Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas:a case series study and clinical experience using Quicktome  

作　　者：Zhiqiang Wu Guanjie Hu Bowen Cao Xingdong Liu Zifeng Zhang Nicholas B.Dadario Qinyu Shi Xiao Fan Yao Tang Zhangchun Cheng Xiefeng Wang Xia Zhang Xiaorong Hu Junxia Zhang Yongping You 

机构地区：[1]Department of Neurosurgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China [2]Robert Wood Johnson Medical School,Rutgers University,Newark,NJ 08901,USA [3]International Joint Research Center On Precision Brain Medicine,XD Group Hospital,Shaanxi Province,Xi’an 710077,China [4]Institute for Brain Tumors,Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine,Nanjing Medical University,Nanjing 211166,China

出　　处：《Chinese Neurosurgical Journal》2023年第3期166-176,共11页中华神经外科杂志（英文）

基　　金：supported by a grant from the National Natural Science Foundation of China(81974389);the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)

摘　　要：Background 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.Methods 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.Results 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.Conclusions 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.

关 键 词：CONNECTOME Brain network Machine learning Insulo-Sylvian gliomas Cognitive function 

分 类 号：R739.41[医药卫生—肿瘤]