使用基于体素的病变-症状映射研究成人胶质瘤病变位置与语言功能之间的关联。
Association between lesion location and language function in adult glioma using voxel-based lesion-symptom mapping.
作者信息
Banerjee Pia, Leu Kevin, Harris Robert J, Cloughesy Timothy F, Lai Albert, Nghiemphu Phioanh L, Pope Whitney B, Bookheimer Susan Y, Ellingson Benjamin M
机构信息
UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 760 Westwood Plaza, C8-746, Los Angeles, CA 90095, USA.
UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers (CVIB), David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA.
出版信息
Neuroimage Clin. 2015 Oct 23;9:617-24. doi: 10.1016/j.nicl.2015.10.010. eCollection 2015.
BACKGROUND
Management of language difficulties is an important aspect of clinical care for glioma patients, and accurately identifying the possible language deficits in patients based on lesion location would be beneficial to clinicians. To that end, we examined the relationship between lesion presence and language performance on tests of receptive language and expressive language using a highly specific voxel-based lesion-symptom mapping (VLSM) approach in glioma patients.
METHODS
98 adults with primary glioma, who were pre-surgical candidates, were administered seven neurocognitive tests within the domains of receptive language and expressive language. The association between language performance and lesion presence was examined using VLSM. Statistical parametric maps were created for each test, and composite maps for both receptive language and expressive language were created to display the significant voxels common to all tests within these language domains.
RESULTS
We identified clusters of voxels with a significant relationship between lesion presence and language performance. All tasks were associated with several white matter pathways. The receptive language tasks were additionally all associated with regions primarily within the lateral temporal lobe and medial temporal lobe. In contrast, the expressive language tasks shared little overlap, despite each task being independently associated with large anatomic areas.
CONCLUSIONS
Our findings identify the key anatomic structures involved in language functioning in adult glioma patients using an innovative lesion analysis technique and suggest that expressive language abilities may be more task-dependent and distributed than receptive language abilities.
背景
语言障碍的管理是胶质瘤患者临床护理的一个重要方面，基于病变位置准确识别患者可能存在的语言缺陷对临床医生有益。为此，我们在胶质瘤患者中使用高度特异性的基于体素的病变-症状映射（VLSM）方法，研究了病变存在与接受性语言和表达性语言测试中的语言表现之间的关系。
方法
98名成年原发性胶质瘤患者，均为手术前候选人，接受了接受性语言和表达性语言领域的七项神经认知测试。使用VLSM研究语言表现与病变存在之间的关联。为每项测试创建统计参数图，并创建接受性语言和表达性语言的复合图，以显示这些语言领域内所有测试共有的显著体素。
结果
我们确定了病变存在与语言表现之间存在显著关系的体素簇。所有任务均与几条白质通路相关。接受性语言任务还均与主要位于颞叶外侧和颞叶内侧的区域相关。相比之下，表达性语言任务几乎没有重叠，尽管每个任务都与大面积解剖区域独立相关。
结论
我们的研究结果使用创新的病变分析技术确定了成年胶质瘤患者语言功能中涉及的关键解剖结构，并表明表达性语言能力可能比接受性语言能力更依赖任务且分布更分散。
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