M Kob

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Frannk Christian Veggro Rios

Universidad Nacional Federico Villarreal

Université de Liège

University of Liege

Anglia Ruskin University

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Papers by M Kob

A Proton Magnetic Resonance Spectroscopy Study

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A Large Mass Mimicking Calcified Hematoma of the Skull Showing Involvement of Myeloma Cells and a Good Response to Irradiation

The Surgery Journal, 2019

Patients with multiple myeloma often show skull bone involvement, although in most cases this is ... more Patients with multiple myeloma often show skull bone involvement, although in most cases this is manifested as skull erosion and large masses develop only rarely. Here we report a patient who presented with a large cranial mass mimicking a subdural hematoma with calcification. The tumor shrunk with 37.5 Gy of focal irradiation in 15 fractions after biopsy. After irradiation the patient was treated with Bortezomib but died because of adverse events. The differential diagnosis of lenticular lesion of the skull and treatment strategy for large skull mass with myeloma cells are discussed.

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Determination of Language Lateralization using Functional MRI during the Performance of Shiritori Tasks in Neurosurgery Patients

Japanese Journal of Neurosurgery, 2001

Assessment of language lateralization is crucial in patients considered f () r neurologica ！surge... more Assessment of language lateralization is crucial in patients considered f () r neurologica ！surgery ． The authors used functional MRI (fMRI)in conjunction with shiritori ， a kind of word − generation task as paradigms ， to deter − Inine ianguage lateralization in the patients． We used a 1． 5 Tesla magnetic resonance imaging devise with an echo − planar inlaging sequence ． Thirty − two patients undergoing neurological surgery would alternately rest and silently perforrn shiritori during fMRI acquisition ． Language lateralization was determined in 29 out of 32 patients． Twenty − two patients were considered as lef し一 hemisphere donlinant and seven were right − hemisphere dominant ． Brain acti − vation was seen in the prefrontal area ， premotor area ， superior temporal gyrus and parietal lobe of the dominant hemisphere ， which is consistent with the results in nQrmal adults ． Language lateralization was particularly useful in acase of meningioma in the lef しlateral ventricle and in a case of AVM in the left temporoparietal region ． fMRI with shiritori tasks revealed righ レ hemisphere dominance in both cases ， which was also confirmed by intracarotid amo − barbital (Wada)testing ， Both lesions were treated successfully without causing any further deficit to the patients ' slanguage function ． These results suggest that fMRI with shiritori tasks can be used to assess language lateralization non − inva − sive 茎 y， compared with the current techniques ， such as intracarotid amobarbital testing and cortical electrostimula − tion nlapping ． Thus ， fMRI with shiritori tasks has significant clinical potential as a presurgical evaluation tool ．

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Ipsilateral motor cortex activation on functional magnetic resonance imaging during unilateral hand movements is related to interhemispheric interactions

NeuroImage, 2003

Distal, unilateral hand movements can be associated with activation of both sensorimotor cortices... more Distal, unilateral hand movements can be associated with activation of both sensorimotor cortices on functional MRI. The neurophysiological significance of the ipsilateral activation remains unclear. We examined 10 healthy right-handed subjects with and without activation of the ipsilateral sensorimotor area during unilateral index-finger movements, to examine ipsilateral, uncrossed-descending pathways and interhemispheric interaction between bilateral motor areas, using transcranial magnetic stimulation (TMS). No subject showed ipsilateral activation during right hand movement. Five subjects showed ipsilateral sensorimotor cortical activation during left hand movement (IpsiLM1). In these subjects, paired-pulse TMS revealed a significant interhemispheric inhibition of the left motor cortex by the right hemisphere that was not present in the 5 subjects without IpsiLM1. Neither ipsilateral MEPs nor ipsilateral silent periods were evoked by TMS in any subjects. Our observation suggests that IpsiLM1 is not associated with the presence of ipsilateral uncrossed-descending projections. Instead, IpsiLM1 may reveal an enhanced interhemispheric inhibition from the right hemisphere upon the left to suppress superfluous, excessive activation.

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Central Tumor Necrosis of a Large Meningioma Following Acute Anemia Caused by Hysterectomy

Neurologia medico-chirurgica, 2009

A 55-year-old woman, with a one-year history of headache, gait disturbance, and slight aphasia, w... more A 55-year-old woman, with a one-year history of headache, gait disturbance, and slight aphasia, was transferred to our hospital after head injury. Magnetic resonance (MR) imaging and computed tomography revealed a large meningioma with peripheral edema. However, priority was given to previously planned gynecological surgery for uterine cancer. She developed severe anemia after the surgery, followed by consciousness disturbance. MR imaging revealed spontaneous tumor necrosis. The meningioma was totally removed. Her consciousness improved, and she was discharged with no neurological deficit. Patients with large meningioma may suffer deterioration of symptoms due to central tumor necrosis triggered by acute anemia.

