UCL Queen Square Institute of Neurology, London, UK.
Neurology Department of Centro Hospitalar de Leiria, Leiria, Portugal.
Brain. 2020 Mar 1;143(3):877-890. doi: 10.1093/brain/awaa032.
In theory the most powerful technique for functional localization in cognitive neuroscience, lesion-deficit mapping is in practice distorted by unmodelled network disconnections and strong 'parasitic' dependencies between collaterally damaged ischaemic areas. High-dimensional multivariate modelling can overcome these defects, but only at the cost of commonly impracticable data scales. Here we develop lesion-deficit mapping with metabolic lesions-discrete areas of hypometabolism typically seen on interictal 18F-fluorodeoxyglucose PET imaging in patients with focal epilepsy-that inherently capture disconnection effects, and whose structural dependence patterns are sufficiently benign to allow the derivation of robust functional anatomical maps with modest data. In this cross-sectional study of 159 patients with widely distributed focal cortical impairments, we derive lesion-deficit maps of a broad range of psychological subdomains underlying affect and cognition. We demonstrate the potential clinical utility of the approach in guiding therapeutic resection for focal epilepsy or other neurosurgical indications by applying high-dimensional modelling to predict out-of-sample verbal IQ and depression from cortical metabolism alone.
在认知神经科学中，理论上最强大的功能定位技术是病变-缺损映射，但实际上，它受到未建模的网络连接中断和并发缺血区域之间强烈的“寄生”依赖性的扭曲。高维多元建模可以克服这些缺陷，但代价是通常不可行的数据规模。在这里，我们开发了一种病变-缺损映射，使用代谢性病变——在局灶性癫痫患者的发作间期 18F-氟脱氧葡萄糖 PET 成像上通常可见的代谢低下的离散区域——这些病变可以捕获连接中断效应，并且其结构依赖性模式足够良性，可以用适度的数据得出稳健的功能解剖图谱。在这项对 159 名广泛分布的局灶性皮质损伤患者的横断面研究中，我们得出了广泛的情感和认知心理亚领域的病变-缺损图谱。我们通过将高维模型应用于从皮质代谢中预测皮质代谢以外的样本言语智商和抑郁，来证明该方法在指导局灶性癫痫或其他神经外科适应证的治疗性切除方面的潜在临床应用价值。
