Department of Public Health and Nursing, Norwegian University of Science and Technology, Mauritz Hansens Gate 2, 7030, Trondheim, Norway.
Department of Neurology, St. Olavs hospital, Trondheim, Norway.
Neurosurg Rev. 2023 Oct 25;46(1):282. doi: 10.1007/s10143-023-02177-z.
Objective cognitive function in patients with glioblastoma may depend on tumor location. Less is known about the potential impact of tumor location on cognitive function from the patients' perspective. This study aimed to investigate the association between patient-reported cognitive function and the location of glioblastoma using voxel-based lesion-symptom mapping. Patient-reported cognitive function was assessed with the European Organisation for Research and Treatment (EORTC) QLQ-C30 cognitive function subscale preoperatively and 1 month postoperatively. Semi-automatic tumor segmentations from preoperative MRI images with the corresponding EORTC QLQ-C30 cognitive function score were registered to a standardized brain template. Student's pooled-variance t-test was used to compare mean patient-reported cognitive function scores between those with and without tumors in each voxel. Both preoperative brain maps (n = 162) and postoperative maps of changes (n = 99) were developed. Glioblastomas around the superior part of the left lateral ventricle, the left lateral part of the thalamus, the left caudate nucleus, and a portion of the left internal capsule were significantly associated with reduced preoperative patient-reported cognitive function. However, no voxels were significantly associated with postoperative change in patient-reported cognitive function assessed 1 month postoperatively. There seems to be an anatomical relation between tumor location and patient-reported cognitive function before surgery, with the left hemisphere being the dominant from the patients' perspective.
患者的脑胶质瘤位置可能会影响其认知功能，然而从患者角度出发，关于肿瘤位置对认知功能潜在影响的研究却较少。本研究旨在通过基于体素的病灶-症状映射，调查患者报告的认知功能与脑胶质瘤位置之间的关联。采用欧洲癌症研究与治疗组织（EORTC）的生活质量核心问卷（QLQ-C30）认知功能子量表，在术前和术后 1 个月对患者的认知功能进行评估。将术前 MRI 图像和相应的 EORTC QLQ-C30 认知功能评分的半自动肿瘤分割注册到标准化大脑模板。使用学生 pooled-variance t 检验比较每个体素中有无肿瘤患者的平均认知功能评分。分别建立术前脑图（n=162）和术后变化图（n=99）。位于左侧侧脑室上部、左侧丘脑外侧部、左侧尾状核以及部分左侧内囊的脑胶质瘤与术前患者报告的认知功能降低显著相关。然而，术后 1 个月评估的患者报告的认知功能变化与任何体素均无显著相关性。肿瘤位置与术前患者报告的认知功能之间似乎存在解剖关系，从患者角度来看，左半球占主导地位。
