Department of Radiology, Neuroradiology Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
NESMOS Department, Neuroradiology Unit, Sant'Andrea Hospital, La Sapienza University, 00189, Rome, Italy.
Eur Radiol. 2023 Sep;33(9):6069-6078. doi: 10.1007/s00330-023-09610-3. Epub 2023 Apr 19.
Language reorganization may follow tumor invasion of the dominant hemisphere. Tumor location, grade, and genetics influence the communication between eloquent areas and tumor growth dynamics, which are drivers of language plasticity. We evaluated tumor-induced language reorganization studying the relationship of fMRI language laterality to tumor-related variables (grade, genetics, location), and patient-related variables (age, sex, handedness).
The study was retrospective cross-sectional. We included patients with left-hemispheric tumors (study group) and right-hemispheric tumors (controls). We calculated five fMRI laterality indexes (LI): hemispheric, temporal lobe, frontal lobe, Broca's area (BA), Wernicke's area (WA). We defined LI ≥ 0.2 as left-lateralized (LL) and LI < 0.2 as atypical lateralized (AL). Chi-square test (p < 0.05) was employed to identify the relationship between LI and tumor/patient variables in the study group. For those variables having significant results, confounding factors were evaluated in a multinomial logistic regression model.
We included 405 patients (235 M, mean age: 51 years old) and 49 controls (36 M, mean age: 51 years old). Contralateral language reorganization was more common in patients than controls. The statistical analysis demonstrated significant association between BA LI and patient sex (p = 0.005); frontal LI, BA LI, and tumor location in BA (p < 0.001); hemispheric LI and fibroblast growth factor receptor (FGFR) mutation (p = 0.019); WA LI and O6-methylguanine-DNA methyltransferase promoter (MGMT) methylation in high-grade gliomas (p = 0.016).
Tumor genetics, pathology, and location influence language laterality, possibly due to cortical plasticity. Increased fMRI activation in the right hemisphere was seen in patients with tumors in the frontal lobe, BA and WA, FGFR mutation, and MGMT promoter methylation.
• Patients harboring left-hemispheric tumors present with contralateral translocation of language function. Influential variables for this phenomenon included frontal tumor location, BA location, WA location, sex, MGMT promoter methylation, and FGFR mutation. • Tumor location, grade, and genetics may influence language plasticity, thereby affecting both communication between eloquent areas and tumor growth dynamics. • In this retrospective cross-sectional study, we evaluated language reorganization in 405 brain tumor patients by studying the relationship of fMRI language laterality to tumor-related variables (grade, genetics, location), and patient-related variables (age, sex, handedness).
语言重组可能发生在大脑优势半球受到肿瘤侵袭之后。肿瘤位置、分级和遗传学影响语言区域之间的连通性和肿瘤生长动力，而这些因素是语言可塑性的驱动因素。我们通过研究功能磁共振成像（fMRI）语言偏侧性与肿瘤相关变量（分级、遗传学、位置）以及患者相关变量（年龄、性别、利手）之间的关系，来评估肿瘤引起的语言重组。
本研究为回顾性的横断面研究。我们纳入了左侧大脑半球肿瘤（研究组）和右侧大脑半球肿瘤（对照组）患者。我们计算了五个 fMRI 偏侧性指数（LI）：半球、颞叶、额叶、布罗卡区（BA）、韦尼克区（WA）。我们将 LI≥0.2 定义为左侧偏侧化（LL），LI<0.2 定义为非典型偏侧化（AL）。采用卡方检验（p<0.05）来识别研究组中 LI 与肿瘤/患者变量之间的关系。对于具有显著结果的变量，我们在多项逻辑回归模型中评估了混杂因素。
我们纳入了 405 名患者（235 名男性，平均年龄 51 岁）和 49 名对照组患者（36 名男性，平均年龄 51 岁）。与对照组相比，患者的语言更常出现对侧重组。统计学分析显示，BA LI 与患者性别之间存在显著相关性（p=0.005）；额叶 LI、BA LI 和 BA 肿瘤位置之间（p<0.001）；半球 LI 和成纤维细胞生长因子受体（FGFR）突变之间（p=0.019）；WA LI 和高级别胶质瘤的 O6-甲基鸟嘌呤-DNA 甲基转移酶启动子（MGMT）甲基化之间（p=0.016）。
肿瘤遗传学、病理学和位置影响语言偏侧性，可能是由于皮质可塑性所致。额叶、BA 和 WA、FGFR 突变以及 MGMT 启动子甲基化的患者肿瘤中观察到右半球 fMRI 激活增加。
左侧大脑半球肿瘤患者存在语言功能的对侧移位。这种现象的影响因素包括额叶肿瘤位置、BA 位置、WA 位置、性别、MGMT 启动子甲基化和 FGFR 突变。
肿瘤位置、分级和遗传学可能影响语言可塑性，从而影响语言区域之间的连通性和肿瘤生长动力。
在这项回顾性的横断面研究中，我们通过研究 fMRI 语言偏侧性与肿瘤相关变量（分级、遗传学、位置）以及患者相关变量（年龄、性别、利手）之间的关系，评估了 405 名脑肿瘤患者的语言重组。