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拡散強調画像による脳出血の経時変化

Nosotchu, 1999

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Assessment of Cognitive Function Before and After Surgery for Posterior Cranial Fossa Lesions

Skull Base, 2009

Cognitive function has not been well studied after neurosurgery for posterior fossa lesions despi... more Cognitive function has not been well studied after neurosurgery for posterior fossa lesions despite its potential importance in determining surgical indications and approaches. The present study evaluated changes in cognitive functions after posterior fossa surgery to detect any differences between the middle cranial fossa and lateral suboccipital approaches in 50 patients with posterior fossa lesions such as tumors and vascular diseases. Twenty-five patients underwent surgery via the middle fossa and 25 via the lateral suboccipital approaches. Computerized test battery (CogState TM) and conventional neuropsychological tests (serial seven-word learning test and mini-mental state examination) were examined before, 1 month after, and 3 months after surgery. All scores of the neuropsychological tests remained within normal limits after surgery. However, the scores of one computerized test battery and serial sevenword learning tests decreased significantly 1 month after surgery and recovered within 3 months, indicating temporary deterioration of short-term memory in the middle fossa group. The computerized tests detected significantly larger numbers of patients with worsened results than the conventional tests. The middle fossa approach and operation time showed correlations with the postoperative neuropsychological declines. The computerized tests could be performed easily and were beneficial for detecting subtle changes of the cognitive function after surgery. Cognitive function, especially short-term memory, may decline temporarily with the middle fossa approach and long operation time.

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Longitudinal Changes of Metabolites in Frontal Lobes After Hemorrhagic Stroke of Basal Ganglia

Stroke, 2001

Background and Purpose — We investigated serial metabolic changes in frontal lobes of patients wi... more Background and Purpose — We investigated serial metabolic changes in frontal lobes of patients with deep intracerebral hemorrhage (ICH) to examine the correlation between N -acetylaspartate (NAA) and degree of motor impairment or clinical outcome. Methods — Twenty patients with deep ICH were examined with proton magnetic resonance spectroscopy with the application of a multivoxel method (1 voxel=10×10×20 mm; 64 voxels). NAA/creatine ratios in the white matter of the primary motor and premotor areas on both sides were measured sequentially: within 48 hours, at 2 weeks, and 1 month after onset. The National Institutes of Health Stroke Scale and Barthel Index for disability were measured for each patient. Results — In the primary motor area on the affected side, where the hematoma did not extend, the NAA/creatine ratio decreased sequentially. At 48 hours and 2 weeks after onset, a negative correlation was detected between NAA/creatine and hematoma volume, but there was no correlation 1...

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Intracranial measurement of current densities induced by transcranial magnetic stimulation in the human brain

Neuroscience Letters, 2004

Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses the principle of el... more Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses the principle of electromagnetic induction to generate currents in the brain via pulsed magnetic fields. The magnitude of such induced currents is unknown. In this study we measured the TMS induced current densities in a patient with implanted depth electrodes for epilepsy monitoring. A maximum current density of 12 mA/cm 2 was recorded at a depth of 1 cm from scalp surface with the optimum stimulation orientation used in the experiment and an intensity of 7% of the maximal stimulator output. During TMS we recorded relative current variations under different stimulating coil orientations and at different points in the subject's brain. The results were in accordance with current theoretical models. The induced currents decayed with distance form the coil and varied with alterations in coil orientations. These results provide novel insight into the physical and neurophysiological processes of TMS.

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Speech-induced modulation of interhemispheric inhibition

Neuroscience Letters, 2012

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Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas

Journal of Neurosurgery, 2011

Object Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas,... more Object Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas, subtotal resection (STR) with or without radiation therapy can be considered as an alternative treatment for patients at considerable surgical risk. The long-term prognosis of such patients might be related to the biological activity of the tumor. This study examined predictors of progression-free survival (PFS) and sought to determine the optimal treatment strategies, focusing on the pathobiological findings of skull base meningiomas. Methods This study included 281 patients with skull base meningiomas (mean follow-up period 88.4 months). Risk factors for tumor progression were examined using a multivariate analysis. The PFS and overall survival (OS) rates were evaluated using the Kaplan-Meier method. The functional outcomes of the patients were measured using the Karnofsky Performance Scale (KPS). Results The 10-year PFS and OS rates were 66.4% and 97.4%, respectively. Overall, 83.3% ...

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Suppression of ipsilateral motor cortex facilitates motor skill learning

European Journal of Neuroscience, 2009

The primary motor cortex (M1) plays a critical role in early aspects of motor skill learning. Giv... more The primary motor cortex (M1) plays a critical role in early aspects of motor skill learning. Given the notion of inter‐hemispheric competition, unilateral disruption of M1 may increase excitability of the unaffected motor cortex and thus improve motor learning with the ipsilateral hand. We applied slow‐frequency repetitive transcranial magnetic stimulation (rTMS) before the initiation of practice of a simple motor skill. Participants were randomly divided into three stimulation groups: (i) ipsilateral M1; (ii) contralateral M1; and (iii) Cz (control site). The mean execution time and error rate were recorded in four sessions distributed over 2 days. Disruption of M1 with rTMS slowed down skill acquisition with the contralateral hand, albeit non significantly, but paradoxically enhanced learning with the ipsilateral hand. This was evidenced by a significant decrease of execution time at the end of day 1 in the group that received rTMS over the ipsilateral M1 compared with both contr...

