原发性脑肿瘤患者认知表型的神经解剖特征。

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2024-08-29 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae152
Jiwandeep S Kohli, Anny Reyes, Austin Hopper, Alena Stasenko, Natalia Menendez, Kathryn R Tringale, Mia Salans, Roshan Karunamuni, Jona A Hattangadi-Gluth, Carrie R McDonald
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引用次数: 0

摘要

背景:脑肿瘤患者表现出不同的认知障碍模式,这可能与多因素病因和可变的肿瘤特异性因素有关。认知表型分析提供了一种以患者为中心的方法,通过根据损伤模式对个体进行分类来解析异质性。本研究的目的是调查与每种表型相关的神经解剖模式,以更好地了解损伤的内在机制:方法:招募原发性脑肿瘤患者进行前瞻性观察研究。在之前的一项研究中,利用潜伏特征分析对患者进行了认知表型分析,发现了3个不同的组别:泛化记忆、孤立言语记忆和轻微障碍。研究人员比较了不同表型的全脑皮质厚度(CT)、分数各向异性和平均扩散率(MD),并探讨了成像指标与认知评分之间的关联:82名参与者的神经认知、结构磁共振成像和弥散磁共振成像基线数据可用。与轻度损伤组相比,广泛性损伤组显示出广泛的双半球 CT 下降模式(P 值范围:.004-.049),而言语记忆损伤组则显示出双侧颞叶 CT 下降(P 值范围:.006-.049)和 MD 增加(P 值范围:.015-.045)。仅在言语记忆障碍组中,海马旁 MD 的增加与言语记忆得分的降低有关(P 值 结论):脑肿瘤患者的认知表型显示出独特的脑部病理模式,表明其损伤特征的潜在机制各不相同。这些独特的模式凸显了我们的表型分析方法的生物学相关性,并有助于确定结构和微结构的薄弱区域,为治疗决策提供依据。
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Neuroanatomical profiles of cognitive phenotypes in patients with primary brain tumors.

Background: Patients with brain tumors demonstrate heterogeneous patterns of cognitive impairment, likely related to multifactorial etiologies and variable tumor-specific factors. Cognitive phenotyping offers a patient-centered approach to parsing heterogeneity by classifying individuals based on patterns of impairment. The aim of this study was to investigate the neuroanatomical patterns associated with each phenotype to gain a better understanding of the mechanisms underlying impairments.

Methods: Patients with primary brain tumors were recruited for a prospective, observational study. Patients were cognitively phenotyped using latent profile analysis in a prior study, revealing 3 distinct groups: generalized, isolated verbal memory, and minimal impairment. Whole brain cortical thickness (CT), fractional anisotropy, and mean diffusivity (MD) were compared across phenotypes, and associations between imaging metrics and cognitive scores were explored.

Results: Neurocognitive, structural MRI, and diffusion MRI data were available for 82 participants at baseline. Compared to the minimal impairment group, the generalized impairment group showed a widespread, bi-hemispheric pattern of decreased CT (P-value range: .004-.049), while the verbal memory impairment group showed decreased CT (P-value range: .006-.049) and increased MD (P-value range: .015-.045) bilaterally in the temporal lobes. In the verbal memory impairment group only, increased parahippocampal MD was associated with lower verbal memory scores (P-values < .01).

Conclusions: Cognitive phenotypes in patients with brain tumors showed unique patterns of brain pathology, suggesting different underlying mechanisms of their impairment profiles. These distinct patterns highlight the biological relevance of our phenotyping approach and help to identify areas of structural and microstructural vulnerability that could inform treatment decisions.

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CiteScore
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