Pasquini Luca, Peck Kyung K, Tao Alice, Del Ferraro Gino, Correa Denise D, Jenabi Mehrnaz, Kobylarz Erik, Zhang Zhigang, Brennan Cameron, Tabar Viviane, Makse Hernán, Holodny Andrei I
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, 00189 Rome, Italy.
Cancers (Basel). 2023 Jan 29;15(3):836. doi: 10.3390/cancers15030836.
Language reorganization may represent an adaptive phenomenon to compensate tumor invasion of the dominant hemisphere. However, the functional changes over time underlying language plasticity remain unknown. We evaluated language function in patients with low-grade glioma (LGG), using task-based functional MRI (tb-fMRI), graph-theory and standardized language assessment. We hypothesized that functional networks obtained from tb-fMRI would show connectivity changes over time, with increased right-hemispheric participation. We recruited five right-handed patients (4M, mean age 47.6Y) with left-hemispheric LGG. Tb-fMRI and language assessment were conducted pre-operatively (pre-op), and post-operatively: post-op1 (4-8 months), post-op2 (10-14 months) and post-op3 (16-23 months). We computed the individual functional networks applying optimal percolation thresholding. Language dominance and hemispheric connectivity were quantified by laterality indices (LI) on fMRI maps and connectivity matrices. A fixed linear mixed model was used to assess the intra-patient correlation trend of LI values over time and their correlation with language performance. Individual networks showed increased inter-hemispheric and right-sided connectivity involving language areas homologues. Two patterns of language reorganization emerged: Three/five patients demonstrated a left-to-codominant shift from pre-op to post-op3 (type 1). Two/five patients started as atypical dominant at pre-op, and remained unchanged at post-op3 (type 2). LI obtained from tb-fMRI showed a significant left-to-right trend in all patients across timepoints. There were no significant changes in language performance over time. Type 1 language reorganization may be related to the treatment, while type 2 may be tumor-induced, since it was already present at pre-op. Increased inter-hemispheric and right-side connectivity may represent the initial step to develop functional plasticity.
语言重组可能是一种适应性现象，以补偿肿瘤对优势半球的侵袭。然而，语言可塑性背后随时间变化的功能改变仍不清楚。我们使用基于任务的功能磁共振成像（tb-fMRI）、图论和标准化语言评估，对低级别胶质瘤（LGG）患者的语言功能进行了评估。我们假设，从tb-fMRI获得的功能网络会随时间显示出连接性变化，右侧半球的参与度增加。我们招募了5名左半球LGG的右利手患者（4名男性，平均年龄47.6岁）。在术前（pre-op）、术后：术后1（4-8个月）、术后2（10-14个月）和术后3（16-23个月）进行了tb-fMRI和语言评估。我们应用最佳渗透阈值计算个体功能网络。通过fMRI图谱和连接矩阵上的偏侧性指数（LI）对语言优势和半球连接性进行量化。使用固定线性混合模型评估LI值随时间的患者内相关趋势及其与语言表现的相关性。个体网络显示涉及语言区域同源物的半球间和右侧连接性增加。出现了两种语言重组模式：3/5的患者从术前到术后3表现出从左到共优势的转变（1型）。2/5的患者在术前开始为非典型优势，在术后3保持不变（2型）。从tb-fMRI获得的LI在所有患者的各个时间点均显示出显著的从左到右的趋势。语言表现随时间没有显著变化。1型语言重组可能与治疗有关，而2型可能是肿瘤诱导的，因为它在术前就已存在。半球间和右侧连接性增加可能代表了发展功能可塑性的初始步骤。
