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感觉运动区胶质瘤所致优势脑皮质的结构性改变。

Structural changes in eloquent cortex secondary to glioma in sensorimotor area.

机构信息

Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Hum Brain Mapp. 2024 Jun 1;45(8):e26723. doi: 10.1002/hbm.26723.

Abstract

This study aims to investigate the structural reorganization in the sensorimotor area of the brain in patients with gliomas, distinguishing between those with impaired and unimpaired strength. Using voxel-based morphometry (VBM) and region of interest (ROI) analysis, gray matter volumes (GMV) were compared in the contralesional primary motor gyrus, primary sensory gyrus, premotor area, bilateral supplementary motor area, and medial Brodmann area 8 (BA8). The results revealed that in patients with right hemisphere gliomas, the right medial BA8 volume was significantly larger in the impaired group than in the unimpaired group, with both groups exceeding the volume in 16 healthy controls (HCs). In patients with left hemisphere gliomas, the right supplementary motor area (SMA) was more pronounced in the impaired group compared to the unimpaired group, and both groups were greater than HCs. Additionally, the volumes of the right medial BA8 in both the impaired group were greater than HCs. Contralateral expansions in the gray matter of hand- and trunk-related cortices of the premotor area, precentral gyrus, and postcentral gyrus were observed compared to HCs. Furthermore, a negative correlation was found between hand Medical Research Council (MRC) score and volumes of the contralateral SMA and bilateral medial BA8. Notably, our findings reveal consistent results across both analytical approaches in identifying significant structural reorganizations within the sensorimotor cortex. These consistent findings underscore the adaptive neuroplastic responses to glioma presence, highlighting potential areas of interest for further neurosurgical planning and rehabilitation strategies.

摘要

本研究旨在探讨脑感觉运动区的结构重组,区分胶质瘤患者中力量受损和未受损的患者。使用基于体素的形态测量学(VBM)和感兴趣区域(ROI)分析,比较了对侧初级运动皮层、初级感觉皮层、运动前区、双侧辅助运动区和内侧布罗德曼区 8(BA8)的灰质体积(GMV)。结果表明,在右侧脑胶质瘤患者中,受损组右侧内侧 BA8 体积明显大于未受损组,两组均大于 16 名健康对照(HC)。在左侧脑胶质瘤患者中,受损组右侧辅助运动区(SMA)较未受损组更为明显,两组均大于 HCs。此外,受损组的右侧内侧 BA8 体积也大于 HCs。与 HCs 相比,观察到运动前区、中央前回和中央后回与手部和躯干相关的皮质的灰质对侧扩张。此外,手医学研究委员会(MRC)评分与对侧 SMA 和双侧内侧 BA8 的体积呈负相关。值得注意的是,我们的发现通过两种分析方法都识别出感觉运动皮层内的显著结构重组,这一结果一致。这些一致的发现强调了神经对胶质瘤存在的适应性神经可塑性反应,突出了进一步神经外科规划和康复策略的潜在关注领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de1a/11167403/6795b8a2569b/HBM-45-e26723-g005.jpg

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