Cortical organization of object knowledge before and after brain surgery

脑手术前后对象知识的皮层组织

• 批准号: 8302608
• 负责人: BRADFORD Zack MAHON
• 金额: $ 22.36万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-01 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8302608
• 关键词: Affect; Area; Behavior; Brain; Brain Injuries; Brain Mapping; Brain Neoplasms; Brain region; Clinical; Clinical assessments; Cognitive; Cognitive deficits; Complex; Control Groups; Craniotomy; Data; Development; Excision; Feedback; Functional Magnetic Resonance Imaging; Fusiform gyrus; Goals; Impaired cognition; Inferior; Knowledge; Lead; Left; Lesion; Lobule; Location; Maps; Measures; Mediating; Methods; Metric; Modeling; Nature; Neurocognitive; Neurophysiology - biologic function; Neuropsychological Tests; Neurosurgeon; Operative Surgical Procedures; Outcome; Parietal; Parietal Lobe; Pathway interactions; Patients; Pattern; Performance; Process; Protocols documentation; Recovery; Recovery of Function; Research; Resected; Rest; Role; Scanning; Seeds; Stimulus; Structure of middle temporal gyrus; Surface; Symptoms; System; Temporal Lobe; Temporal Lobe Neoplasm; Testing; Time; Tissues; Visual; analytical tool; base; brain shape; brain surgery; brain tissue; gray matter; imaging modality; indexing; interest; neurosurgery; object recognition; prognostic; programs; relating to nervous system; tumor; visual-motor integration; white matter

DESCRIPTION (provided by applicant): Surgery for removal of intrinsic brain tumors can lead to unintended cognitive impairments. This is particularly the case when healthy tissue must be resected (corticectomy) in order to access the tumor. The consequences of corticectomy for neural function and cognitive outcome remain poorly understood. Recent advances in studying dynamic interactions among brain regions using functional magnetic resonance imaging (fMRI) data collected while subjects are at rest, with no overt stimulus or task, open up new horizons for studying the neural consequences of radical resection of intrinsic brain tumors. This imaging modality is well suited for application and development within a clinical setting, as data may be collected from patients of heterogeneous cognitive abilities as part of their standard clinical assessment. The ability to recognize and use objects according to their function (e.g., fork, hammer, pencil) requires coordinated processing across multiple brain regions in temporal and parietal cortex. Those cognitive abilities can be compromised after neurosurgery for removal of temporal or parietal lobe brain tumors. The proposed research program uses resting fMRI to study the organization of the cortical networks supporting knowledge of common objects. Patients with brain tumors in the temporal and parietal lobes will be scanned with stimulus- based and resting fMRI and will undergo detailed neuropsychological testing before surgery and after surgery. Using regions of interest (ROIs) defined with stimulus-based fMRI, functional connectivity will be quantified within the temporal-parietal cortical network supporting object knowledge. On the basis of the PIs previous research, specific hypotheses are advanced about anticipated changes in connectivity as a function of the location of the brain tumor and the nature of the surgical approach for removal of the tumor. Those hypotheses are then tested by comparing the post-surgery data to the pre-surgery data, and relating changes in functional connectivity to changes in cognitive abilities. To this end, a new method is developed that applies the analytical tool of lesion-symptom mapping to fMRI connectivity maps in order to be able to derive whole brain maps showing how changes in functional connectivity are related to changes in cognitive performance. This research program serves two goals. First, it will generate a new type of feedback about patient outcome to neurosurgeons that will inform surgical planning in patients undergoing resection of intrinsic brain tumors. Second, hypotheses about the functional brain networks that support visual object identification and object use are tested, and causal inferences are drawn about the brain processes that subserve those complex behaviors. PUBLIC HEALTH RELEVANCE: Functional MRI is used to test hypotheses about plasticity in the cortical networks supporting object knowledge in neurosurgery patients with dominant hemisphere brain tumors. In addition to studying the constraints that shape brain organization, a prognostic metric will be developed for planning the location of corticectomies.

描述（由申请人提供）：切除内在脑肿瘤的手术可能会导致意外的认知障碍。当必须切除健康组织（皮质切除术）才能进入肿瘤时，尤其是这种情况。皮质切除术对神经功能和认知结果的后果知之甚少。使用功能磁共振成像（fMRI）数据在受试者处于静止时收集的功能性磁共振成像（fMRI）数据（没有明显的刺激或任务），为研究内在脑肿瘤的根本切除的神经后果打开了新的视野。这种成像方式非常适合在临床环境中的应用和开发，因为作为其标准临床评估的一部分，可以从异质认知能力的患者那里收集数据。根据对象的功能识别和使用对象的能力（例如，叉子，锤子，铅笔）需要在颞皮层和顶叶皮质中的多个大脑区域进行协调。神经外科手术后，这些认知能力可能会损害，以切除颞叶或顶叶脑肿瘤。拟议的研究计划使用静止fMRI来研究支持共同对象知识的皮质网络的组织。颞叶和顶叶中脑肿瘤的患者将用基于刺激的和静止的fMRI扫描，并将在手术前和手术后进行详细的神经心理学测试。使用基于刺激的fMRI定义的感兴趣区域（ROI），将在支持对象知识的颞顶皮层网络中量化功能连接性。根据PIS先前的研究，预期的连通性变化是脑肿瘤位置的函数以及外科手术方法切除肿瘤的性质的预期变化。然后，通过将手术后数据与手术前数据进行比较，并将功能连接性变化与认知能力的变化相关联，从而测试了这些假设。为此，开发了一种新方法，该方法将病变 - 检查者映射的分析工具应用于fMRI连接图，以便能够得出整个脑图，以显示功能连接的变化与认知性能的变化如何相关。该研究计划实现了两个目标。首先，它将产生有关神经外科医生的患者结果的新型反馈，这些反馈将为接受内在脑肿瘤切除的患者提供依据。其次，测试了支持视觉对象识别和对象使用的功能性大脑网络的假设，并就利用这些复杂行为的大脑过程提出了因果推断。 公共卫生相关性：功能性MRI用于测试有关在具有显性半球脑肿瘤的神经外科患者中支持对象知识的皮质网络中可塑性的假设。除了研究塑造大脑组织的限制外，还将开发预后的度量标准，以计划皮质切除的位置。