Sinha Rohitashwa, Dijkshoorn Aicha B C, Li Chao, Manly Tom, Price Stephen J
Cambridge Brain Tumour Imaging Laboratory, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, CB2 7EF, UK.
Brain Commun. 2020 Oct 12;2(2):fcaa169. doi: 10.1093/braincomms/fcaa169. eCollection 2020.
Patients with glioblastoma face abysmal overall survival, cognitive deficits, poor quality of life and limitations to social participation; partly attributable to surgery. Emotion recognition deficits mediated by pathophysiological mechanisms in the right inferior fronto-occipital fasciculus and right inferior longitudinal fasciculus have been demonstrated in traumatic brain injury and dementia, with negative associations for social participation. We hypothesize similar mechanisms occur in patients undergoing resection surgery for glioblastoma. Here, we apply tract-based spatial statistics using a combination of automated image registration methods alongside cognitive testing before and after surgery. In this prospective, longitudinal, observational study of 15 patients, surgery is associated with an increase in emotion recognition deficits (=0.009) and this is correlated with decreases in fractional anisotropy in the inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation and uncinate fasciculus; all in the right hemisphere (=0.014). Methodologically, the combination of registration steps used demonstrate that tract-based spatial statistics can be applied in the context of large, scan distorting lesions such as glioblastoma. These results can inform clinical consultations with patients undergoing surgery, support consideration for social cognition rehabilitation and are consistent with theoretical mechanisms that implicate these tracts in emotion recognition deficits across different diseases.
胶质母细胞瘤患者面临着极差的总体生存率、认知缺陷、生活质量差以及社会参与受限等问题；部分原因可归咎于手术。在创伤性脑损伤和痴呆症中，已证实右侧额枕下束和右侧下纵束的病理生理机制介导的情绪识别缺陷与社会参与呈负相关。我们推测，在接受胶质母细胞瘤切除手术的患者中也会出现类似机制。在此，我们在手术前后结合认知测试，应用基于轨迹的空间统计学方法，并结合自动图像配准方法。在这项针对15名患者的前瞻性、纵向观察研究中，手术与情绪识别缺陷增加（=0.009）相关，这与下纵束、额枕下束、丘脑前辐射和钩束的各向异性分数降低相关；均在右半球（=0.014）。在方法上，所使用的配准步骤组合表明，基于轨迹的空间统计学可应用于胶质母细胞瘤等大型扫描变形病变的情况。这些结果可为接受手术的患者的临床咨询提供参考，支持对社会认知康复的考虑，并且与涉及这些束在不同疾病的情绪识别缺陷中的理论机制一致。
