[National and world experience in functioning of centers for collective use of biological resource collections of tumors of the central nervous system]. / Analiz mirovogo i otechestvennogo opyta funktsionirovaniya tsentrov kollektivnogo pol'zovaniya bioresursnymi kollektsiyami opukholei tsentral'noi nervnoi sistemy.

Collective use center is an organization or structural unit with unique resource providing access to this resource for internal and third-party users. Collective use centers are a relatively new phenomenon in bioresource collections, especially collections of human biological material due to some ethical and legal issues. At the same time, the demand for human biological material continues to grow in fundamental and applied researches. The collective use center «Bioresource collection of tissues and cell cultures of tumors of the human nervous system for fundamental and applied researches¼ has worked since October 14, 2022. This center has access to unique collection of the Laboratory of Neurosurgical Anatomy and Conservation of Human Biological Tissues of the Burdenko Neurosurgical Center. OBJECTIVE: To analyze the experience of collective use center and biobank of the Burdenko Neurosurgical Center compared to national and international data on functioning of collective use centers specializing in tumors of the human central nervous system. MATERIAL AND METHODS: We reviewed the PubMed and e-Library databases using the following keywords: core facilities brain tumors, repository of collective use brain tumors, biobank of CNS tumors, central nervous system tumor collection centers. We also analyzed the organizations registered on the portal of scientific and technical infrastructure of the Russian Federation. RESULTS: We analyzed 275 publications devoted to collective use centers and biobanks. These biobanks do not position themselves as collective use centers but actively realize biological material for researches. Structure of institutions presented on the portal of scientific and technical infrastructure of the Russian Federation is characterized. The collective use center «Bioresource collection of tissues and cell cultures of tumors of the human nervous system for fundamental and applied researches¼ has access to biobank of the Burdenko Neurosurgical Center. To date, the biobank contains more than 8478 aliquots of tumor tissue frozen at ultra-low temperature (-196°C) and obtained from 1993 patients. Considering available data, we established the basic principles of work in collective use centers with bioresource collections. CONCLUSION: Collective use centers with bioresource collections of tumors of the central nervous system are rare. There is only one collective use center organized at the Burdenko Neurosurgical Center on the portal of scientific and technical infrastructure of the Russian Federation. At the same time, there is an urgent need to increase their number and activity in Russia and other countries worldwide. You can use the resource of brain tumor collections by leaving a request on the official website of this organization in the «Collective use center¼ section.

[Metastatic brain lesion following gastrointestinal stromal tumor of the stomach complicated by coma.( A case report and literature review)]. / Metastaticheskoe porazhenie golovnogo mozga gastrointestinal'noi stromal'noi opukhol'yu zheludka, oslozhnivsheesya razvitiem komatoznogo sostoyaniya. (Opisanie sluchaya i obzor literatury).

The authors present an extremely rare case of metastatic brain lesion in a patient with gastrointestinal stromal tumor of the stomach. There are literature data on 23 cases of metastatic lesions of the brain, skull and soft tissues of the head in similar patients. Atypical localization of metastases can lead to some diagnostic difficulties, unreasonable cancellation of chemotherapy and delayed surgical treatment. A feature of our observation was postoperative coma determined by the features of the underlying disease.

[Principles of biobanking and biobanks of central nervous system tumors in world practice]. / Printsipy biobankirovaniya i biobanki opukholei nervnoi sistemy v mirovoi praktike.

Biobanks of central nervous system tumors are created in parallel with development of modern technologies for evaluation of molecular features of human diseases. In modern world practice, no one doubts that creation of biobanks of tumors is necessary and critical for personalized medicine. An important aspect of recent improvements in biobanks has been the expansion of tumor sample storage conditions. Development of cell technologies has made it possible to create cell cultures from tumor material that made it possible to evaluate further therapy before affecting the patient himself. Biobanks have become especially attractive in the study of brain tumors, where the peculiarity of location and blood-brain barrier complicate treatment approaches. This review describes the approaches to creation of biobanks of CNS tumors in world practice, sample storage conditions, ethical and legal regulation of biobanks, as well as experience of biobanking in different countries.

[Multimodal method of tissue differentiation in neurooncology using Raman spectroscopy, fluorescence and diffuse reflectance spectroscopy]. / Mul'timodal'nyi metod differentsiatsii tkanei v neiroonkologii s ispol'zovaniem spektroskopii kombinatsionnogo rasseyaniya, fluorestsentsii i diffuznogo otrazheniya.

