Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
Brain Behav. 2021 Mar;11(3):e01917. doi: 10.1002/brb3.1917. Epub 2021 Jan 27.
To investigate changes of vision-related resting-state activity in pituitary adenoma (PA) patients with visual improvement after transsphenoidal surgery.
14 PA patients with visual improvement after surgery were enrolled. The resting-state functional MRI and neuro-ophthalmologic evaluation were performed before and after the operation. The functional connectivity (FC) of 8 seeds (the primary visual cortex (V1), the secondary visual cortex (V2), the middle temporal visual cortex (MT+), and fusiform gyrus(FG)) was evaluated. A paired t test was conducted to identify the differences between the two groups.
Compared with the preoperation counterparts, the PA patients with improved vision exhibited decreased FC with the V1, V2, MT+, FG in the left paracentral lobule, bilateral lingual gyrus, precentral gyrus(BA 4), right superior temporal gyrus(BA 22), left fusiform gyrus, bilateral middle occipital gyrus (BA 19), left cuneus, right inferior occipital gyrus, left superior frontal gyrus, right cuneus, left superior parietal lobule(BA 7),the medulla, right postcentral gyrus, and increased FC in the right middle frontal gyrus, left inferior parietal lobule (BA 40), left declive, right lentiform nucleus, inferior frontal gyrus, right superior frontal gyrus(BA 11), cingulate gyrus(BA 32), right putamen, right thalamus, left medial frontal gyrus, left claustrum, left superior frontal Medial, right rectal gyrus(BA 25) and right parahippocampal gyrus.
The results show most subareas within the visual cortex exhibit decreased functional connectivity. The functional changes in subareas within default mode network (DMN), action observation network (AON) and the multisensory system in PAs propose that vision improvement may lead to function remodeling in higher-order cortex.
本研究旨在探讨经蝶窦手术后视觉改善的垂体腺瘤(PA)患者视觉相关静息态活动的变化。
纳入 14 例术后视觉改善的 PA 患者,分别在术前和术后进行静息态功能磁共振成像和神经眼科评估。评估 8 个种子(初级视觉皮层(V1)、次级视觉皮层(V2)、中颞叶视觉皮层(MT+)和梭状回(FG))的功能连接(FC)。采用配对 t 检验比较两组之间的差异。
与术前相比,视觉改善的 PA 患者左旁中央小叶、双侧舌回、中央前回(BA4)、右侧颞上回(BA22)、左侧梭状回、双侧中枕回(BA19)、左侧楔前回、右侧枕下回、左侧额上回、右侧楔叶、左侧顶上回(BA7)、延髓、右侧中央后回、左侧额下回、左侧下斜方、右侧豆状核、下额回、右侧额上回(BA11)、扣带回(BA32)、右侧壳核、右侧丘脑、左侧额内侧回、左侧屏状核、左侧额上内侧回、右侧直回(BA25)和右侧海马旁回的 V1、V2、MT+、FG 与左旁中央小叶、双侧舌回、中央前回(BA4)、右侧颞上回(BA22)、左侧梭状回、双侧中枕回(BA19)、左侧楔前回、右侧枕下回、左侧额上回、右侧楔叶、左侧顶上回(BA7)、延髓、右侧中央后回、左侧额下回、左侧下斜方、右侧豆状核、下额回、右侧额上回(BA11)、扣带回(BA32)、右侧壳核、右侧丘脑、左侧额内侧回、左侧屏状核、左侧额上内侧回、右侧直回(BA25)和右侧海马旁回的 FC 降低,右侧额中回、左侧顶下小叶(BA40)、左侧下斜方、右侧豆状核、额下回、右侧额上回(BA11)、扣带回(BA32)、右侧壳核、右侧丘脑、左侧额内侧回、左侧屏状核、左侧额上内侧回、右侧直回(BA25)和右侧海马旁回的 FC 增高。
结果表明,视皮层内的大多数亚区表现出功能连接的降低。默认模式网络(DMN)、动作观察网络(AON)和 PA 多感觉系统内的亚区功能变化表明,视觉改善可能导致高级皮层的功能重塑。