Hu Bohan, Guan Xueyi, Zhai Huina, Han Xu, Hu Cuiling, Gong Jian
Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Front Hum Neurosci. 2024 Dec 9;18:1509899. doi: 10.3389/fnhum.2024.1509899. eCollection 2024.
Temporal lobe mass lesions are the most common intracranial space-occupying lesions in children, among various brain lobes. The temporal lobe is critically involved in higher cognitive functions, and surgical interventions often risk causing damage to these functions. If necessary interventions and prehabilitation can be conducted preoperatively, it might be possible to achieve a larger extent of lesion resection with minimal cognitive impairment. However, research in this area has been relatively limited in the past. Our study aims to fill this gap.
We enrolled 15 children with temporal lobe mass lesions and 15 age- and gender-matched healthy children as controls. All participants underwent cognitive assessments and functional MRI scans. The cognitive testing data and functional MRI data were then analyzed and compared between the two groups.
Our findings suggest that children with temporal lobe mass lesions primarily exhibit impairments in working memory and sustained attention. Multiple brain network indices were altered in the affected children, with the most prominent change being hyperactivation of the default mode network (DMN). This hyperactivation was correlated with cognitive impairments, indicating that the overactivation of the DMN might represent an inefficient compensatory mechanism within the brain's networks.
Compared to healthy children, those with temporal lobe mass lesions experience deficits in working memory and sustained attention, and the hyperactivation of the DMN may be the underlying network mechanism driving these cognitive impairments. Our research offers a unique and clinically valuable reference for future studies on preoperative interventions and prehabilitation in this population.
颞叶占位性病变是儿童颅内最常见的脑叶占位性病变。颞叶在高级认知功能中起着关键作用，手术干预往往有损害这些功能的风险。如果术前能进行必要的干预和预康复，或许有可能在最小程度的认知损害下实现更大范围的病变切除。然而，过去该领域的研究相对有限。我们的研究旨在填补这一空白。
我们招募了15名患有颞叶占位性病变的儿童，并选取15名年龄和性别匹配的健康儿童作为对照。所有参与者均接受了认知评估和功能磁共振成像扫描。然后对两组的认知测试数据和功能磁共振成像数据进行分析和比较。
我们的研究结果表明，患有颞叶占位性病变的儿童主要表现为工作记忆和持续注意力受损。患病儿童的多个脑网络指标发生了改变，最显著的变化是默认模式网络（DMN）的过度激活。这种过度激活与认知障碍相关，表明DMN的过度激活可能代表了大脑网络内一种低效的代偿机制。
与健康儿童相比，患有颞叶占位性病变的儿童存在工作记忆和持续注意力缺陷，DMN的过度激活可能是导致这些认知障碍的潜在网络机制。我们的研究为该人群术前干预和预康复的未来研究提供了独特且具有临床价值的参考。
