Gleneagles Hospital Penang: Leading the Way in Advanced Neurosurgery

A Team Approach to Neurological Care:

• Expert Neurosurgeons: Our team of neurosurgeons possesses extensive experience and in-depth knowledge across a broad spectrum of neurological disorders. This expertise empowers them to tackle even the most intricate procedures with confidence.
• Dedicated Support Staff: Beyond our neurosurgeons, a dedicated team of specialists from various fields works collaboratively to ensure holistic care for each patient. This team includes nurses, dietitians, and physiotherapists, each with the expertise to support your recovery journey at every stage.

At Gleneagles Hospital Penang, alongside our team of highly skilled neurosurgeons and support staffs, we employ cutting-edge technologies such as Diffusion Tensor Imaging (DTI) to ensure the most precise diagnoses and treatments.

Advanced Technologies for Precise Diagnosis and Treatment:

The DTI is an innovative MRI-based technique that offers a unique glimpse into the brain's white matter architecture.

Unveiling the Brain's Hidden Pathways: A Look at DTI

The human brain is a marvel of intricate connections. Billions of nerve fibres, bundled together as white matter tracts, form a complex network that allows different brain regions to communicate and orchestrate our thoughts, actions, and sensations. But how do we visualize this hidden architecture? Enter diffusion tensor imaging, or DTI, a technique that offers a unique window into the brain's white matter organization.

Figure 1: White and Gray matter image

Why is the White Matter in our brain important to us?

White matter allows different parts of the brain to talk to each other.

When you see an object, for example, visual information travels from your eyes to the visual cortex in the back of your brain. The white matter then carries signals to other brain regions involved in processing the information, like those responsible for recognition or movement.

This coordinated communication across different brain areas is essential for all our thoughts, actions, and sensations.

The integrity and organization of white matter are crucial for efficient brain function. If the white matter is damaged or diseased, the pathways themselves can become disrupted. This affects the flow of information, leading to various neurological problems. For example, impaired white matter integrity can manifest as:

• Difficulty learning and memory problems
• Coordination issues and tremors
• Sensory disturbances
• Speech and language problems

DTI Applications: Beyond Visualization

Figure 2: Diffusion tensor imaging used to reconstruct network connections in the brain (tractography). Similarly oriented fibres are shown in the same colour. Reprinted from Moriah E. Thomason and Paul M. Thompson, 2011, Diffusion imaging, white matter, and psychopathology, Annual Review of Clinical Psychology 7:63-85. National Academies of Sciences, Engineering, and Medicine. 2012. Fueling Innovation and Discovery: The Mathematical Sciences in the 21st Century. Washington, DC: The National Academies Press. https://doi.org/10.17226/13373.

Beyond offering a map of the white matter pathways in your brain, DTI serves as a valuable tool in various neurological contexts:

• Understanding Brain Development: DTI can track the progressive organization of white matter tracts as the brain matures, providing insights into neurodevelopment.

  DTI is a valuable tool for studying how the brain develops. A 2015 study showed that DTI could track the progressive organization of white matter tracts in infants, providing insights into brain development [1].

• Diagnosing Neurological Disorders: Altered diffusion patterns can aid in diagnosing conditions like stroke, tumours, and multiple sclerosis, where white matter integrity is compromised.

  DTI readings can help explain unclear changes in a patient's condition, especially for multiple sclerosis (MS). This is particularly valuable when conventional MRI scans are inconclusive, as DTI can detect abnormalities in white matter structure that may precede symptoms [2].

• Surgical Planning: DTI helps surgeons visualize and avoid critical white matter tracts during brain surgery, minimizing the risk of post-surgical complications.

  Studies have shown that DTI can significantly improve surgical outcomes. Using DTI for brain tumour surgery has led to a reduction in post-operative neurological deficits [3] [4]. 

Your Partner in Neurological Health

By combining a team-oriented approach with the latest advancements in technology like DTI, Gleneagles Hospital Penang is committed to providing exceptional neurosurgical care to our patients. We are confident in offering the most accurate diagnoses, effective treatment plans, and successful outcomes for a wide range of neurological conditions.

References:

[1] Qiu A, Mori S, Miller MI. Diffusion tensor imaging for understanding brain development in early life. Annu Rev Psychol. 2015 Jan 3;66:853-76. doi: 10.1146/annurev-psych-010814-015340. PMID: 25559117; PMCID: PMC4474038.

[2] ElSayed, M.E.K.A., El-Toukhy, M.M.B., Asaad, R.E. et al. Diffusion tensor imaging for assessment of normally appearing white matter of the brain and spinal cord in cases of multiple sclerosis: a multi-parametric correlation in view of patient’s clinical status. Egypt J Radiol Nucl Med 50, 30 (2019). https://doi.org/10.1186/s43055-019-0031-x

[3] Jung, H., Shah, A. & Li, G. Use of Diffusion Tensor Imaging in the Resection of Gliomas. Curr Surg Rep 2, 69 (2014). https://doi.org/10.1007/s40137-014-0069-7

[4] Edgar G. Ordonez-Rubiano1, Jason M. Johnson2, Nadin Abdalá-Vargas3, Oscar F. Zorro1, Jorge H. Marin-Munoz1, Ricardo Álvarez-Tobián4, Valeria Forlizzi5, Carlos Castillo Rangel6, Sabino Luzzi7, Alvaro Campero8, Javier G. Patiño-Gómez1, Matias Baldoncini9. Preoperative tractography algorithm for safe resection of tumors located in the descending motor pathways zone. 21-Jul-2023;14:255. Available from: https://surgicalneurologyint.com/surgicalint-articles/preoperative-tractography-algorithm-for-safe-resection-of-tumors-located-in-the-descending-motor-pathways-zone/