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TMS suppression of right pars triangularis, but not pars opercularis, improves naming in aphasia

Brain and Language, 2011

This study sought to discover if an optimum 1 cm 2 area in the non-damaged right hemisphere (RH) ... more This study sought to discover if an optimum 1 cm 2 area in the non-damaged right hemisphere (RH) was present, which could temporarily improve naming in chronic, nonfluent aphasia patients when suppressed with repetitive transcranial magnetic stimulation (rTMS). Ten minutes of slow, 1 Hz rTMS was applied to suppress different RH ROIs in eight aphasia cases. Picture naming and response time (RT) were examined before, and immediately after rTMS. In aphasia patients, suppression of right pars triangularis (PTr) led to significant increase in pictures named, and significant decrease in RT. Suppression of right pars opercularis (POp), however, led to significant increase in RT, but no change in number of pictures named. Eight normals named all pictures correctly; similar to aphasia patients, RT significantly decreased following rTMS to suppress right PTr, versus right POp. Differential effects following suppression of right PTr versus right POp suggest different functional roles for these regions.

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Transcranial magnetic stimulation in neurology

The Lancet Neurology, 2003

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Bony foramina facilitate magnetic stimulation: an experimental cat sciatic nerve model

Electroencephalography and Clinical Neurophysiology/Electromyography and Motor Control, 1997

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Does arteriosclerosis contribute to hemifacial spasm?

Acta Neurochirurgica, 2015

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未破裂巨大脳動脈瘤における母動脈近位部閉塞術の長期予後

Surgery for Cerebral Stroke, 1997

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Unusual Location of Intracranial Vagus Neurinoma —Case Report—

Neurologia medico-chirurgica, 1995

A 55-year-old male presented with hearing disturbance and tinnitus in the left ear. Computed tomo... more A 55-year-old male presented with hearing disturbance and tinnitus in the left ear. Computed tomography (CT) and magnetic resonance imaging demonstrated a well-defined, homogeneously enhanced mass in the left cerebellomedullary cistern without extension close to the jugular foramen. A three-dimensional image reconstructed from thin-slice CT scans demonstrated that the mass was clear ly separated from the jugular foramen. The mass lesion was totally removed surgically. At surgery the tumor was found to originate from one rootlet of the vagal nerve just after its exit from the medulla oblongata. The histological diagnosis was neurinoma. Intracranial neurinomas of the glossopharyn geal, vagal, or accessory nerve usually originate within or close to the jugular foramen. This unusual location made it difficult to achieve a correct preoperative diagnosis.

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Suppression of complex visual hallucinatory experiences by occipital transcranial magnetic stimulation: a case report

Neurocase, 2003

We report a patient with visual hallucinations and illusions along with an associated visual fiel... more We report a patient with visual hallucinations and illusions along with an associated visual field defect after bilateral ischemic damage to his occipital visual cortex. These hallucinations were long-standing and of both simple and complex (well-formed) type. Application of low frequency (1 Hz) repetitive Transcranial Magnetic Stimulation (rTMS) to the occipital cortex led to a complete cessation of visual hallucinatory symptoms. The use of TMS to probe the neurophysiology, and possibly alleviate, visual hallucinatory experiences is discussed.

Chapter 21 Exploring paradoxical functional facilitation with TMS

Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation, Proceedings of the 2nd International Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) Symposium, 2003

Publisher Summary This chapter describes experiments conducted in cats to underscore the local an... more Publisher Summary This chapter describes experiments conducted in cats to underscore the local and distant effects exerted by repetitive transcranial magnetic stimulation (TMS). The better understanding of the modulatory effects of repetitive transcranial magnetic stimulation (rTMS) can then lead to the experimental testing of specific hypotheses relating to the paradoxical effects of TMS-induced “virtual lesions.” The chapter describes studies on attention and motor performance that highlight the potential of TMS as a tool to reveal functional facilitations and ultimately offer the possibility to use such an approach for therapeutic purposes. The chapter presents the results that underscore the potential of TMS as a tool to probe the paradoxical functional facilitations that may occur following lesions to a particular node of a complex and distributed neural network. Work in cats has shown the robust metabolic effects of rTMS on local and distant cortical and subcortical sites.

A Proton Magnetic Resonance Spectroscopy Study

The online version of this article, along with updated information and services, is located on the

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A Large Mass Mimicking Calcified Hematoma of the Skull Showing Involvement of Myeloma Cells and a Good Response to Irradiation

The Surgery Journal, 2019

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Determination of Language Lateralization using Functional MRI during the Performance of Shiritori Tasks in Neurosurgery Patients

Japanese Journal of Neurosurgery, 2001

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Ipsilateral motor cortex activation on functional magnetic resonance imaging during unilateral hand movements is related to interhemispheric interactions

NeuroImage, 2003

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