Tang Hanlu, Bie Zhixu, Wang Bo, Yang Zhijun, Li Peng, Wang Xingchao, Liu Pinan
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing, China.
J Neurooncol. 2023 Mar;162(1):79-91. doi: 10.1007/s11060-023-04247-0. Epub 2023 Feb 20.
Brain structural remodeling alters related brain function. However, few studies have assessed morphological alterations of unilateral vestibular schwannoma (VS) patients. Therefore, this study examined the characteristics of brain structural remodeling in unilateral VS patients.
We recruited 39 patients with unilateral VS (19 left, 20 right) and 24 matched normal controls (NCs). We obtained brain structural imaging data using 3T T1-weighted anatomical and diffusion tensor imaging scans. Then, we evaluated both gray and white matter (WM) changes using FreeSurfer software and tract-based spatial statistics, respectively. Furthermore, we constructed a structural covariance network to assess brain structural network properties and the connectivity strength between brain regions.
Compared with NCs, VS patients showed cortical thickening in non-auditory areas (e.g., the left precuneus), especially left VS patients, along with reduced cortical thickness in the right superior temporal gyrus (auditory areas). VS patients also showed increased fractional anisotropy in extensive non-auditory-related WM (e.g., the superior longitudinal fasciculus), especially right VS patients. Both left and right VS patients showed increased small-worldness (more efficient information transfer). Left VS patients had a single reduced-connectivity subnetwork in contralateral temporal regions (right-side auditory areas), but increased connectivity between some non-auditory regions (e.g., left precuneus and left temporal pole).
VS patients exhibited greater morphological alterations in non-auditory than auditory areas, with structural reductions seen in related auditory areas and a compensatory increase in non-auditory areas. Left and right VS patients show differential patterns of brain structural remodeling. These findings provide a new perspective on the treatment and postoperative rehabilitation of VS.
脑结构重塑会改变相关脑功能。然而，很少有研究评估单侧前庭神经鞘瘤（VS）患者的形态学改变。因此，本研究探讨了单侧VS患者脑结构重塑的特征。
我们招募了39例单侧VS患者（19例左侧，20例右侧）和24例匹配的正常对照（NCs）。我们使用3T T1加权解剖和扩散张量成像扫描获取脑结构成像数据。然后，我们分别使用FreeSurfer软件和基于束的空间统计学评估灰质和白质（WM）变化。此外，我们构建了一个结构协方差网络来评估脑结构网络特性和脑区之间的连接强度。
与NCs相比，VS患者在非听觉区域（如左侧楔前叶）出现皮质增厚，尤其是左侧VS患者，同时右侧颞上回（听觉区域）皮质厚度降低。VS患者在广泛的非听觉相关WM（如弓状束）中也表现出各向异性分数增加，尤其是右侧VS患者。左右VS患者均表现出小世界特性增加（信息传递更有效）。左侧VS患者在对侧颞区（右侧听觉区域）有一个单一的连接减少子网，但一些非听觉区域（如左侧楔前叶和左侧颞极）之间的连接增加。
VS患者在非听觉区域比听觉区域表现出更大的形态学改变，相关听觉区域出现结构减少，非听觉区域出现代偿性增加。左右VS患者表现出不同的脑结构重塑模式。这些发现为VS的治疗和术后康复提供了新的视角。
