de Zubicaray Greig I, Brownsett Sonia L E, Copland David A, Drummond Kate, Jeffree Rosalind L, Olson Sarah, Murton Emma, Ong Benjamin, Robinson Gail A, Tolkacheva Valeriya, McMahon Katie L
School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4059, Australia.
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD 4072, Australia; Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.
Brain Lang. 2023 Apr;239:105244. doi: 10.1016/j.bandl.2023.105244. Epub 2023 Mar 6.
Surgical resection of brain tumours is associated with an increased risk of aphasia. However, relatively little is known about outcomes in the chronic phase (i.e., >6 months). Using voxel-based lesion symptom mapping (VLSM) in 46 patients, we investigated whether chronic language impairments are related to the location of surgical resection, residual tumour characteristics (e.g., peri-resection treatment effects, progressive infiltration, oedema) or both. Approximately 72% of patients scored below the cut-off for aphasia. Action naming and spoken sentence comprehension deficits were associated with lesions in the left anterior temporal and inferior parietal lobes, respectively. Voxel-wise analyses revealed significant associations between ventral language pathways and action naming deficits. Reading impairments were also associated with increasing disconnection of cerebellar pathways. The results indicate chronic post-surgical aphasias reflect a combination of resected tissue and tumour infiltration of language-related white matter tracts, implicating progressive disconnection as the critical mechanism of impairment.
脑肿瘤手术切除与失语风险增加相关。然而，对于慢性期（即>6个月）的结果了解相对较少。我们对46例患者使用基于体素的病变症状映射（VLSM），研究慢性语言障碍是否与手术切除部位、残留肿瘤特征（如切除周围治疗效果、渐进性浸润、水肿）或两者都有关。约72%的患者失语评分低于临界值。动作命名和口语句子理解缺陷分别与左前颞叶和顶下叶的病变有关。体素分析显示腹侧语言通路与动作命名缺陷之间存在显著关联。阅读障碍也与小脑通路的连接中断增加有关。结果表明，慢性术后失语反映了切除组织和与语言相关的白质束肿瘤浸润的结合，提示渐进性连接中断是损伤的关键机制。
