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了解胶质母细胞瘤患者的认知功能:IDH 突变状态和功能连接的相关性。

Understanding cognitive functioning in glioma patients: The relevance of IDH-mutation status and functional connectivity.

机构信息

Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.

VUmc CCA Brain Tumor Center Amsterdam, Amsterdam, The Netherlands.

出版信息

Brain Behav. 2019 Apr;9(4):e01204. doi: 10.1002/brb3.1204. Epub 2019 Feb 26.

Abstract

INTRODUCTION

Cognitive deficits occur frequently in diffuse glioma patients, but are limitedly understood. An important marker for survival in these patients is isocitrate dehydrogenase (IDH) mutation (IDH-mut). Patients with IDH-mut glioma have a better prognosis but more often suffer from epilepsy than patients with IDH-wildtype (IDH-wt) glioma, who are generally older and more often have cognitive deficits. We investigated whether global brain functional connectivity differs between patients with IDH-mut and IDH-wt glioma, and whether this measure reflects variations in cognitive functioning in these subpopulations beyond the associated differences in age and presence of epilepsy.

METHODS

We recorded magnetoencephalography and tested cognitive functioning in 54 diffuse glioma patients (31 IDH-mut, 23 IDH-wt). Global functional connectivity between 78 atlas regions spanning the entire cortex was calculated in two frequency bands (theta and alpha). Group differences in global functional connectivity were tested, as was their association with cognitive functioning, controlling for age, education, and presence of epilepsy.

RESULTS

Patients with IDH-wt glioma had lower functional connectivity in the alpha band than patients with IDH-mut glioma (p = 0.040, corrected for age and presence of epilepsy). Lower alpha band functional connectivity was associated with poorer cognitive performance (p < 0.034), corrected for age, education, and presence of epilepsy.

CONCLUSION

Global functional connectivity is lower in patients with IDH-wt diffuse glioma compared to patients with IDH-mut diffuse glioma. Moreover, having lower functional alpha connectivity relates to poorer cognitive performance in patients with diffuse glioma, regardless of age, education, and presence of epilepsy.

摘要

简介

认知缺陷在弥漫性神经胶质瘤患者中经常发生,但了解有限。这些患者的一个重要生存标志物是异柠檬酸脱氢酶(IDH)突变(IDH-mut)。IDH-mut 型神经胶质瘤患者的预后较好,但比 IDH-野生型(IDH-wt)神经胶质瘤患者更容易患癫痫,后者通常年龄较大,且更常出现认知缺陷。我们研究了 IDH-mut 和 IDH-wt 神经胶质瘤患者之间的全脑功能连接是否存在差异,以及这种测量方法是否反映了这些亚群的认知功能变化,而不仅仅是与年龄和癫痫发作相关的差异。

方法

我们记录了 54 例弥漫性神经胶质瘤患者(31 例 IDH-mut,23 例 IDH-wt)的脑磁图和认知功能测试。在两个频带(theta 和 alpha)中计算了跨越整个皮层的 78 个图谱区域之间的全局功能连接。测试了全局功能连接在组间的差异,并控制年龄、教育程度和癫痫发作的存在,检验其与认知功能的关联。

结果

IDH-wt 神经胶质瘤患者的 alpha 频带功能连接低于 IDH-mut 神经胶质瘤患者(p=0.040,校正年龄和癫痫发作的存在)。alpha 频带功能连接越低,认知表现越差(p<0.034,校正年龄、教育程度和癫痫发作的存在)。

结论

与 IDH-mut 弥漫性神经胶质瘤患者相比,IDH-wt 弥漫性神经胶质瘤患者的全局功能连接较低。此外,无论年龄、教育程度和癫痫发作的存在如何,弥漫性神经胶质瘤患者的功能 alpha 连接越低,认知表现越差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d776/6456787/dd99185828a1/BRB3-9-e01204-g001.jpg

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