BACKGROUND: There is a need to expand the possibilities of urgent analysis of intracranial tumor type during resection. These measures are necessary to improve resection quality with preservation of intact tissues and avoiding recurrence and neurological impairment in postoperative period. OBJECTIVE: To create optical-spectral method for differentiating the intracranial tumor types. MATERIAL AND METHODS: We used a combination of certain methods such as fluorescence spectroscopy to analyze the content of endogenous and exogenous fluorophores in samples, diffuse reflectance spectroscopy to analyze structural integrity of tissues according to light scattering and blood filling according to hemoglobin spectrum absorption, as well as spontaneous Raman spectroscopy detecting individual molecular components of tissues. The study was conducted at the Laboratory of Neurosurgical Anatomy and Conservation of Biological Materials of the Burdenko Neurosurgical Center and included 93 tissue samples from 60 patients diagnosed with glioblastoma (n=28), meningioma (n=12), astrocytoma (n=9), oligodendroglioma (n=5), and metastasis (n=6). RESULTS: Different types of intracranial tumors that cannot be differentiated using one of the considered spectroscopy modes can be distinguished in another one. Thus, we can conclude possible advantages of combined optical-spectral approach.

[Conduction aphasia in patients with glioma in the left hemisphere]. / Provodnikovaya afaziya u bol'nykh s gliomami levogo polushariya.

Background. According to Wernicke-Geschwind model, conduction aphasia following arcuate tract lesion was canonized as primary disorder of repetition in relatively intact speech. OBJECTIVE: Syndromic analysis of speech and writing disorders in patients with arcuate tract lesion using the method by A.R. Luria and their comparison with well-known types of aphasia. MATERIAL AND METHODS: Clinical and neuropsychological survey was performed in 14 patients with gliomas who underwent surgical treatment at the Burdenko Neurosurgical Center (10 gliomas of the frontal lobe and 4 tumors of the temporal lobe). All patients underwent MRI, HARDI MRI tractography and A.R. Luria's neuropsychological examination prior to surgery and after 5-6 postoperative days. Thirteen patients underwent awake craniotomy, 3 of them were examined one year after surgery. RESULTS: In all patients, the tumor was localized near arcuate tract and its infiltration was noted. No intraoperative damage to the tract was ever noted according to speech monitoring data. However, postoperative edema followed by infiltration and dislocation of the tract (in all patients), as well as local ischemia in 4 patients were observed. After resection of prefrontal and premotor gliomas, aphasia included frontal (perseveration) and temporal components (disorders of naming, auditory-speech memory). Unusual verbal paraphrases were noted. We also observed severe violation of writing (temporal type) even if spontaneous speech and repetition were preserved. In case of resection of deep posterior temporal gliomas, speech disorders included signs of frontal lobe lesion (perseveration) and writing disorders. Similar motor abnormalities were identified in writing. CONCLUSION: Arcuate tract lesion can result speech and writing disorders as signs of damage to certain cortical speech zones (frontal and temporal lobe). Violations of repetition were not predominant in any case. At the same time, interruption of connection between motor and auditory image of the word could be revealed in writing.

[Visual fluorescence combined with laser spectroscopy in surgery for intramedullary spinal cord tumors]. / Vizual'naya fluorestsentsiya v kombinatsii s lazernoi spektroskopiei v khirurgii spinal'nykh intramedullyarnykh opukholei.

