Global Effects of Focal Brain Tumors on Functional Complexity and Network Robustness: A Prospective Cohort Study
Global Effects of Focal Brain Tumors on Functional Complexity and Network Robustness: A Prospective Cohort Study
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DOI：
10.1093/neuros/nyy378
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发表时间：
2019-06-01
期刊：
影响因子：
4.8
通讯作者：
Suckling, John
中科院分区：
文献类型：
--
作者：
Hart, Michael G.;Romero-Garcia, Rafael;Suckling, John
背景脑肿瘤的神经外科治疗已经进入了一个超边缘切除的范例，需要彻底了解肿瘤周围的功能影响。从历史上看，肿瘤的影响被认为是局部的，和长期的影响没有被认为是considered.OBJECTIVE要测试的假设，即肿瘤影响大脑的全球性，产生长期梯度皮质function.METHODS静息状态功能磁共振成像（fMRI）的数据从11名参与者与胶质母细胞瘤和分裂成发现和验证数据集在一个单中心的前瞻性队列研究。分形复杂度的计算与基于小波的估计的赫斯特指数。肿瘤的距离相关的影响进行了测试与肿瘤的面具扩张技术和parcellation的基础Hurst maps.RESULTS分形复杂性表现出半暗带的抑制在瘤周区域。在全局水平上，随着与肿瘤的距离增加，这种初始抑制在最终正常化之前被随后的过度活动所平衡。这些影响最适合二次模型，并在不同的网络建设管道一致。Hurst指数与图论措施的中心性，包括网络的鲁棒性，但图论措施并没有表现出距离依赖性effects.CONCLUSION这项工作提供了证据支持的理论，局灶性脑肿瘤产生长期梯度的功能。因此，局灶性病变的影响需要解释的功能复杂性和网络结构的全球变化，而不是纯粹的功能定位。确定瘤周改变是否代表潜在的可塑性可能有助于肿瘤的扩大切除而不影响功能。
BACKGROUND Neurosurgical management of brain tumors has entered a paradigm of supramarginal resections that demands thorough understanding of peritumoral functional effects. Historically, the effects of tumors have been believed to be local, and long-range effects have not been considered.OBJECTIVE To test the hypothesis that tumors affect the brain globally, producing long-range gradients in cortical function.METHODS Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 11 participants with glioblastoma and split into discovery and validation datasets in a single-center prospective cohort study. Fractal complexity was computed with a wavelet-based estimator of the Hurst exponent. Distance-related effects of the tumors were tested with a tumor mask-dilation technique and parcellation of the underlying Hurst maps.RESULTS Fractal complexity demonstrates a penumbra of suppression in the peritumoral region. At a global level, as distance from the tumor increases, this initial suppression is balanced by a subsequent overactivity before finally normalizing. These effects were best fit by a quadratic model and were consistent across different network construction pipelines. The Hurst exponent was correlated with graph theory measures of centrality including network robustness, but graph theory measures did not demonstrate distance-dependent effects.CONCLUSION This work provides evidence supporting the theory that focal brain tumors produce long-range gradients in function. Consequently, the effects of focal lesions need to be interpreted in terms of the global changes on functional complexity and network architecture rather than purely in terms of functional localization. Determining whether peritumoral changes represent potential plasticity may facilitate extended resection of tumors without functional cost.