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Function-guided differences of arcuate fascicle and inferior fronto-occipital fascicle tractography as diagnostic indicators for surgical risk stratification.

作者信息

Kram Leonie, Schroeder Axel, Meyer Bernhard, Krieg Sandro M, Ille Sebastian

机构信息

Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

出版信息

Brain Struct Funct. 2024 Dec;229(9):2219-2235. doi: 10.1007/s00429-024-02787-3. Epub 2024 Apr 10.


DOI:10.1007/s00429-024-02787-3
PMID:38597941
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11612008/
Abstract

BACKGROUND: Several patients with language-eloquent gliomas face language deterioration postoperatively. Persistent aphasia is frequently associated with damage to subcortical language pathways. Underlying mechanisms still need to be better understood, complicating preoperative risk assessment. This study compared qualitative and quantitative functionally relevant subcortical differences pre- and directly postoperatively in glioma patients with and without aphasia. METHODS: Language-relevant cortical sites were defined using navigated transcranial magnetic stimulation (nTMS) language mapping in 74 patients between 07/2016 and 07/2019. Post-hoc nTMS-based diffusion tensor imaging tractography was used to compare a tract's pre- and postoperative visualization, volume and fractional anisotropy (FA), and the preoperative distance between tract and lesion and postoperative overlap with the resection cavity between the following groups: no aphasia (NoA), tumor- or previous resection induced aphasia persistent pre- and postoperatively (TIA_P), and surgery-induced transient or permanent aphasia (SIA_T or SIA_P). RESULTS: Patients with NoA, TIA_P, SIA_T, and SIA_P showed distinct fasciculus arcuatus (AF) and inferior-fronto-occipital fasciculus (IFOF) properties. The AF was more frequently reconstructable, and the FA of IFOF was higher in NoA than TIA_P cases (all p ≤ 0.03). Simultaneously, SIA_T cases showed higher IFOF fractional anisotropy than TIA_P cases (p < 0.001) and the most considerable AF volume loss overall. While not statistically significant, the four SIA_P cases showed complete loss of ventral language streams postoperatively, the highest resection-cavity-AF-overlap, and the shortest AF to tumor distance. CONCLUSION: Functionally relevant qualitative and quantitative differences in AF and IFOF provide a pre- and postoperative pathophysiological and clinically relevant diagnostic indicator that supports surgical risk stratification.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/90c4e01a31bb/429_2024_2787_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/59ea23b280da/429_2024_2787_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/db0da9bd0a26/429_2024_2787_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/7afadb4c7057/429_2024_2787_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/90c4e01a31bb/429_2024_2787_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/59ea23b280da/429_2024_2787_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/db0da9bd0a26/429_2024_2787_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/7afadb4c7057/429_2024_2787_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/11612008/90c4e01a31bb/429_2024_2787_Fig4_HTML.jpg

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Function-guided differences of arcuate fascicle and inferior fronto-occipital fascicle tractography as diagnostic indicators for surgical risk stratification.

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引用本文的文献

[1]
Redefining language networks: connectivity beyond localised regions.

Brain Struct Funct. 2024-12

本文引用的文献

[1]
Personalized surgery of brain tumors in language areas: the role of preoperative brain mapping in patients not eligible for awake surgery.

Neurosurg Focus. 2022-12

[2]
Diffusion tensor imaging versus intraoperative subcortical mapping for glioma resection: a systematic review and meta-analysis.

Neurosurg Rev. 2023-6-28

[3]
Improved prediction of glioma-related aphasia by diffusion MRI metrics, machine learning, and automated fiber bundle segmentation.

Hum Brain Mapp. 2023-8-15

[4]
Reorganization and Plasticity of the Language Network in Patients with Cerebral Gliomas.

Neuroimage Clin. 2023

[5]
Preoperative language tract integrity is a limiting factor in recovery from aphasia after glioma surgery.

Neuroimage Clin. 2023

[6]
Tractography-based navigated TMS language mapping protocol.

Front Oncol. 2022-12-9

[7]
Structural disconnections associated with language impairments in chronic post-stroke aphasia using disconnectome maps.

Cortex. 2022-10

[8]
Transcranial magnetic stimulation for post-operative neurorehabilitation in neuro-oncology: a review of the literature and future directions.

J Neurooncol. 2022-5

[9]
Interventional neurorehabilitation for promoting functional recovery post-craniotomy: a proof-of-concept.

Sci Rep. 2022-2-23

[10]
Functional Contributions of the Arcuate Fasciculus to Language Processing.

Front Hum Neurosci. 2021-6-25

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