BACKGROUND: Surgical treatment of intramedullary spinal cord tumors is aimed at total resection of tumor with maximum preservation of neurological and functional status. In some cases, intramedullary tumors have unclear dissection plane or gliosis zone. This area is not a tumor and does not require resection. However, it is difficult to distinguish visually intact spinal cord tissue and tumor at the last surgical stages. Thus, we evaluated the effectiveness of fluorescence combined with laser spectroscopy in surgical treatment of intramedullary spinal cord tumors. OBJECTIVE: To determine the effectiveness of visual fluorescence combined with laser spectroscopy in surgery for intramedullary spinal cord tumors. MATERIAL AND METHODS: There were 850 patients with intramedullary spinal cord tumors for the period 2001-2019. In 35 cases, intraoperative fluoroscopy with laser spectroscopy were used. All patients underwent a comprehensive pre- and postoperative clinical and instrumental examination (general and neurological status, McCormick grade, spinal cord MRI). Carl Zeiss OPMI Pentero microscope with a fluorescent module was used for intraoperative fluorescence diagnosis. A domestic preparation 5-ALA «ALASENS¼ (State Research Center NIOPIK, Moscow, Russia) was used for induction of visible fluorescence. Laser spectroscopy was carried out using a LESA-01-BIOSPEK spectrum analyzer. Morphological analysis of intramedullary spinal cord tumors was performed in the neuromorphology laboratory of the Burdenko Neurosurgery Center. RESULTS: Intramedullary anaplastic ependymoma and astrocytoma, as well as conventional ependymoma were characterized by the highest index of 5-ALA accumulation. Intramedullary hemangioblastoma and cavernoma do not accumulate 5-aminolevulinic acid due to morphological structure of these tumors. In particular, there are no cells capable of capturing and processing 5-ALA in these tumors. Sensitivity of visual fluorescence combined with laser spectroscopy varies from 0% to 100% depending on the histological type of tumor: hemangiogblastoma and cavernoma - 0%, low-grade astrocytoma - 70%, high-grade astrocytoma - 80%, ependymoma - 92%, anaplastic ependymoma 100%. Dissection plane is absent in anaplastic ependymoma, high-grade astrocytoma. We often observed gliosis during resection of ependymoma. This tissue is not a part of tumor. Intraoperative metabolic navigation with neurophysiological monitoring are advisable for total tumor resection in case of unclear dissection plane and peritumoral gliosis. CONCLUSION: Visual fluorescence combined with laser spectroscopy is a perspective method for intraoperative imaging of tumor remnants and total resection of intramedullary spinal cord tumors with minimum risk of neurological impairment.

[Comparative analysis of mono- and bipolar pyramidal tract mapping in patients with supratentorial tumors adjacent to motor areas: comparison of data at 64 stimulation points]. / Sravnitel'nyi analiz potochechnogo mono- i bipolyarnogo kartirovaniya piramidnogo trakta u patsientov s supratentorial'nymi opukholyami, prilezhashchimi k motornym zonam golovnogo mozga: sravnenie dannykh v 64 tochkakh stimulyatsii.

OBJECTIVE: To compare monopolar and bipolar mapping in point-by-point fashion by using of threshold amperage, frequency of positive motor responses and the number of muscles involved in response. MATERIAL AND METHODS: A prospective non-randomized study included 14 patients with supratentorial tumors who underwent surgery in 2018-2019. All neoplasms were localized within 2 cm from the motor cortex and pyramidal tract. Age of patients ranged from 25 to 74 years. There were 9 women and 5 men. Eight patients had malignant glioma (grade III - 4, grade IV - 4), 6 patients - meningioma. Motor functions were assessed in all patients before and after surgery (1, 7 days and 3 months later) by using of a 5-point scale. In addition to routine neurophysiological monitoring, comparative mono- and bipolar mapping of the pyramidal tract within the bed of excised tumor was carried out at the end of surgery. The points of motor responses were marked. Comparative analysis of mono- and bipolar stimulation at identical points included threshold amperage, frequency of positive motor responses and the number of muscles involved in response (leg, forearm, hand, facial muscles). Brain MRI was performed in early postoperative period for assessment of resection quality. RESULTS: There were 64 points of motor responses in 14 patients. The number of these points ranged from 2 to 8 per a patient (mean 5 points). Motor responses were recorded in 57 points during monopolar and bipolar stimulation, in other 7 points - only during monopolar stimulation. Amperage of monopolar stimulation was 3-15 mA, bipolar stimulation - 2.5-25 mA. Threshold amperage (7.37 mA for monopolar stimulation and 8.88 mA for bipolar stimulation; p=0.12), frequency of positive motor responses and the number of muscles involved in response (p=0.1 and p=0.73) were similar. Seven (50%) patients had neurological deterioration in early postoperative period (4 patients with glial tumors and 3 patients with meningiomas). At the same time, only 2 patients (14.3%) had persistent neurological deficit (both patients with infiltrative meningioma). According to postoperative MRI in T1+C mode, resection volume was 100% in 1 patient with contrast-enhanced glioma and 94% in another one. According to FLAIR MRI data, resection volume exceeded 70% in 2 patients with non-enhancing glioma and less than 70% in 2 patients. Meningioma resection volume was estimated according to postoperative T1+C MRI data and made up over 90% in 4 patients. CONCLUSION: Monopolar stimulation is a reliable method of pyramidal tract identification in supratentorial brain tumor surgery.

[Multicystic transformation of the post-radiation necrosis zone of the brain. A case report and literature review]. / Mul'tikistoznaya transformatsiya zony postluchevogo nekroza golovnogo mozga. Klinicheskoe nablyudenie i obzor literatury.

