Sublethal laser interstitial thermal therapy leads to confined neurological deficits and glioblastoma regression

Purpose

Laser interstitial thermal therapy (LITT) is a novel, minimally invasive treatment for intracranial lesions. In addition to a direct ablation effect, it can cause sublethal damage at mild temperatures. The impact of sublethal damage on the eloquent brain cortex, neural function, and growth of glioblastomas has not yet been fully investigated.

Method

This study involved a comparative assessment conducted before and after sublethal LITT treatment in an animal model. Pre-LITT and post-LITT behavioral tests were conducted to evaluate neural function. Magnetic resonance imaging data and brain samples were collected to evaluate morphological and pathological alterations in the brain tissue. IBA-1 staining was performed to examine the effect of the microglial cell-induced inflammatory response on cortical damage. Blood–brain barrier (BBB) disruption tests were conducted to evaluate BBB integrity. Finally, tumor-bearing rats were used to assess the tumor-suppressive effects of sublethal LITT.

Results

Neuronal deterioration was observed immediately after sublethal LITT treatment, which recovered within 4 weeks. No significant variation was observed in motor, memory, or cognitive function before and after the unilateral or contralateral LITT intervention. Tumor suppression was evident with sublethal LITT intervention. BBB integrity was initially disrupted but recovered 2 weeks later.

Conclusion

The impact of sublethal LITT on the eloquent cortex appears to be reversible, with no observed effects on neural function. Sublethal LITT treatment may effectively suppress tumors and disrupt the BBB.

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