Yan Zheng, Tang Jun, Ge Honglin, Liu Dongming, Liu Yong, Liu Hongyi, Zou Yuanjie, Hu Xinhua, Yang Kun, Chen Jiu
Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Neurosurgery, Yixing Hospital of Traditional Chinese Medicine, Yixing, China.
Front Neurosci. 2023 Mar 27;17:1136534. doi: 10.3389/fnins.2023.1136534. eCollection 2023.
High-grade gliomas (HGGs) are characterized by a high degree of tissue invasion and uncontrolled cell proliferation, inevitably damaging the thalamus and the basal ganglia. The thalamus exhibits a high level of structural and functional connectivity with the default mode network (DMN). The present study investigated the structural and functional compensation within the DMN in HGGs invading the thalamus along with the basal ganglia (HITBG).
A total of 32 and 22 healthy controls were enrolled, and their demographics and neurocognition (digit span test, DST) were assessed. Of the 32 patients, 18 patients were involved only on the left side, while 15 of them were involved on the right side. This study assessed the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), gray matter (GM) volume, and functional connectivity (FC) within the DMN and compared these measures between patients with left and right HITBG and healthy controls (HCs).
The medial prefrontal cortex (mPFC) region existed in synchrony with the significant increase in ALFF and GM volume in patients with left and right HITBG compared with HCs. In addition, patients with left HITBG exhibited elevated ReHo and GM precuneus volumes, which did not overlap with the findings in patients with right HITBG. The patients with left and right HITBG showed decreased GM volume in the contralateral hippocampus without any functional variation. However, no significant difference in FC values was observed in the regions within the DMN. Additionally, the DST scores were significantly lower in patients with HITBG, but there was no significant correlation with functional or GM volume measurements.
The observed pattern of synchrony between structure and function was present in the neuroplasticity of the mPFC and the precuneus. However, patients with HITBG may have a limited capacity to affect the connectivity within the regions of the DMN. Furthermore, the contralateral hippocampus in patients with HITBG exhibited atrophy. Thus, preventing damage to these regions may potentially delay the progression of neurological function impairment in patients with HGG.
高级别胶质瘤（HGGs）的特征是高度的组织侵袭和不受控制的细胞增殖，不可避免地会损害丘脑和基底神经节。丘脑与默认模式网络（DMN）表现出高水平的结构和功能连接。本研究调查了侵袭丘脑及基底神经节的高级别胶质瘤（HITBG）患者DMN内的结构和功能代偿情况。
共纳入32名健康对照者和22名患者，并评估了他们的人口统计学特征和神经认知功能（数字广度测试，DST）。32例患者中，18例仅左侧受累，15例右侧受累。本研究评估了DMN内的低频振幅（ALFF）、局部一致性（ReHo）、灰质（GM）体积和功能连接（FC），并比较了左侧和右侧HITBG患者与健康对照者（HCs）之间的这些指标。
与健康对照者相比，左侧和右侧HITBG患者的内侧前额叶皮质（mPFC）区域存在ALFF和GM体积显著增加的同步现象。此外，左侧HITBG患者的ReHo和楔前叶GM体积升高，这与右侧HITBG患者的结果不重叠。左侧和右侧HITBG患者对侧海马GM体积减小，但无任何功能变化。然而，DMN内各区域的FC值未观察到显著差异。此外，HITBG患者的DST评分显著较低，但与功能或GM体积测量值无显著相关性。
在mPFC和楔前叶的神经可塑性中存在观察到的结构和功能同步模式。然而，HITBG患者影响DMN区域内连接性的能力可能有限。此外，HITBG患者的对侧海马表现出萎缩。因此防止这些区域受损可能会潜在延缓HGG患者神经功能损害的进展。
