左侧半球胶质瘤患者的语言重组与语言相关区域和默认模式网络的皮质体积增加有关。
Language reorganization in patients with left-hemispheric gliomas is associated with increased cortical volume in language-related areas and in the default mode network.
机构信息
Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital, La Sapienza University, Rome 00189, Italy.
Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
出版信息
Cortex. 2022 Dec;157:245-255. doi: 10.1016/j.cortex.2022.09.014. Epub 2022 Oct 19.
BACKGROUND
Language function may reorganize to overcome focal impairment; however, the relation between functional and structural changes in patients with brain tumors remains unclear. We investigated the cortical volume of atypical language dominant (AD) patients with left frontal-insular high-grade (HGG) and low-grade glioma (LGG). We hypothesized atypical language being associated with areas of increased cortical volume in the right hemisphere, including language areas homologues.
METHODS
Patient were recruited following the criteria: left frontal-insular glioma; functional MRI and 3DT1-weighted images; no artifacts. We calculated an hemispheric language laterality index (LI), defined as: AD if LI < .2; left-dominant (LD) if LI ≥ .2. We measured cortical volume in three voxel-based morphometry (VBM) analyses: total AD vs. LD patients; AD vs. LD in HGG; AD vs. LD in LGG. We repeated the analysis in AD vs. LD healthy controls (HC). A minimum threshold of t > 2 and corrected p < .025 (Bonferroni) was employed.
RESULTS
We recruited 119 patients (44LGG, 75HGG). Hemispheric LI demonstrated 64/119AD and 55/119LD patients. The first VBM analysis demonstrated significantly increased cortical volume in AD patients in the right inferior frontal gyrus (IFG), right superior temporal gyrus (STG), right insula, right fusiform gyrus (FG), right precentral gyrus, right temporal-parietal junction, right posterior cingulate cortex (PCC), right hippocampus, right- and left cerebellum. AD patients with HGG showed the same areas of significantly increased cortical volume. AD patients with LGG displayed significantly increased cortical volume in right IFG, right STG, right insula, right FG, right anterior cingulate cortex, right PCC, right dorsal-lateral prefrontal cortex. HC showed no significant results.
CONCLUSION
Right-sided (atypical) language activations in patients with left-hemispheric gliomas are associated with areas of increased cortical volume. Additionally, default mode network nodes showed greater cortical volume in AD patients regardless of the tumor grade, supporting the idea of these cortices participating in the development of language plasticity.
背景
语言功能可能会重新组织以克服局灶性损伤；然而，肿瘤患者的功能和结构变化之间的关系尚不清楚。我们研究了左额-岛叶高级别（HGG）和低级别胶质瘤（LGG）伴非典型语言优势（AD）患者的皮质体积。我们假设，异常语言与右侧包括语言区域同源的皮质体积增加区域相关。
方法
根据以下标准招募患者：左额-岛叶胶质瘤；功能 MRI 和 3DT1 加权图像；无伪影。我们计算了半球语言侧化指数（LI），定义为：LI<0.2 为 AD；LI≥0.2 为左优势（LD）。我们在三个基于体素的形态测量学（VBM）分析中测量皮质体积：总 AD 与 LD 患者；HGG 中的 AD 与 LD；LGG 中的 AD 与 LD。我们在 AD 与 LD 健康对照组（HC）中重复了分析。采用 t>2 且校正后 p<0.025（Bonferroni）的最小阈值。
结果
我们招募了 119 名患者（44 名 LGG，75 名 HGG）。半球 LI 显示 64/119 名 AD 和 55/119 名 LD 患者。第一项 VBM 分析显示，AD 患者的右侧额下回（IFG）、右侧颞上回（STG）、右侧岛叶、右侧梭状回（FG）、右侧中央前回、右侧颞顶交界处、右侧后扣带回皮质（PCC）、右侧海马、右侧和左侧小脑皮质体积增加显著。HGG 中 AD 患者也显示出相同的皮质体积增加区域。LGG 中 AD 患者的右侧 IFG、右侧 STG、右侧岛叶、右侧 FG、右侧前扣带回、右侧 PCC、右侧背外侧前额叶皮质体积增加显著。HC 无显著结果。
结论
左半球胶质瘤患者的右侧（非典型）语言激活与皮质体积增加区域相关。此外，无论肿瘤级别如何，AD 患者的默认模式网络节点显示出更大的皮质体积，支持这些皮质参与语言可塑性发展的观点。
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