Dataset Information

Motor cortex gliomas induces microstructural changes of large fiber tracts revealed by TBSS.

ABSTRACT: Gliomas grow and invade along white matter fiber tracts. This study assessed the effects of motor cortex gliomas on the cerebral white matter fiber bundle skeleton. The motor cortex glioma group included 21 patients, and the control group comprised 14 healthy volunteers. Both groups underwent magnetic resonance imaging-based 3.0 T diffusion tensor imaging. We used tract-based spatial statistics to analyze the characteristics of white matter fiber bundles. The left and right motor cortex glioma groups were analyzed separately from the control group. Results were statistically corrected by the family-wise error rate. Compared with the controls, patients with left motor cortex gliomas exhibited significantly reduced fractional anisotropy and an increased radial diffusivity in the corpus callosum. The alterations in mean diffusivity (MD) and the axial diffusivity (AD) were widely distributed throughout the brain. Furthermore, atlas-based analysis showed elevated MD and AD in the contralateral superior fronto-occipital fasciculus. Motor cortex gliomas significantly affect white matter fiber microstructure proximal to the tumor. The range of affected white matter fibers may extend beyond the tumor-affected area. These changes are primarily related to early stage tumor invasion.

SUBMITTER: Wang X

PROVIDER: S-EPMC7547011 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Motor cortex gliomas induces microstructural changes of large fiber tracts revealed by TBSS.

Wang Xiangdong X Zhou Chunyao C Wang Lei L Wang Yinyan Y Jiang Tao T

Scientific reports 20201009 1

Gliomas grow and invade along white matter fiber tracts. This study assessed the effects of motor cortex gliomas on the cerebral white matter fiber bundle skeleton. The motor cortex glioma group included 21 patients, and the control group comprised 14 healthy volunteers. Both groups underwent magnetic resonance imaging-based 3.0 T diffusion tensor imaging. We used tract-based spatial statistics to analyze the characteristics of white matter fiber bundles. The left and right motor cortex glioma g ...[more]

PMID: 33037275

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Project description:Surgical planning with nTMS-based tractography is proven to increase safety during surgery. A preoperative risk stratification model has been published based on the M1 infiltration, RMT ratio, and tumor to corticospinal tract distance (TTD). The correlation of TTD with corticospinal tract to resection cavity distance (TRD) and outcome is needed to further evaluate the validity of the model. To use the postop MRI-derived resection cavity to measure how closely the resection cavity approximated the preoperatively calculated corticospinal tract (CST) and how this correlates with the risk model and the outcome. We included 183 patients who underwent nTMS-based DTI and surgical resection for presumed motor-eloquent gliomas. TTD, TRD, and motor outcome were recorded and tested for correlations. The intraoperative monitoring documentation was available for a subgroup of 48 patients, whose responses were correlated to TTD and TRD. As expected, TTD and TRD showed a good correlation (Spearman's ρ = 0.67, p < 0.001). Both the TTD and the TRD correlated significantly with the motor outcome at three months (Kendall's Tau-b 0.24 for TTD, 0.31 for TRD, p < 0.001). Interestingly, the TTD and TRD correlated only slightly with residual tumor volume, and only after correction for outliers related to termination of resection due to intraoperative monitoring events or the proximity of other eloquent structures (TTD ρ = 0.32, p < 0.001; TRD ρ = 0.19, p = 0.01). This reflects the fact that intraoperative monitoring (IOM) phenomena do not always correlate with preoperative structural analysis, and that additional factors influence the intraoperative decision to abort resection, such as the adjacency of other vulnerable structures. The TTD was also significantly correlated with variations in motor evoked potential (MEP) responses (no/reversible decrease vs. irreversible decrease; p = 0.03). The TTD approximates the TRD well, confirming the best predictive parameter and giving strength to the nTMS-based risk stratification model. Our analysis of TRD supports the use of the nTMS-based TTD measurement to estimate the resection preoperatively, also confirming the 8 mm cutoff. Nevertheless, the TRD proved to have a slightly stronger correlation with the outcome as the surgeon's experience, anatomofunctional knowledge, and MEP observations influence the expected EOR.

Project description:Alcohol Use Disorders (AUD) is associated with negative consequences on global functioning, likely reflecting chronic changes in brain morphology and connectivity. Previous attempts to characterize cognitive impairment in AUD addressed patients' performance in single domains, without considering their cognitive profile as a whole. While altered cognitive performance likely reflects abnormal white-matter microstructural properties, to date no study has directly addressed the relationship between a proxy of patients' cognitive profile and microstructural damage. To fill this gap we aimed to characterize the microstructural damage pattern, and its relationship with cognitive profile, in treatment-seeking AUD patients. Twenty-two AUD patients and 18 healthy controls underwent a multimodal MRI protocol including diffusion tensor imaging (DTI), alongside a comprehensive neurocognitive assessment. We used a principal component analysis (PCA) to identify superordinate components maximally explaining variability in cognitive performance, and whole-brain voxelwise analyses to unveil the neural correlates of AUD patients' cognitive impairment in terms of different white-matter microstructural features, i.e. fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). PCA revealed a basic executive component, significantly impaired in AUD patients, associated with tasks tapping visuo-motor processing speed, attention and working-memory. Within a widespread pattern of white-matter damage in patients, we found diverse types of relationship linking WM microstructure and executive performance: (i) in the whole sample, we observed a linear relationship involving MD/RD metrics within both 'superficial' white-matter systems mediating connectivity within large-scale brain networks, and deeper systems modulating their reciprocal connections; (ii) in AUD patients vs. controls, a performance-by-group interaction highlighted a MD/AD pattern involving two frontal white-matter systems, including the genu of corpus callosum and cingulum bundle, mediating structural connectivity among central executive, salience and default mode networks. Alterations of prefrontal white-matter pathways are suggestive of abnormal structural connectivity in AUD, whereby a defective interplay among large-scale networks underpins patients' executive dysfunction. These findings highlight different directions for future basic and translational research aiming to tailor novel rehabilitation strategies and assess their functional outcomes.

Dataset Information

Motor cortex gliomas induces microstructural changes of large fiber tracts revealed by TBSS.

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Motor cortex gliomas induces microstructural changes of large fiber tracts revealed by TBSS.

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