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在小脑沉默综合征中,二次大脑-小脑和大脑内功能障碍
Samuel S McAfee1, Giles Robinson2, Amar Gajjar2
1Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Neuro-oncology
|April 6, 2024
概括
脑细胞母细胞瘤手术后的大脑默综合征 (CMS) 涉及大脑连接的改变,特别是与中腹前额叶皮层 (VM-PFC) 的连接. 这些变化表明二次功能异常,而不是直接的手术损伤.
科学领域:
- 神经科学是一个神经科学.
- 功能神经成像 功能神经成像
- 儿科瘤学 儿科瘤学
背景情况:
- 大脑默综合征 (CMS) 呈现出言语,运动和影响缺陷后后腔瘤切除.
- 目前尚不完全了解CMS的确切原因,特别是大脑小脑管损伤的作用.
- 慢性脑小脑功能障碍越来越多地与CMS病因有关.
研究的目的:
- 为了研究脑髓母细胞瘤患者的功能连接性改变.
- 确定小脑外流通路损伤与大脑-小脑功能连接之间的关系.
- 探索大脑默综合征 (CMS) 的神经基础.
主要方法:
- 功能磁共振成像 (fMRI) 用于测量小脑皮质连接在70名脑髓母细胞瘤患者在辅助治疗前.
- 手术损伤的位置被映射到下肢解剖学上.
- 连接性被统计分析为依赖于小脑外流通路损伤程度的依赖.
主要成果:
- CMS诊断与右小脑与左脑半球连接性增加相关,特别是涉及腹中前额叶皮层 (VM-PFC).
- 与小脑外流损伤相关的连接性变化观察到语音节点,但不是VM-PFC.
- 在CMS患者中,后脑小皮层和双侧牙核之间的异常连接被观察到,主要在右半球.
结论:
- 确定的功能异常是在直接的手术损伤之前出现的,这表明CMS中存在次要现象.
- VM-PFC的参与凸显了其在CMS症状 (如情绪控制和运动学习) 中的潜在作用.
- 假设的不适应性小脑学习可能是中脑功能障碍影响运动和边缘路径的结果.
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