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Does right hemisphere compensate for the left in school-age children with large left middle fossa arachnoid cysts?
Wenjian Zheng1,2, Xueyi Guan1, Zheng Lu1
1Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, PR China.
Insights
Children with large left middle fossa arachnoid cysts (MFACs) exhibit impaired attention and memory. Brain network analysis reveals reduced functional connectivity, with limited compensatory neuroplasticity in the healthy hemisphere.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Neuroscience
Background:
- Large left middle fossa arachnoid cysts (MFACs) can impact neurological development in children.
- Assessing cognitive function and brain network alterations is crucial for understanding MFACs' effects.
Purpose of the Study:
- To evaluate cognitive function and brain network neuroplasticity in school-aged children with large left MFACs.
- To investigate the relationship between cognitive deficits and altered functional connectivity in these patients.
Main Methods:
- Cognitive assessment using CNS Vital Signs (CNS VS) in 11 MFAC patients and 22 controls (ages 6-14).
- Resting-state functional magnetic resonance imaging (rs-fMRI) to analyze functional connectivity (FC) and local correlations (LCOR).
- Comparison of cognitive data and FC between patient and control groups, with correlation analysis.
Main Results:
- MFAC patients showed significantly poorer attention and memory function compared to controls (p < 0.05).
- Lower LCOR and reduced bilateral frontal and temporal lobe FC were observed in MFAC patients (p-FDR < 0.001 and p-FDR < 0.05, respectively).
- Altered FC, particularly between the right and left temporal lobes, correlated with cognitive scores, while cyst size showed a weak correlation with reaction time.
Conclusions:
- Large left MFACs are associated with significant deficits in attention and memory domains in school-aged children.
- Neuroplasticity and compensatory mechanisms in the healthy hemisphere appear limited in children with MFACs.
Background:
To assess the cognitive function changes and brain network neuroplasticity in school-age children having large (diameter > 5 cm) left middle fossa arachnoid cyst (MFACs).
Methods:
Eleven patients and 22 normal controls (NC) between 6 and 14 years of age were included. The CNS Vital Signs (CNS VS) were administered for cognitive assessment. The differences of cognitive data and functional connectivity (FC) in resting-state functional magnetic resonance imaging (rs-fMRI) were compared between the patient group and the NC group. The correlations between the altered FC and cognitive data in the patient group were assessed.
Results:
Patient group had significantly poorer attention (including Complex Attention, Sustained Attention, Simple Attention, Cognitive Flexibility, and Executive Function) and memory function (Visual Memory and Working Memory) than the NC group (uncorrected p-value, p-unc < 0.05). Whole-brain local correlation (LCOR) analysis showed an extensively lower LCOR in the patient group (voxel threshold p-unc < 0.001, cluster-size threshold of false discovery rate adjusted p (p-FDR) < 0.001). Functional connectivity (FC) analysis showed that bilateral frontal and temporal lobes connectivity in the patient group was significantly lower than the NC group (p-FDR < 0.05). Seed-based FC analysis indicated that there was altered FC between the right temporal lobe and the left temporal-parietal/temporal-occipital area (p-FDR < 0.05). In the patient group, most of the altered FC had a negative correlation to the cognitive score, while the FC in the right temporal lobe-left temporal-occipital area positively correlated to Verbal/Visual Memory (r = 0.41-0.60, p-FDR < 0.05). In correlation analysis between clinical data and cognitive score, the only significant result was a low correlation between cyst size and Reaction Time (-0.30--0.36, P-FDR < 0.05).
Conclusions:
School-aged children with large left MFAC showed significantly lower cognitive performance primarily in attention and memory domains. Distinct from neuroplasticity in a unilateral brain lesion, compensation in the healthy hemisphere in MFAC patients was sparse.
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