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高级别胶质瘤的结构和功能连接组学分析:一项系统综述。

Structural and functional connectomic analysis of high-grade gliomas: A systematic review.

作者信息

Burrington Logan R, Smith Alexander D, Lauinger Alexa R, Hassaneen Wael

机构信息

Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL, United States.

Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL, United States; Department of Computer Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States.

出版信息

J Clin Neurosci. 2025 Jul 1;139:111415. doi: 10.1016/j.jocn.2025.111415.


DOI:10.1016/j.jocn.2025.111415
PMID:40602275
Abstract

INTRODUCTION: High-grade glioma (HGG) is a highly aggressive and proliferative brain cancer. Treatment most often involves maximum safe resection, followed by adjuvant chemotherapy and radiation. However, an incomplete understanding of HGG's impact on brain connectivity limits the prediction of post-HGG resection complications and extent-of-resection protocols. Previous work has primarily focused on analyzing clinical and structural data to understand and predict post-surgical outcomes. These models overlook connectomics - an emerging field focused on the functional mapping of brain neural networks. In this systematic review, the authors 1) summarize the current understanding of major neural networks impacted by HGG resection through both a functional and structural viewpoint, and 2) discuss associated advancements in connectomics-based machine-learning models and application towards predicting post-surgical outcomes. METHODS: A systematic search was performed of peer-reviewed articles before 10/19/2023 according to PRISMA guidelines. No restrictions on publication date were utilized. Search terms included, "connectomics," and "glioma." Articles were included in the review if DTI structural data and/or rs-fMRI functional data involving white matter tracts impacted by HGG were analyzed. Articles were excluded if results did not apply to HGGs, tumor location was not included, or a full-text copy was unavailable. RESULTS: We reviewed 41 studies which analyzed the impact of HGGs on the brain connectome. HGGs tend to increase structural connectivity (SC) among rich-club nodes and reduce SC among peripheral nodes, though effects on functional connectivity (FC) tend to vary by tumor location. Frontal HGGs elicit bilateral FC changes, including decreased global efficiency (GE), local efficiency (LE), degree centrality, and increased average path length. Similarly, temporal HGGs often result in altered bilateral FC, including decreased LE with preserved GE and small-world properties. Parietal HGGs have mainly local effects and preserved small world organization, apart from observed bilateral FC changes of the default-mode network (DMN) and with precuneus HGGs. Insular HGGs also primarily affect local FC. In application, connectomic metrics including FC, LE, and GE have improved the predictive capabilities of post-HGG resection complications when combined with clinical and structural metrics. CONCLUSIONS: HGG has distinct impacts on the functional connectome based on tumor location. In general, HGGs tend to decrease long-distance, interhemispheric FC and LE while GE and clustering coefficient are preserved. In application, these metrics have been used in connectomic-based models to predict post-HGG resection complications more accurately than previous clinical- or structural-based models.

摘要

引言:高级别胶质瘤(HGG)是一种具有高度侵袭性和增殖性的脑癌。治疗通常包括最大限度的安全切除,随后进行辅助化疗和放疗。然而,对HGG对脑连接性影响的不完全理解限制了对HGG切除术后并发症和切除范围方案的预测。先前的工作主要集中在分析临床和结构数据以理解和预测术后结果。这些模型忽略了连接组学——一个专注于脑神经网络功能映射的新兴领域。在本系统评价中,作者1)从功能和结构角度总结了目前对受HGG切除影响的主要神经网络的理解,2)讨论了基于连接组学的机器学习模型的相关进展及其在预测术后结果方面的应用。 方法:根据PRISMA指南,对2023年10月19日前的同行评审文章进行了系统检索。未对发表日期进行限制。检索词包括“连接组学”和“胶质瘤”。如果分析了涉及受HGG影响的白质束的DTI结构数据和/或rs-fMRI功能数据,则将文章纳入本评价。如果结果不适用于HGG、未包括肿瘤位置或无法获得全文副本,则排除文章。 结果:我们回顾了41项分析HGG对脑连接组影响的研究。HGG倾向于增加富俱乐部节点之间的结构连接性(SC),并减少外周节点之间的SC,尽管对功能连接性(FC)的影响往往因肿瘤位置而异。额叶HGG引起双侧FC变化,包括全局效率(GE)、局部效率(LE)、度中心性降低,平均路径长度增加。同样,颞叶HGG通常会导致双侧FC改变,包括LE降低,GE和小世界特性保留。顶叶HGG主要产生局部影响并保留小世界组织,除了观察到的默认模式网络(DMN)和楔前叶HGG的双侧FC变化。岛叶HGG也主要影响局部FC。在应用中,当与临床和结构指标结合时,包括FC、LE和GE在内的连接组学指标提高了HGG切除术后并发症的预测能力。 结论:HGG对基于肿瘤位置的功能连接组有不同影响。一般来说,HGG倾向于减少远距离、半球间FC和LE,而GE和聚类系数保留。在应用中,这些指标已被用于基于连接组学的模型中,以比以前基于临床或结构的模型更准确地预测HGG切除术后并发症。

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