Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Hum Brain Mapp. 2023 May;44(7):2790-2801. doi: 10.1002/hbm.26245. Epub 2023 Feb 28.
Brain arteriovenous malformations (AVMs) may involve language areas but usually do not lead to aphasia. This study evaluated resting-state functional alterations and investigated the language reorganization mechanism in AVM patients. Thirty-nine patients with AVMs involving language areas and 32 age- and sex-matched healthy controls were prospectively enrolled. The AVM patients were categorized into three subgroups according to lesion location: the frontal (15 patients), temporal (14 patients), and parietal subgroups (10 patients). All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI), and the amplitude of low-frequency fluctuation (ALFF) approach was applied to analyze rs-fMRI data. Language abilities were normal in all participants based on the Western Aphasia Battery. Compared with those of healthy subjects, ALFF values significantly increased (FDR corrected p < .01) in the anterior part of the right putamen in the frontal AVM subgroup, in the posterior part of the right inferior and middle temporal gyrus in the temporal AVM subgroup, and in the inferior lateral part of the left cerebellar hemisphere (lobule VIII) and the right inferior parietal lobule in the parietal AVM subgroup. Functional annotation using Neurosynth indicated that the ALFF t-map was only significantly positively associated with the language-related domain (FDR corrected p < .01). In patients with AVMs involving the language cortex, language network reorganization occurs to maintain normal language abilities. The brain areas recruited into the reorganized language network were located in the right cerebral and left cerebellar hemispheres, both of which are nondominant hemispheres. Differences in lesion location led to distinct reorganization patterns.
脑动静脉畸形（AVM）可能涉及语言区域，但通常不会导致失语症。本研究评估了静息状态下的功能改变，并研究了 AVM 患者的语言重组机制。前瞻性纳入 39 例涉及语言区的 AVM 患者和 32 例年龄和性别匹配的健康对照者。根据病变部位将 AVM 患者分为三组：额叶组（15 例）、颞叶组（14 例）和顶叶组（10 例）。所有受试者均行静息态功能磁共振成像（rs-fMRI）检查，采用低频振幅（ALFF）方法分析 rs-fMRI 数据。所有参与者均根据西方失语症成套测验（WAB）评估正常的语言能力。与健康对照组相比，额叶 AVM 亚组右侧壳核前份、颞叶 AVM 亚组右侧颞下回和中回后份、顶叶 AVM 亚组左侧小脑半球（VIII 小叶）和右侧顶下小叶的 ALFF 值显著升高（经 FDR 校正 p <.01）。使用 Neurosynth 进行功能注释显示，ALFF t 图仅与语言相关领域呈显著正相关（经 FDR 校正 p <.01）。在语言皮层受累的 AVM 患者中，语言网络发生重组以维持正常的语言能力。重新组织的语言网络募集的脑区位于右侧大脑半球和左侧小脑半球，两者均为非优势半球。病变部位的差异导致了不同的重组模式。
