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The Origins of Diffuse Low-Grade Gliomas (DLGGs): “Functional Theory” Versus “Molecular Theory”

  • Catherine GozéEmail author
  • Luc Taillandier
  • Valérie Rigau
  • Luc Bauchet
  • Hugues Duffau
Chapter

Abstract

The improved understanding of the natural course of DLGGs has allowed a paradigmatic shift in their management from a “wait-and-see” attitude to an early, individualized, and dynamic therapeutic strategy. However, optimization of this management implies to better understand the origin of DLGG. First, because its growth rate is constant during the initial presymptomatic period, it was possible to extrapolate backward in time, leading to approximate the glioma date of birth in early adulthood. Another way to improve our knowledge about the mechanisms of DLGG genesis is to study their spatial distribution. Indeed, this tumor has preferential cerebral locations, especially in the supplementary motor area or the insular lobe – while occipital DLGG is very rare. On the basis of strong relationships between DLGG development and the eloquence of brain regions frequently invaded by this tumor, we propose a “functional theory” to explain the origin of DLGG. In addition, anatomo-molecular studies showed significant correlations between the DLGG locations and tumor genetics, especially with a lower rate of 1p19q codeletion in the insula. Here, the ultrastructural mechanisms of such “molecular theory” based on a cortical origin of DLGG will be reviewed. Finally, future directions such as potential interactions between environment–brain function–tumoral genes, the study of genetic susceptibility variants in DLGGs and the possible role of hormones in their etiology will be discussed. These crucial issues illustrate very well the close relationships between the pathophysiology of gliomagenesis, the anatomo-functional organization of the brain, and the personalized management in DLGG patients.

Keywords

DLGG Anatomo-molecular correlations Eloquent areas ­Brain–tumor interactions Ultrastructural mechanisms Extracellular matrix Oligoden­droglial progenitor cells Subventricular zone 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Catherine Gozé
    • 1
    • 2
    Email author
  • Luc Taillandier
    • 3
  • Valérie Rigau
    • 4
    • 5
  • Luc Bauchet
    • 6
    • 7
    • 8
  • Hugues Duffau
    • 9
    • 10
  1. 1.Department of Cellular BiologyMontpellier University Medical CenterMontpellierFrance
  2. 2.Institute for Neurosciences of Montpellier, Team “Brain Plasticity, Stem Cells and Glial Tumors”Montpellier University Medical CenterMontpellierFrance
  3. 3.Department of NeurologyNancy University Medical Center, Hôpital centralNancyFrance
  4. 4.Cytology and Anatomical Pathology LaboratoryMontpellier University Medical Center, Gui de Chauliac HospitalMontpellierFrance
  5. 5.Team “Neuronal Death and Epilepsia”CNRS UMR 5203 INSERM U661 UM1-UM2MontpellierFrance
  6. 6.Institute for Neurosciences of Montpellier, Team “Brain Plasticity, Stem Cells and Glial Tumors”National Institute for Health and Medical Research (INSERM), U1051, Montpellier University Medical CenterMontpellierFrance
  7. 7.Department of Neurosurgery, Gui de Chauliac HospitalMontpellier University Medical CenterMontpellierFrance
  8. 8.French Brain Tumor DataBase, Groupe de Neuro-Oncologie du Languedoc-Roussillon, Registre des Tumeurs de l’HéraultCentre de Lutte Contre le Cancer Val d’AurelleMontpellierFrance
  9. 9.Department of Neurosurgery, Gui de Chauliac HospitalMontpellier University Medical CenterMontpellier Cedex 5France
  10. 10.National Institute for Health and Medical Research (INSERM), U1051 Laboratory, Team “Brain Plasticity, Stem Cells and Glial Tumors”, Institute for Neurosciences of MontpellierMontpellier University Medical CenterMontpellierFrance

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