Post-radiation cyst of the brain is a rare complication that often arises many years after irradiation for head and neck neoplasms. The majority of the articles devoted to this problem are small samples or case reports. Nevertheless, the overall number of these patients is steadily increasing. The feature of post-radiation cysts is gradual enlargement followed by general cerebral and focal symptoms and ineffectiveness of therapy. Some patients with clinically significant post-radiation cysts can require surgical treatment. Insertion of Ommaya reservoir may be preferred in these patients. In some cases, this method is ineffective and more complex surgeries may be required. The objectives of this report were to analyze literature data and describe the patient with multiple recurrent brain cysts after previous irradiation for frontotemporal skin melanoma. Twenty-seven publications were analyzed for the period from 1997 to 2018. According to the literature, the incidence of post-radiation cysts varies from 0.4% to 28%, timing of occurrence - from 2 months to 27 years. These values significantly depend on the underlying disease. We report a 27-year-old patient who admitted to the Burdenko Neurosurgery Center with focal and general cerebral symptoms after irradiation for skin melanoma of the right frontotemporal region. These symptoms were caused by cystic lesion of the right temporal and frontal lobes. Surgical treatment consisted in insertion of 2 Ommaya reservoirs. This approach ensured complete regression of the cyst in the right temporal lobe and mild decrease of the cyst in the right frontal lobe.

[Repetitive resection and intrasurgery radiation therapy of brain malignant gliomas: history of question and modern state of problem]. / Povtornaia rezektsiia i intraoperatsionnaia luchevaia terapiia zlokachestvennykh gliom golovnogo mozga: istoricheskii ékskurs i sovremennoe sostoianie problemy.

Numerous studies have shown that the degree of primary resection of malignant gliomas of the brain (MG) directly correlates with rates of relapse-free and overall patient survival. Currently, there is no unequivocal opinion regarding the indications and effectiveness of repeated resection in relapse of MG after combined treatment. Surgical intervention, taking into account the pathomorphological features of these tumors, is not healing and should be supplemented with certain methods of adjuvant treatment. The article reviews and analyzes publications devoted to repeated resection and various methods of intraoperative radiation therapy in the treatment of MG. Based on the analysis, the authors of the article came to the conclusion that it is advisable to start their own research on the use of intraoperative balloon brachytherapy in the treatment of recurrent MG based on modern technological solutions.

[Long association tracts of the human white matter: an analysis of 18 hemisphere dissections and in vivo HARDI-CSD tractography]. / Dlinnye assotsiativnye provodyashie puti belogo veshchestva golovnogo mozga cheloveka: analiz dissektsii 18 polusharii i HARDI-CSD traktografii in vivo.

BACKGROUND: Anatomy of the conduction tracts of the cerebral cortex has been studied for a long time. Invention of diffusion tensor tractography renewed interest in this subject. The objectives of this work were to develop and improve protocols for dissection of the long association tracts of the human brain with studying the features of their segmentation, topography, and variability, compare the obtained data with the MR tractography data, and prepare for further clinical and anatomical studies. MATERIAL AND METHODS: We used 18 cerebral hemispheres (from 10 males and 8 females; 9 left and 9 right hemispheres). The mean age of cadavers was 68 years. Specimen were fixated in accordance with the Klingler technique. Immediately after collection, specimens were placed in a 10% formalin solution for at least 4 weeks. After that, the pia was removed; specimens were frozen at -20 °C for a week and then unfrozen in a 96% ethanol solution for a day. We performed 10 lateral dissections, 2 lateral dissections with isolation of the frontal aslant tract, 2 basal dissections, 1 combined basolateral dissection, 2 frontal dissections, and 1 medial dissection. At the time of dissection and after it, specimens were stored in a 96% ethanol solution. Modified, disposable, therapeutic wooden spatulas were used for manipulations. A microscope (magnification of 6-40x) was used in 2 lateral and 2 basal dissections. MR tractography (HARDI-CSD) was carried out in 5 healthy volunteers using a GE Signa HDxt MRI scanner a field strength of 3.0 T. RESULTS: We clearly identified the following fascicles: the arcuate fascicle (AF) and superior longitudinal fascicle (SLF) in 6/6 hemispheres on the right and in 5/6 hemispheres on the left, the inferior longitudinal fascicle (ILF) in 3/6 hemispheres on the left and in 4/6 hemispheres on the right, the uncinate fascicle (UF) in 4/4 hemispheres on the left and in 4/4 hemispheres on the right, and the inferior fronto-occipital fascicle (IFOF) in 4/4 hemispheres on the left and in 3/4 hemispheres on the right. Identification was less successful in the case of the frontal aslant tract (FAT) in 1/2 hemispheres on the left and in 0/2 hemispheres on the right. The used technique failed to identify the vertical occipital fascicle (VOF) of Wernicke, a segment of the superior longitudinal fascicle SLF I, and the middle longitudinal fascicle (MdLF). The MR tractography HARDI-CSD data were compared with the dissection data. We described in detail segmentation of the superior longitudinal, arcuate, and inferior fronto-occipital fascicles. Contradictory data were obtained for the superior longitudinal fascicle: a two-segment structure (SLFh and SLFv) was found in most (10/12) specimens, while a three-segment structure was revealed in the other (2/12) specimens (identified SLF II and SLF III). In the arcuate fascicle, the ventral and dorsal segments were successfully identified in 2/12 cases (1 left and 1 right), whereas identification failed in the other cases. During dissection of the inferior fronto-occipital fascicle, we could identify its surface layer in 1 of 8 cases (left) and its deep layer in one more case (left). CONCLUSION: Examination of the long association tracts using the Klingler technique has significant limitations in the fiber intersection areas (sagittal striatum). The frontal aslant tract was least studied; we proposed a special anterior dissection technique for its isolation. The superior longitudinal fascicle can have both the two-segment (10/12) and three-segment (2/12) structure. Investigation of the segmental anatomy of the long association tracts will be continued in further dissections. When planning neurosurgical interventions in the projection areas of the long association tracts, both preoperative HARDI-tractography and anatomical dissections ex vivo, based on the proposed protocols, can be recommended for the operating surgeon to master a three-dimensional picture of the tract topography.

