Cabrera Sergio, Edelstein Kim, Mason Warren P, Tartaglia Maria Carmela
Memory Clinic, Toronto Western Hospital, 399 Bathurst St, Toronto M5T 2S8, Canada (S.C., M.C.T.); Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, 610 University Ave, Toronto M5G 2M9, Canada (S.C., K.E., W.P.M.); Department of Psychosocial Oncology & Palliative Care, Princess Margaret Cancer Centre, 610 University Ave, Toronto M5G 2M9, Canada (K.E.); Department of Hematology Oncology, Princess Margaret Cancer Centre, 610 University Ave, Toronto M5G 2M9, Canada (S.C., W.P.M.); Department of Neurology, University of Toronto, Toronto, Canada (S.C., W.P.M., M.C.T.); Department of Psychiatry, University of Toronto, Toronto, Canada (K.E.); Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Canada (M.C.T.).
Neurooncol Pract. 2016 Jun;3(2):113-119. doi: 10.1093/nop/npv055. Epub 2015 Nov 24.
Personality changes following brain tumors may be due to disruption of frontal-subcortical networks. The relation between personality changes and tumor parameters such as volumes of the surgical cavity, residual tumor, or nonspecific white matter abnormalities is unknown. In this study we examined the relation between these tumor parameters and abnormal behaviors typically associated with frontal lobe dysfunction.
Thirty-one patients with intracranial tumors who completed the Frontal Systems Behavior Scale (FrSBe) during clinical neuropsychological assessment and had a solitary, well-delimited brain lesion on MRI within 3 months of that assessment were included. Tumor parameters were manually segmented using OsiriX. Nonparametric statistics were used to determine the relationship between tumor parameters and frontal behavioral dysfunction as measured by FrSBe scores.
Patients reported significantly more behavior problems after tumor diagnosis. Tumor cavity volume was correlated with self-reported Executive Dysfunction (rho = 0.450, = .047), and there was a trend in the relationship with self-reported Apathy (rho = 0.438, = .053). Nonspecific white matter abnormality volume was also correlated with self-reported Apathy (rho = 0.810, = .01). There were no correlations between FrSBe scores and residual tumor volume or summed volumes of tumor-related parameters.
Our results suggest that tumor parameters have differential effects on behaviors associated with frontal-subcortical networks and corroborate the high frequency of behavioral dysfunction in brain tumor patients. Examination of these relationships in a prospective trial is warranted to establish incidence, prevalence, risk factors, and consequences of behavioral disturbances in brain tumor patients.
脑肿瘤后出现的人格改变可能是由于额叶 - 皮质下网络中断所致。人格改变与肿瘤参数（如手术腔体积、残余肿瘤或非特异性白质异常）之间的关系尚不清楚。在本研究中，我们研究了这些肿瘤参数与通常与额叶功能障碍相关的异常行为之间的关系。
纳入31例颅内肿瘤患者，这些患者在临床神经心理学评估期间完成了额叶系统行为量表（FrSBe），并且在该评估的3个月内MRI显示有单个、边界清晰的脑病变。使用OsiriX手动分割肿瘤参数。采用非参数统计来确定肿瘤参数与FrSBe评分所测量的额叶行为功能障碍之间的关系。
患者在肿瘤诊断后报告的行为问题明显更多。肿瘤腔体积与自我报告的执行功能障碍相关（rho = 0.450，P = 0.047），并且与自我报告的冷漠之间的关系有一个趋势（rho = 0.438，P = 0.053）。非特异性白质异常体积也与自我报告的冷漠相关（rho = 0.810，P = 0.01）。FrSBe评分与残余肿瘤体积或肿瘤相关参数的总体积之间没有相关性。
我们的结果表明，肿瘤参数对与额叶 - 皮质下网络相关的行为有不同影响，并证实了脑肿瘤患者行为功能障碍的高发生率。有必要在前瞻性试验中研究这些关系，以确定脑肿瘤患者行为障碍的发生率、患病率、危险因素和后果。
