Dataset Information

A pilot study of pre-operative motor dysfunction from gliomas in the region of corticospinal tract: Evaluation with diffusion tensor imaging.

ABSTRACT:

Background and purpose

Brain tumors in the corticospinal tract (CST) region are more likely to cause motor dysfunction. The aim of this study is to evaluate the effect of gliomas located in the CST region on motor function with diffusion tensor imaging (DTI) preoperatively.

Materials and methods

Forty-five patients with histopathologically confirmed gliomas were included in this pilot study, in all cases (low-grade n = 13, high-grade n = 32) CST but not the motor cortex were involved by the tumor. DTI image were acquired and the posterior limb of the internal capsule fractional anisotropy (FA) and relative FA (rFA = affected FA/contralateral FA) were measured. Injury of the CST from tumor was divided into three grades (grade 1: displacement, grade 2: displacement and infiltration, grade 3: displacement and disruption). The fiber density index (FDi) and relative FDi (rFDi = affected FDi/contralateral FDi) of the injured and contralateral CST were measured. The correlations between muscle strength and the CST injury grade and the rFA, affected FDi, rFDi values were calculated using Spearman rank correlation analysis. rFA and rFDi values of muscle strength groups (MMT2-5) were compared with one-way analysis of variance (ANOVA). The difference of muscle strength between low- and high-grade glioma groups were analysed with the Mann-Whitney U-test.

Results

Muscle strength was negatively correlated with the injury grade of the CST (r = -0.840, P<0.001). Muscle strength was positively correlated with rFA, FDi and rFDi (correlation coefficients (r) were 0.615, 0.643 and 0.567 for rFA, FDi and rFDi, respectively). The rFA values between grades (2&3, 2&4, 2&5, 3&5, 4&5) of muscle strength were significantly different (P<0.05), the rFDi values between grades (2&4, 2&5, 3&4, 3&5) of muscle strength were significantly different (P<0.05), while the rFA and rFDi values in the remaining groups of muscle strength grades showed no significant differences(P>0.05).

Conclusions

Preoperative DTI and diffusion tensor tractography may quantify the injury degrees of CST and the extent of motor dysfunction in patients with brain glioma.

SUBMITTER: Gao B

PROVIDER: S-EPMC5568729 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

A pilot study of pre-operative motor dysfunction from gliomas in the region of corticospinal tract: Evaluation with diffusion tensor imaging.

Gao Bo B Shen Xudong X Shiroishi Mark S MS Pang Mingfan M Li Zhiqian Z Yu Benxia B Shen Guiquan G

PloS one 20170822 8

<h4>Background and purpose</h4>Brain tumors in the corticospinal tract (CST) region are more likely to cause motor dysfunction. The aim of this study is to evaluate the effect of gliomas located in the CST region on motor function with diffusion tensor imaging (DTI) preoperatively.<h4>Materials and methods</h4>Forty-five patients with histopathologically confirmed gliomas were included in this pilot study, in all cases (low-grade n = 13, high-grade n = 32) CST but not the motor cortex were invol ...[more]

PMID: 28829841

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Project description:BackgroundTo investigate the efficacy of acupuncture in improving motor dysfunction after ischemic stroke (IS) and to investigate the effect of acupuncture on corticospinal tract (CST) remodeling using diffusion tensor imaging.MethodsPublished literature on the effect of acupuncture on CST remodeling after IS using diffusion tensor imaging in the form of randomized controlled trials (RCTs) were systematically retrieved and screened from Cochrane Library, Web of Science, PubMed, Embase, CNKI, CBM, VIP, and Wanfang databases from inception to December 2022. The methodological quality of the included studies was critically and independently evaluated by 2 reviewers using the Cochrane Risk of Bias Assessment Tool for RCTs. The correlated data were extracted using the pre-designed form, and all analyses were performed using Reviewer Manager version 5.4.ResultsEleven eligible RCTs involving 459 patients were eventually included. The combined evidence results showed that the acupuncture group significantly improved patients' National Institute of Health stroke scale, Fugl-Meyer Assessment Scale, and Barthel index compared with conventional medical treatment. The acupuncture group significantly promoted remodeling of the CST, as reflected by an increase in fractional anisotropy (FA) throughout the CST [MD = 0.04, 95% CI (0.02, 0.07), P = .001], and in addition, subgroup analysis showed that the acupuncture group significantly improved FA in the infarct area compared with conventional medical treatment at around 4 weeks [MD = 0.04, 95% CI (0.02, 0.06), P = .0002] and FA of the affected cerebral peduncle [MD = 0.03, 95% CI (0.00, 0.07), P = .02]. Also, compared with conventional medical treatment, the acupuncture group significantly increased average diffusion coefficient of the affected cerebral peduncle [MD = -0.21, 95% CI (-0.28, -0.13), P < .00001].ConclusionThe results of the meta-analysis suggest that acupuncture therapy can improve the clinical manifestations of motor dysfunction in patients after IS and advance a possibly beneficial effect on CST remodeling. However, due to the number and quality of eligible studies, these findings need to be further validated in more standardized, rigorous, high-quality clinical trials.

