Samuel Nardin, Harmsen Irene E, Ding Mandy Yi Rong, Sarica Can, Vetkas Artur, Wong Christine, Lawton Vanessa, Yang Andrew, Rowland Nathan C, Kalia Suneil K, Valiante Taufik, Wennberg Richard, Zadeh Gelareh, Kongkham Paul, Kalyvas Aristotelis, Lozano Andres M
Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada.
Mitchell Goldhar MEG Unit, University Health Network, Toronto, Canada.
Neurooncol Adv. 2023 Jul 21;5(1):vdad091. doi: 10.1093/noajnl/vdad091. eCollection 2023 Jan-Dec.
In patients with glioma, clinical manifestations of neural network disruption include behavioral changes, cognitive decline, and seizures. However, the extent of network recovery following surgery remains unclear. The aim of this study was to characterize the neurophysiologic and functional connectivity changes following glioma surgery using magnetoencephalography (MEG).
Ten patients with newly diagnosed intra-axial brain tumors undergoing surgical resection were enrolled in the study and completed at least two MEG recordings (pre-operative and immediate post-operative). An additional post-operative recording 6-8 weeks following surgery was obtained for six patients. Resting-state MEG recordings from 28 healthy controls were used for network-based comparisons. MEG data processing involved artifact suppression, high-pass filtering, and source localization. Functional connectivity between parcellated brain regions was estimated using coherence values from 116 virtual channels. Statistical analysis involved standard parametric tests.
Distinct alterations in spectral power following tumor resection were observed, with at least three frequency bands affected across all study subjects. Tumor location-related changes were observed in specific frequency bands unique to each patient. Recovery of regional functional connectivity occurred following glioma resection, as determined by local coherence normalization. Changes in inter-regional functional connectivity were mapped across the brain, with comparable changes in low to mid gamma-associated functional connectivity noted in four patients.
Our findings provide a framework for future studies to examine other network changes in glioma patients. We demonstrate an intrinsic capacity for neural network regeneration in the post-operative setting. Further work should be aimed at correlating neurophysiologic changes with individual patients' clinical outcomes.
在胶质瘤患者中，神经网络破坏的临床表现包括行为改变、认知衰退和癫痫发作。然而，手术后网络恢复的程度仍不清楚。本研究的目的是使用脑磁图（MEG）来描述胶质瘤手术后神经生理和功能连接的变化。
10例新诊断的接受手术切除的脑内肿瘤患者纳入本研究，并完成至少两次MEG记录（术前和术后即刻）。6例患者在术后6 - 8周进行了额外的术后记录。来自28名健康对照者的静息态MEG记录用于基于网络的比较。MEG数据处理包括伪迹抑制、高通滤波和源定位。使用来自116个虚拟通道的相干值估计分割脑区之间的功能连接。统计分析采用标准参数检验。
观察到肿瘤切除后频谱功率有明显改变，所有研究对象中至少有三个频段受到影响。在每个患者特有的特定频段观察到与肿瘤位置相关的变化。通过局部相干归一化确定，胶质瘤切除后区域功能连接得以恢复。跨脑绘制了区域间功能连接的变化，4例患者在低至中γ相关功能连接方面有类似变化。
我们的研究结果为未来研究胶质瘤患者的其他网络变化提供了一个框架。我们证明了术后神经网络再生的内在能力。进一步的工作应旨在将神经生理变化与个体患者的临床结果相关联。
