Frontal pathologies

Fronto-temporal dementia

Frontotemporal dementia (FTD) results from frontotemporal lobar degeneration, and is the second most common form of early-onset dementia after Alzheimer’s disease. The behavioral variant of frontotemporal dementia (bvFTD) is characterized by a progressive deterioration of personality, social conduct and cognition. Particularly, patients with bvFTD show progressive cognitive and behavioral changes.

BvFTD is a good model for studying apathy as well as disinhibition, because apathy and disinhibition are clinical core features of bvFTD, and they remain almost constant throughout the disease. In 2011, the International bvFTD Criteria Consortium (FTDC) developed revised guidelines for the diagnosis of bvFTD, wherein bvFTD is a syndrome defined by a set of clinical (behavioral and cognitive) criteria: disinhibition, apathy/inertia, loss of empathy, perseverative/compulsive behaviors, hyperorality and a dysexecutive neuropsychological profile.

Among these symptoms, disinhibition and apathy are among the major causes of caregiver distress.

People in the team working on fronto-temporal dementia: Isabelle Le Ber, Raffaella Lara Migliaccio, Bénédicte Batrancourt, Richard Levy, Emmanuelle Volle

focal or diffuse brain damages

Glioma

Spatial distribution of resection cavities in a series of patients operated on for a lower-grade glioma. From Mrah & al. 2022, Journal of Neurosurgery

Diffuse low-grade glioma are slowly growing tumors. The diagnosis is made after a first seizure, in a young adult with a normal socio-professional life. Surgery is the first line of treatment, as it has been demonstrated that the larger the resection, the better the survival. However, the extent of resection should be tailored according to each tumor location and patient's way of life, so that patients could resume the same life as before. To this end, the best methodology is to awake the patient in order to monitor continuously his cognitive and sensori-motor abilities and to perform brain mapping with electrical stimulation, allowing to detect critical areas that should not be resected. All the patients undergo, both before and after the surgery, and as a standard of clinical practice, extensive cognitive evaluations, as well as advanced MRI sequences of functional and structural connectivity.

In this context, it has been observed that while most patients do experience marked cognitive deficits in the immediate postoperative period, a vast majority recover at the late examination, four months after the surgery.

The goal of our research is:

  • to predict how the resection topography will impact the different types of tested functions (executive functions, social cognition, memory, ...),

  • to understand how preoperative networks re-organize postoperatively, through plasticity mechanisms,

  • to develop new tasks in order to better assess functions currently not tested, albeit important for daily life (creativity, fatigability, motivation, ...)

People in the team working on brain tumors: Emmanuel Mandonnet, Emmanuelle Volle, Antoni Valero-Cabre.

Close collaboration with the team of Mathias Pessiglione and Jean Daunizeau.