Neurosurgery

Early intraoperative photobiomodulation accelerates short-term recovery after incomplete cervical SCI

Adults with acute ASIA C cervical SCI undergoing decompression within 24 hours were randomized to adjunctive early photobiomodulation (PBM) or standard care. PBM consisted of 810 nm irradiation once daily for 7 days via a diffusing fiber positioned above the exposed cord during posterior surgery. PBM significantly improved ASIA motor scores at 0.5 and 3 months and enhanced SCIM and quality-of-life scores at 3–6 months, with convergence by 12 months. CSF biomarkers of neural injury were lower at day 7 with PBM, and fewer complications occurred without device-related serious adverse events. 1

Surgery for polymicrogyria-related epilepsy yields ~70% seizure freedom with functional trade-offs

This subject-level pooled analysis included 161 patients from 20 retrospective series of epilepsy surgery for polymicrogyria (PMG). About 70% achieved Engel Class I seizure freedom at ≥12 months, with shorter epilepsy duration associated with better outcomes. Among unilateral non-hemispheric and bilateral PMG, seizure-free rates were similar for hemispheric versus more limited resections, but limited resections caused fewer new or worsened motor deficits. Mixed-effects modeling showed a nonsignificant trend toward higher seizure-freedom odds with hemispheric surgery, emphasizing individualized, function-preserving planning. 2

Planned two-stage resection increases glioma EOR near eloquent cortex while preserving function

Among 1558 diffuse glioma patients, 36 underwent planned two-stage surgery, usually at first diagnosis and within about 12 days between stages. Indications included multifocal approaches, non-compliance during initial awake surgery, or primary debulking before subsequent awake mapping in eloquent regions. Second-stage surgery significantly reduced contrast-enhancing and non–contrast-enhancing residual volumes, converting most initially submaximal resections to maximal or supramaximal resections. Neurological and functional scores (NIHSS, KPS) remained stable, despite second-stage complications in 25%, including serious events requiring reoperation or ICU care in 16.7%. 3

MRI-compatible DBS reveals network-level signatures linked to Parkinson’s outcomes

Fourteen Parkinson’s disease patients with MRI-compatible DBS underwent extensive longitudinal imaging across five timepoints under seven stimulation conditions. Each patient contributed many hours of fMRI, structural, and diffusion data, with 27 healthy participants serving as comparators. DBS normalized connectivity in the somatocognitive action network and produced distinct modulation of primary motor and globus pallidus circuits. Target cortical functional connectivity predicted clinical outcomes, supporting network-informed DBS targeting and programming strategies. 4