Evidence map›Paper›PMID 41060457›Full record

ArticleActa neurochirurgica2025

Epileptogenic LGG surgery with seizure freedom purpose: Supratotal resection (ETT-SpTR) based on Electrocorticography and navigated transcranial magnetic stimulation.

Francesca Battista, Giovanni Muscas, Andreea Cristina Aldea, Eleonora Visocchi, Alberto Parenti, Camilla Bonaudo, Maddalena Spalletti, Riccardo Carrai, Giulia Masi, Antonio Maiorelli and 4 more

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Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Inhibitory glutamatergic feedback for brain tumor therapy.Medical oncology (Northwood, London, England) · 2026
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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Francesca BattistaDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy. francesca.battista@unifi.it.
Giovanni MuscasDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy.
Andreea Cristina AldeaDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy.
Eleonora VisocchiDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy.
Alberto ParentiDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy.
Camilla BonaudoDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy.
Maddalena SpallettiNeurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
Riccardo CarraiNeurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
Giulia MasiNeurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
Antonio MaiorelliNeurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
Andrea AmadoriNeuro-Anesthesiology and Intensive Care Unit, Careggi University Hospital, Florence, Italy.
Davide GaddaDepartment of Neuro-Radiology, Careggi Hospital and University of Florence, Florence, Italy.
Antonello GrippoNeurophysiology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
Alessandro Della PuppaDepartment of Neurosurgery, Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Careggi University Hospital, Florence, Italy. alessandro.dellapuppa@unifi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow-grade gliomas (LGG)-related seizures may persist after gross total resection (GTR). Supratotal resection (SpTR) seems to have better seizure outcomes, likely due to removing the epileptogenic peritumoral neocortex. However, its role in achieving postoperative seizure freedom remains poorly considered, likely because SpTR is achievable in only one out of three patients.

methodsWe retrospectively analyzed a prospectively collected series of epileptogenic surgically resected LGGs. Intraoperative Electrocorticography (iECoG) guided the extension of GTR to areas with interictal activity and negative on navigated Transcranial Magnetic Stimulation (nTMS). Patients were divided into Group I (GTR) and Group II [iECoG nTMS Tailored - SpTR (ETT-SpTR)], and we compared the seizure outcomes at follow-up (minimum 12 months). We also compared the rate of postoperative neurological deficits.

resultsThirty patients were included. Group I (n = 15) showed only a 20% rate of seizure freedom (Engel IA), compared to 86.6% in Group II (n = 15, p = 0.0001). Neurological outcomes showed no differences between groups. Four patients (13.3%) with resection margins < 1 cm from nTMS-positive points developed transient deficits; no deficits were observed for distances > 1 cm.

conclusionThe ETT-SpTR is more frequently achievable than radiologically defined SpTR. In our experience, ETT-SpTR yields better seizure outcomes without compromising functional outcomes compared to GTR. In our cohort, iECoG is a reliable technique for identifying LGG-related epileptogenic foci, while nTMS is a trustworthy method for predicting postoperative deficits.

Indexed as

Brain NeoplasmsElectrocorticographyEpilepsyGliomaNeuronavigationNeurosurgical ProceduresSeizuresTranscranial Magnetic StimulationAdolescentAdultFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeEPILEPSYLGGNTMSSURGERY

Identifiers

PMID41060457
PMCPMC12507924

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