glioma grades. Methods The study group consisted of 253 patients aged 7 to 78 years with supratentorial gliomas (65 had low-grade gliomas (LGG), 188 – high-grade gliomas (HGG)). Maximal tumor blood flow (maxTBF) in small ROIs (20 mm2 ± 10 mm2) were evaluated by subsequently normalized tumor blood flow (nTBF) calculation which was compared with normal appearing white matter of center semiovale of the contralateral hemisphere. Results TBF and nTBF values were significantly differed in HGG and LGG groups, as well as grade II and grade III gliomas; grade III and grade IV gliomas (p

Hand dominance is known to make a robust bias on human brain activity in a normal state. Recent studies showed that simple motor tasks performed by a non-dominant hand caused increased activation, similar to that which occurs when more complex tests are performed with a dominant hand. The influence of dominance on brain activity in Parkinon’s disease (PD) remains unclear. In the present study we made an attempt to analyse the differences between brain activity during dominant and non-dominant hand movements in PD and compare it with the control group. We used functional MRI and an event-related paradigm to study the brain activity of 16 subjects in control group and 16 patients with PD during left and right hand movements. Data analysis showed few clearly lateralized clusters of activity in major motor areas in the control group and two hemispheric activation in motor and non-motor areas in PD group during both hand movements. We also found a deficit in the activation of the primary somatosensory cortex, primary motor cortex, basal ganglia, and insula during both movements in the PD group compared to controls. At the same time we found brain activity asymmetry caused by the dominance influence in the PD group. Thus, we have shown that although motor deficit in Parkinson's disease has a greater effect on habitual movement, the influence of dominance still persists and should be taken into account in PD studies.

An imbalance in the activity of the basal ganglia in Parkinsons disease is known to result in disturbance of the planning and initiation of mainly self-initiated voluntary movements. The effectiveness of self-initiated movements can be improved by adding an external stimulus. Despite a large number of studies in this area, the neural mechanisms of motor control of these movements and the role of the basal ganglia in their implementation remain unknown. The aim of the study was to compare brain activity during the execution of externally triggered (ET) and internally guided (IG) movements in normal state and Parkinson's disease. We used functional MRI with block designed paradigm to analyze brain activity caused by voluntary movements. Twenty healthy participants and twenty Parkinson's disease patients (OFF-state) were asked to perform hand movements in response to sound stimuli (ET) and in advance of the stimuli (IG). We showed that brain activity during externally induced movements is lateralized mainly in the contralateral hemisphere, both in normal and in Parkinson's disease. During the IG movement, brain activity was observed also in the ipsilateral hemisphere, to a greater extent in patients, which indicates difficulty in performing this test. At the same time, in patients, activation was observed not only in the posterior parts of the putamen but also in the anterior ones during IG movements. These results showed that IG movements in patients with PD were made with the participation of both sensorimotor and associative basal ganglia-thalamocortical loops. This work was supported by RFBR 19-315-90097.

Intracranial hemorrhage is a pathological condition that requires fast diagnosis and decision making. Recently, a neural network model for classification of different intracranial hemorrhage types was proposed by a member of our research group Konstantin Kotik as part of the machine learning competition at Kaggle. Our current pilot study aimed to test this model on real-world CT scans from patients with intracranial hemorrhage treated at N.N. Burdenko Neurosurgery Center. The deep learning model for intracranial hemorrhage classification based on ResNexT architecture showed an accuracy of detection greater than 0.81 for every subtype of hemorrhage without any tuning. We expect further improvement in the model performance.

Introduction: The prediction of the fluorescent effect of 5-aminolevulinic acid (5-ALA) in patients with diffuse gliomas can improve the selection of patients. The degree of enhancement of gliomas has been reported to predict 5-ALA fluorescence, while, at the same time, rarer cases of fluorescence have been described in non-enhancing gliomas. Perfusion studies, in particular arterial spin labeling perfusion, have demonstrated high efficiency in determining the degree of malignancy of brain gliomas and may be better for predicting fluorescence than contrast enhancement. The aim of the study was to investigate the relationship between tumor blood flow, measured by ASL, and intraoperative fluorescent glow of gliomas of different grades. Materials and methods: Tumoral blood flow was assessed in 75 patients by pCASL (pseudo-continuous arterial spin labeling) within 1 week prior to surgery. In all cases of tumor removal, 5-ALA had been administered preoperatively. Maximum values of tumoral blood flow (TBF max) were measured, and normalized tumor blood flow (nTBF) was calculated. Results: A total of 76% of patients had significant contrast enhancement, while 24% were non-enhancing. The histopathology revealed 17 WHO grade II gliomas, 12 WHO grade III gliomas and 46 glioblastomas. Overall, there was a relationship between the degree of intraoperative tumor fluorescence and ASL-TBF (Rs = 0.28, p = 0.02 or the TBF, Rs = 0.34, p = 0.003 for nTBF). Non-enhancing gliomas were fluorescent in 9/18 patients, with nTBF in fluorescent gliomas being 54.58 ± 32.34 mL/100 mg/s and in non-fluorescent gliomas being 52.99 ± 53.61 mL/100 g/s (p &gt, 0.05). Enhancing gliomas were fluorescent in 53/57 patients, with nTBF being 170.17 ± 107.65 mL/100 g/s in fluorescent and 165.52 ± 141.71 in non-fluorescent gliomas (p &gt, 0.05). Conclusion: Tumoral blood flow levels measured by non-contrast ASL perfusion method predict the fluorescence by 5-ALA, however, the additional value beyond contrast enhancement is not clear. ASL is, however, useful in cases with contraindication to contrast.