[The current state of the brain-computer interface problem].

It was only 40 years ago that the first PC appeared. Over this period, rather short in historical terms, we have witnessed the revolutionary changes in lives of individuals and the entire society. Computer technologies are tightly connected with any field, either directly or indirectly. We can currently claim that computers are manifold superior to a human mind in terms of a number of parameters; however, machines lack the key feature: they are incapable of independent thinking (like a human). However, the key to successful development of humankind is collaboration between the brain and the computer rather than competition. Such collaboration when a computer broadens, supplements, or replaces some brain functions is known as the brain-computer interface. Our review focuses on real-life implementation of this collaboration.

[The long-associative pathway of the white matter: modern view from the perspective of neuroscience].

This review presents basic information about white matter tracts of the human brain, with a special emphasis being placed on long associative fibers (superior and inferior longitudinal fascicles, inferior frontooccipital fascicles, fasciculus arcuatus and fasciclus uncinatus): their structure, history, functions, methods of preoperative and intraoperative identification during neurosurgical operations. Neurological symptoms caused by a damage to each of the above-described long associative fiber are described. There is a detailed analysis of methods of neuropsychological testing and neurophysiological identification in white matter fiber tract mapping in focal brain lesions.

Treatment of poorly differentiated glioma using a combination of monoclonal antibodies to extracellular connexin-43 fragment, temozolomide, and radiotherapy.

Antitumor efficiencies of monoclonal antibodies to connexin-43 second extracellular loop (MAbE2Cx43), temozolomide, and fractionated γ-irradiation in the monotherapy mode and in several optimized combinations were studied in Wistar rats with induced C6 glioma. The survival of animals with glioma and the dynamics of intracerebral tumor development were evaluated by MRT. Temozolomide monotherapy (200 mg/m(2)) and isolated radiotherapy in a total dose of 36 Gy shifted the survival median from 28 days (no therapy) to 34 and 38 days, respectively; 100% animals died under conditions of temozolomide monotherapy and radiotherapy. Monotherapy with MAbE2Cx43 in a dose of 5 mg/kg led to significant regression of the tumor (according to MRT data), cure of 19.23% animals with glioma, and prolongation of the survival median to 39.5 days after tumor implantation. Combined therapy with MAbE2Cx43 and temozolomide completely abolished the antitumor effect (survival median 29 days). Treatment with MAbE2Cx43 in combination with radiotherapy was associated with mutual boosting of the therapeutic efficiencies, leading to a significant inhibition of tumor development and prolongation of the survival median to 60 days. The mechanism of tumorsuppressive activity of the antibodies could be due to connexon blockade in Cx43-positive glioma cells in the peritumor invasion zone. Higher efficiency of combined therapy was presumably due to the increase in blood-brain barrier permeability for antibodies after irradiation of the brain and to additional inhibitory effect of antibodies towards radioresistant migrating glioma cells. The results suggested that MAbE2Cx43 could be effective as the first-line drug in combined therapy for poorly differentiated gliomas.