左侧环侧裂区脑肿瘤对语言网络的影响的初步研究

发布时间：2018-03-25 19:34

本文选题：脑网络　切入点：侧裂区　出处：《中国人民解放军医学院》2017年博士论文

【摘要】：研究背景:语言是人类最重要的高级神经功能之一,追求最大程度的保护神经功能是神经外科的宗旨;目前左侧大脑半球侧裂区脑肿瘤对全脑连接性,尤其是对语言网络的影响尚不清楚。本研究应用经典图论工具,探索由DTI纤维束示踪构建的全脑以及语言纤维连接网络全局和局部拓扑属性的变化,寻找与语言功能的内在联系。方法:1.选取33例左侧大脑半球额颞顶叶脑肿瘤患者,根据术前语言功能分为2组(语言正常组17例、语言受损组16例),并选取对照组9例,同时应用确定性和概率性纤维追踪构建全脑/语言网络,采用图论分析,比较全局和局部参数差异性,采用NBS分析比较连接差异性;2.选取12例序贯患者,构建全脑以及语言纤维连接FA网络,分析术前、术后的拓扑参数变化及其与语言功能的关系;同时,选取5种语言相关传导束测定其平均FA值,并探索语言传导束FA值与术前、术后语言的联系。结果:1.所有研究对象的全脑/语言网络均呈现出小世界性,病例组与对照组的全局效率ELambda具有显著性差异;确定性全脑网络中,排除性别和年龄因素的影响,WAB得分与ELambda具有相关性,但节点效率及其侧化指数均未见明显差异;NBS分析提示语言受损组存在失联子网络;2. ELambda与术前及术后WAB均显著相关;而语言传导束分析提示左侧SLF、ILF、IFOF的FA值仅与术后WAB相关,与术前语言无相关;此外,SLF侧化指数与术后WAB相关。结论:左侧大脑半球侧裂区肿瘤不仅引起局部的脑连接变化,而且导致全脑/语言网络的拓扑属性变化,这种变化与语言功能密切相关。相对于语言传导束示踪,全脑/语言网络分析有望成为预测语言功能变化的有效手段。
[Abstract]:Background: language is one of the most important human advanced neural function, the pursuit of nerve protection function to the maximum extent is the purpose of the Department of Neurosurgery; the left hemisphere lateral fissure area of whole brain connectivity of brain tumors, especially the influence of network language is not clear. This study applied classical graph theory, explore the changes of DTI constructed by fiber beam tracing of whole brain and language fiber connected to the network of local and global topological properties, and find the relation between the language function. Methods: 1. samples from 33 cases of left hemisphere frontotemporal and parietal brain tumor patients, according to the language function before operation were divided into 2 groups (normal language group 17 cases, 16 cases of language impairment group). And selected 9 cases of the control group, while the application of deterministic and probabilistic construction of whole brain fiber tracking / language network, using graph theory analysis, comparison of global and local parameter difference, compared with NBS connection difference; 2. A total of 12 cases of patients with sequential, whole brain construction and language fiber connected to FA network, analysis of preoperative, postoperative changes of topological parameters and its relationship with language function; at the same time, select 5 kinds of language related tracts to determine the average value of FA, and to explore the language bundle FA value and preoperative, postoperative language contact results: 1.. All the research object of the whole brain / language network showed small world ELambda, the overall efficiency of the case group and the control group with significant difference; the uncertainty of whole brain networks, regardless of gender and age factors, associated with the scores of WAB and ELambda, but the node efficiency and laterality index showed no NBS analysis showed obvious differences; language impairment group has lost contact with the sub network; 2. ELambda with preoperative and postoperative WAB were significantly related; and language bundle analysis showed that left SLF, ILF IFOF, the FA value is only related to postoperative WAB and preoperative language phase In addition, SLF; laterality index and postoperative WAB. Conclusion: the left hemisphere lateral fissure area tumor not only cause local brain connectivity changes, but also lead to changes in the network topology language / whole brain, the changes and the language is closely related to the function of language. Compared with the bundle tracer, whole brain / language network analysis is expected to an effective means of predicting language function changes.

【学位授予单位】：中国人民解放军医学院
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R739.4

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