Połczyńska Monika M, Ding Bryan, Dang Bianca H, Cavanagh Lucia
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90095, USA.
Department of Statistics, University of California, Los Angeles, CA 90095, USA.
J Clin Med. 2021 Apr 3;10(7):1491. doi: 10.3390/jcm10071491.
The impact of previous surgery on the assessment of language dominance with preoperative fMRI remains inconclusive in patients with recurrent brain tumors. Samples in this retrospective study included 17 patients with prior brain surgery and 21 patients without prior surgery (38 patients total; mean age 43.2, SD = 11.9; 18 females; seven left-handed). All the patients were left language dominant, as determined clinically. The two samples were matched on 10 known confounds, including, for example, tumor laterality and location (all tumors affected Brodmann areas 44/45/47). We calculated fMRI language dominance with laterality indices using a whole-brain and region of interest approach (ROI; Broca's and Wernicke's area). Patients with prior surgery had decreased fMRI language dominance ( = 0.03) with more activity in the right hemisphere ( = 0.03) than patients without surgery. Patients with prior brain surgery did not display less language activity in the left hemisphere than patients without surgery. These results were replicated using an ROI approach in the affected Broca's area. Further, we observed no differences between our samples in the unaffected Wernicke's area. In sum, prior brain surgery affecting Broca's area could be a confounding factor that needs to be considered when evaluating fMRI language dominance.
对于复发性脑肿瘤患者，既往手术对术前功能磁共振成像（fMRI）评估语言优势的影响尚无定论。这项回顾性研究的样本包括17例曾接受过脑部手术的患者和21例未接受过手术的患者（共38例患者；平均年龄43.2岁，标准差=11.9；18名女性；7名左利手）。根据临床判断，所有患者均为左侧语言优势。这两个样本在10个已知的混杂因素上进行了匹配，例如肿瘤的侧别和位置（所有肿瘤均累及布罗德曼区44/45/47）。我们使用全脑和感兴趣区域方法（ROI；布洛卡区和韦尼克区）通过偏侧指数计算fMRI语言优势。与未接受手术的患者相比，曾接受过手术的患者fMRI语言优势降低（P=0.03），右半球活动更多（P=0.03）。曾接受过脑部手术的患者左半球语言活动并不比未接受手术的患者少。这些结果在受影响的布洛卡区使用ROI方法得到了重复。此外，我们在未受影响的韦尼克区的样本中未观察到差异。总之，影响布洛卡区的既往脑部手术可能是评估fMRI语言优势时需要考虑的一个混杂因素。
