Cargnelutti Elisa, Maieron Marta, Ius Tamara, Skrap Miran, Tomasino Barbara
Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy.
Struttura Organizzativa Complessa (SOC) Fisica Sanitaria, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy.
Front Neurol. 2020 Dec 14;11:563259. doi: 10.3389/fneur.2020.563259. eCollection 2020.
Reading abilities and diffusion tensor imaging (DTI) parameters were retrospectively analyzed in a group of neurosurgical patients to investigate (Study 1) the role of white matter-in particular the arcuate fasciculus (AF)-in preserved vs. impaired reading; 4 months after surgery, we explored the plasticity processes (Study 2). Study 1 involved 40 patients with brain glioma (23 low-grade and 17 high-grade gliomas). We compared preoperative DTI parameters of language-related fascicles between patients who developed a reading impairment after surgery ( = 23) and patients with preserved reading ( = 17). Besides lower fractional anisotropy (FA), patients with impaired reading also displayed lower number and density of streamlines of a direct (i.e., directly connecting temporal and frontal lobes) AF segment. In Study 2, we longitudinally tested at follow-up-when reading performance had generally improved-13 patients diagnosed with low-grade glioma. The most relevant finding was a significant increase in length of streamlines of the direct AF segments in both hemispheres. From a neurosurgical perspective, our preliminary findings suggest the clinical importance of sparing direct AF segments for the involvement they showed in reading; however, the results also suggest the reorganization potential of these segments, possibly compensating of the right homologs as well.
我们对一组神经外科患者的阅读能力和扩散张量成像（DTI）参数进行了回顾性分析，以研究（研究1）白质尤其是弓状束（AF）在阅读保留与受损中的作用；术后4个月，我们探讨了可塑性过程（研究2）。研究1纳入了40例脑胶质瘤患者（23例低级别胶质瘤和17例高级别胶质瘤）。我们比较了术后出现阅读障碍的患者（n = 23）和阅读保留的患者（n = 17）术前与语言相关束的DTI参数。除了分数各向异性（FA）较低外，阅读受损的患者还表现出直接（即直接连接颞叶和额叶）AF段的流线数量和密度较低。在研究2中，我们对13例诊断为低级别胶质瘤的患者进行了纵向随访测试，此时阅读表现总体有所改善。最相关的发现是两个半球直接AF段的流线长度均显著增加。从神经外科角度来看，我们的初步研究结果表明保留直接AF段对阅读的重要性；然而，结果也表明这些段具有重组潜力，可能也会补偿右侧同源段。