Project description:Several studies have questioned the traditional belief that the corticospinal tract (CST) arises exclusively from the precentral gyrus and passes through the anterior half of the posterior limb of the internal capsule (PLIC) in humans; however, no direct evidence existed from structural imaging, and developmental aspects of CST origin have not been clarified. We used diffusion tensor imaging (DTI) tractography to test the hypotheses that CST can originate from both pre- and postcentral gyri and is located posteriorly in the PLIC, and we also determined how age, sex, or handedness affected these locations.Forty-two healthy children (2.6-17.5 years of age; 20 girls) underwent DTI. Subsequently, tractography was performed on the basis of fiber assignment by continuous tracking (FACT) algorithm and brute force approach, with a fractional anisotropy (FA) threshold of <0.2 and an angle threshold of >50 degrees . The CST was isolated by using a knowledge-based region-of-interest approach, and its cortical origin and location on the PLIC was determined.DTI revealed that the CST originated from both pre- and postcentral gyri in 71.4% of hemispheres, from the precentral gyrus only in 19%, and from the postcentral gyrus only in 7.1%. The overall distribution was similar in both hemispheres. However, children with CST originating from both pre- and postcentral gyri were older (mean, 11.1 years of age) than those with precentral origin (mean, 5.8 years of age) or postcentral origin (mean, 7.8 years of age) only (P = .00003). The center of the CST was localized at 65% of the length (from its anterior margin) of the PLIC, and the CST occupied 26.5% of its anteroposterior length. There was a significant positive correlation between age and FA of the CST (r = 0.49; P = .002). The volume of the precentral portion of the left CST was significantly higher than that of its postcentral portion (P = .01) and that of the right CST (P = .0002). The pattern of cortical origin of CST, its location at the level of PLIC, and its volume and FA were unaffected by sex or handedness.The CST most frequently originates from both pre- and postcentral gyri, especially in older children, and is typically centered approximately two thirds of the distance from the anterior margin of the PLIC and occupies about a quarter of its anteroposterior length. In young children, the CST can often be seen originating exclusively from the precentral gyrus by DTI.

Project description:BackgroundAn assessment of the degree of white matter tract injury is important in neurosurgical planning for patients with gliomas. The main objective of this study was to assess the injury grade of the corticospinal tract (CST) in rats with glioma using diffusion tensor imaging (DTI).MethodsA total 17 rats underwent 7.0T MRI on day 10 after tumor implantation. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were acquired in the tumor, peritumoral and contralateral areas, and the ADC ratio (ipsilateral ADC/contralateral ADC) and rFA (relative FA = ipsilateral FA/contralateral FA) in the peritumoral areas were measured. The CST injury was divided into three grades and delineated by diffusion tensor tractography reconstruction imaging. The fiber density index (FDi) of the ipsilateral and contralateral CST and rFDi (relative FDi = ipsilateral FDi/contralateral FDi) in the peritumoral areas were measured. After the mice were sacrificed, the invasion of glioma cells and fraction of proliferating cells were observed by hematoxylin-eosin and Ki67 staining in the tumor and peritumoral areas. The correlations among the pathology results, CST injury grade and DTI parameter values were calculated using a Spearman correlation analysis. One-way analysis of variance was performed to compare the different CST injury grade by the rFA, rFDi and ADC ratio values.ResultsThe tumor cells and proliferation index were positively correlated with the CST injury grade (r = 0.8857, 0.9233, P < 0.001). A negative correlation was demonstrated between the tumor cells and the rFA and rFDi values in the peritumoral areas (r = -0.8571, -0.5588), and the proliferation index was negatively correlated with the rFA and rFDi values (r = -0.8571, -0.5588), while the ADC ratio was not correlated with the tumor cells or proliferation index. The rFA values between the CST injury grades (1 and 3, 2 and 3) and the rFDi values in grades 1 and 3 significantly differed (P < 0.05).ConclusionsDiffusion tensor imaging may be used to quantify the injury degrees of CST involving brain glioma in rats. Our data suggest that these quantitative parameters may be used to enhance the efficiency of delineating the relationship between fiber tracts and malignant tumor.

Project description:Abstract Along tract statistics enables white matter characterization using various diffusion MRI metrics. These diffusion models reveal detailed insights into white matter microstructural changes with development, pathology and function. Here, we aim at assessing the clinical utility of diffusion MRI metrics along the corticospinal tract, investigating whether motor glioma patients can be classified with respect to their motor status. We retrospectively included 116 brain tumour patients suffering from either left or right supratentorial, unilateral World Health Organization Grades II, III and IV gliomas with a mean age of 53.51 ± 16.32 years. Around 37% of patients presented with preoperative motor function deficits according to the Medical Research Council scale. At group level comparison, the highest non-overlapping diffusion MRI differences were detected in the superior portion of the tracts’ profiles. Fractional anisotropy and fibre density decrease, apparent diffusion coefficient axial diffusivity and radial diffusivity increase. To predict motor deficits, we developed a method based on a support vector machine using histogram-based features of diffusion MRI tract profiles (e.g. mean, standard deviation, kurtosis and skewness), following a recursive feature elimination method. Our model achieved high performance (74% sensitivity, 75% specificity, 74% overall accuracy and 77% area under the curve). We found that apparent diffusion coefficient, fractional anisotropy and radial diffusivity contributed more than other features to the model. Incorporating the patient demographics and clinical features such as age, tumour World Health Organization grade, tumour location, gender and resting motor threshold did not affect the model’s performance, revealing that these features were not as effective as microstructural measures. These results shed light on the potential patterns of tumour-related microstructural white matter changes in the prediction of functional deficits. Shams et al. report that glioma patients’ motor status is predicted accurately by diffusion MRI metrics along the corticospinal tract based on support vector machine method, reaching an overall accuracy of 77%. They show that these metrics are more effective than demographic and clinical variables. Graphical Abstract Graphical abstract

Dataset Information

A pilot study of pre-operative motor dysfunction from gliomas in the region of corticospinal tract: Evaluation with diffusion tensor imaging.

Background and purpose

Materials and methods

Results

Conclusions

Publications

A pilot study of pre-operative motor dysfunction from gliomas in the region of corticospinal tract: Evaluation with diffusion tensor imaging.

Similar Datasets

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