Jia Heyuan, Wang Kaikai, Zhang Mingxin, Gu Guocan, Mai Yiying, Wu Xia, Chu Congying, Yin Xuntao, Zhang Peng, Fan Lingzhong, Zhang Liwei
School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
Institute of Large-scale Scientific Facility and Centre for Zero Magnetic Field Science, Beihang University, Hangzhou, China.
Commun Med (Lond). 2025 Mar 25;5(1):91. doi: 10.1038/s43856-025-00810-0.
Brainstem tumors often cause intractable neurobehavioral issues, which can be a challenge for patients and surgeons. Research on cerebellar changes in these patients is limited, despite symptoms similar to cerebellar injuries. This study aims to investigate cerebellar damage pattern resulting from brainstem tumors and its association with behavioral disorders.
This study enrolled 147 children with brainstem tumors. A U-Net-based segmentation algorithm is used to divide their cerebellums into 26 lobules. And these lobules are then used to build a normative model for assessing individual structural deviations. Furthermore, a behavior prediction model is developed using the total outlier count (tOC) index and cerebellar lobule volume as predictive features.
Over 95% of patients are found to have negative deviations in cerebellar regions, particularly in anterior lobules like Left V. Higher tOC is significantly associated with severe social problems (r = 0.31, p = 0.001) and withdrawal behavior (r = 0.28, p = 0.001). Smaller size of cerebellar regions strongly correlates with more pronounced social problems (r = 0.27, p = 0.007) and withdrawal behavior (r = 0.25, p = 0.015). Notably, lobules Right X, V, IV, VIIB, Left IX, VIII, and X influence social problems, while Left V, Right IV, Vermis VI, and VIII impact withdrawal behavior.
Our study reveals cerebellar damage patterns in patients with brainstem tumors, emphasizing the role of both anterior and posterior cerebellar lobes in social problems and withdrawal behavior. This research sheds light on the cerebro-brainstem-cerebellar underlying complex behavioral disorders in brainstem tumor patients.
脑干肿瘤常导致难以治疗的神经行为问题，这对患者和外科医生来说都是一项挑战。尽管这些患者出现的症状与小脑损伤相似，但关于他们小脑变化的研究却很有限。本研究旨在调查脑干肿瘤导致的小脑损伤模式及其与行为障碍的关联。
本研究纳入了147名患有脑干肿瘤的儿童。使用基于U-Net的分割算法将他们的小脑划分为26个小叶。然后利用这些小叶建立一个用于评估个体结构偏差的标准模型。此外，使用总异常值计数（tOC）指数和小脑小叶体积作为预测特征，开发了一个行为预测模型。
发现超过95%的患者小脑区域存在负偏差，特别是在左V等前叶区域。较高的tOC与严重的社交问题（r = 0.31，p = 0.001）和退缩行为（r = 0.28，p = 0.001）显著相关。小脑区域较小与更明显的社交问题（r = 0.27，p = 0.007）和退缩行为（r = 0.25，p = 0.015）密切相关。值得注意的是，右X、V、IV、VIIB、左IX、VIII和X小叶影响社交问题，而左V、右IV、蚓部VI和VIII影响退缩行为。
我们的研究揭示了脑干肿瘤患者的小脑损伤模式，强调了小脑前叶和后叶在社交问题和退缩行为中的作用。这项研究揭示了脑干肿瘤患者潜在的复杂行为障碍的脑-脑干-小脑机制。
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