左额叶高级别胶质瘤患者术前认知功能与基于体素的病变-症状映射
Pre-Surgery Cognitive Performance and Voxel-Based Lesion-Symptom Mapping in Patients with Left High-Grade Glioma.
作者信息
Guarracino Ilaria, Ius Tamara, Baiano Cinzia, D'Agostini Serena, Skrap Miran, Tomasino Barbara
机构信息
Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, 33037 Udine, Italy.
SOC Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, 33100 Udine, Italy.
出版信息
Cancers (Basel). 2021 Mar 23;13(6):1467. doi: 10.3390/cancers13061467.
(1) Background: The literature on the effects of high-grade glioma (HGG) growth on cognition is still scarce. (2) Method: A consecutive series of 85 patients with HGG involving the left hemisphere underwent an extended neuropsychological evaluation prior to surgery. Voxel-based lesion-symptom mapping (VLSM) was used to identify regions related to cognitive performance. (3) Results: The patients' mean level of pre-surgery accuracy was overall high. They showed the greatest difficulties in language with tasks such as naming (42.1% of patients impaired on nouns and 61.4% on verbs), reading (36.3% on words and 32.7% on pseudo-words), auditory lexical decisions (43.9%) and writing (41.3%) being most frequently impaired. VLSM analysis revealed anatomically separated areas along the temporal cortex and the white matter related to impairments on the different tasks, with voxels commonly shared by all tasks restricted to a small region in the ventral superior and middle temporal gyrus. (4) Conclusions: High-grade glioma affects cognition; nonetheless, lesions do not cause diffuse deficits but selectively impact the different language sub-domains along the ventral stream and the dorsal stream for language processing.
(1) 背景：关于高级别胶质瘤（HGG）生长对认知影响的文献仍然匮乏。(2) 方法：连续纳入85例累及左半球的HGG患者，在手术前进行了全面的神经心理学评估。基于体素的病变-症状映射（VLSM）用于识别与认知表现相关的区域。(3) 结果：患者术前的总体准确率较高。他们在语言方面表现出最大困难，命名（42.1%的患者名词受损，61.4%的患者动词受损）、阅读（单词阅读受损率为36.3%，假词阅读受损率为32.7%）、听觉词汇判断（43.9%）和写作（41.3%）等任务受损最为频繁。VLSM分析显示，沿着颞叶皮质和白质存在与不同任务受损相关的解剖学上分离的区域，所有任务共同的体素局限于腹侧颞上回和颞中回的一个小区域。(4) 结论：高级别胶质瘤会影响认知；尽管如此，病变不会导致弥漫性缺陷，而是选择性地影响语言处理腹侧流和背侧流的不同语言子领域。
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