Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas: a case series study and clinical experience using Quicktome.
Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas: a case series study and clinical experience using Quicktome.
复制标题
DOI：
10.1186/s41016-023-00325-4
复制
发表时间：
2023-05-26
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
主要由于神经外科医生不熟悉非传统的大脑网络，胰岛素侧脑胶质瘤患者的认知功能仍有严重障碍。我们试图确定胶质瘤侵袭的频率和与这些网络部分的接近程度。我们回顾分析了45例接受以岛叶为中心的胶质瘤手术的患者的数据。根据肿瘤对非传统认知网络和传统口才结构的接近和侵袭性进行分类。扩散张量成像通过使用Quicktome创建个性化的脑图谱来完成，以确定每个患者的有说服力和无说服力的网络。此外，我们前瞻性地收集了7名患者的神经心理学数据，以比较肿瘤网络受累与认知变化的关系。最后，通过Quicktome确定的网络标测，对2例患者的手术计划进行了影响。45例患者中有44例显示肿瘤受累(<； 1 cm邻近或侵袭)，涉及认知的非传统脑网络组件，如突起网络(60%)和中央执行网络(56%)。在7个预期患者中，肿瘤均累及SN、CEN(5/7，71%)和语言网络(5/7，71%)。术前MMSE和MOCA均分分别为18.71 ± 6.94和17.29 ± 6.26。接受Quicktome术前计划的两例患者的术后表现与预期一致。在胰岛素侧突神经胶质瘤手术切除过程中，会遇到涉及认知的非传统脑网络。Quicktome可以提高对这些网络存在的了解，并允许根据患者的功能目标做出更明智的手术决定。
Patients with insulo-Sylvian gliomas continue to present with severe morbidity in cognitive functions primarily due to neurosurgeons’ lack of familiarity with non-traditional brain networks. We sought to identify the frequency of invasion and proximity of gliomas to portions of these networks. We retrospectively analyzed data from 45 patients undergoing glioma surgery centered in the insular lobe. Tumors were categorized based on their proximity and invasiveness of non-traditional cognitive networks and traditionally eloquent structures. Diffusion tensor imaging tractography was completed by creating a personalized brain atlas using Quicktome to determine eloquent and non-eloquent networks in each patient. Additionally, we prospectively collected neuropsychological data on 7 patients to compare tumor-network involvement with change in cognition. Lastly, 2 prospective patients had their surgical plan influenced by network mapping determined by Quicktome. Forty-four of 45 patients demonstrated tumor involvement (< 1 cm proximity or invasion) with components of non-traditional brain networks involved in cognition such as the salience network (SN, 60%) and the central executive network (CEN, 56%). Of the seven prospective patients, all had tumors involved with the SN, CEN (5/7, 71%), and language network (5/7, 71%). The mean scores of MMSE and MOCA before surgery were 18.71 ± 6.94 and 17.29 ± 6.26, respectively. The two cases who received preoperative planning with Quicktome had a postoperative performance that was anticipated. Non-traditional brain networks involved in cognition are encountered during surgical resection of insulo-Sylvian gliomas. Quicktome can improve the understanding of the presence of these networks and allow for more informed surgical decisions based on patient functional goals.