PDF(Pubmed)
Abstract：
The first therapeutical goal followed by neurooncological surgeons dealing with prefrontal gliomas is attempting supramarginal tumor resection preserving relevant neurological function. Therefore, advanced knowledge of the frontal aslant tract (FAT) functional neuroanatomy in high-order cognitive domains beyond language and speech processing would help refine neurosurgeries, predicting possible relevant cognitive adverse events and maximizing the surgical efficacy. To this aim we performed the recently developed correlational tractography analyses to evaluate the possible relationship between FAT\'s microstructural properties and cognitive functions in 27 healthy subjects having ultra-high-field (7-Tesla) diffusion MRI. We independently assessed FAT segments innervating the dorsolateral prefrontal cortices (dlPFC-FAT) and the supplementary motor area (SMA-FAT). FAT microstructural robustness, measured by the tract\'s quantitative anisotropy (QA), was associated with a better performance in episodic memory, visuospatial orientation, cognitive processing speed and fluid intelligence but not sustained selective attention tests. Overall, the percentual tract volume showing an association between QA-index and improved cognitive scores (pQACV) was higher in the SMA-FAT compared to the dlPFC-FAT segment. This effect was right-lateralized for verbal episodic memory and fluid intelligence and bilateralized for visuospatial orientation and cognitive processing speed. Our results provide novel evidence for a functional specialization of the FAT beyond the known in language and speech processing, particularly its involvement in several higher-order cognitive domains. In light of these findings, further research should be encouraged to focus on neurocognitive deficits and their impact on patient outcomes after FAT damage, especially in the context of glioma surgery.
摘要：
治疗前额叶神经胶质瘤的神经肿瘤外科医师遵循的第一个治疗目标是尝试保留相关神经功能的上边缘肿瘤切除术。因此,高级知识的额叶倾斜道（FAT）功能神经解剖学在高阶认知领域超越语言和语音处理将有助于完善的神经外科手术，预测可能的相关认知不良事件，最大限度地提高手术疗效。为此，我们进行了最近开发的相关纤维束成像分析，以评估27名具有超高场（7特斯拉）扩散MRI的健康受试者中FAT的微观结构特性与认知功能之间的可能关系。我们独立评估了支配背外侧前额叶皮层（dlPFC-FAT）和辅助运动区（SMA-FAT）的FAT节段。FAT微观结构的鲁棒性，通过管道的定量各向异性(QA)测量，与情景记忆的更好表现有关，视觉空间方向，认知处理速度和流体智力，但不是持续的选择性注意力测试。总的来说,与dlPFC-FAT段相比,SMA-FAT段的表现出QA指数与认知评分改善(pQACV)之间关联的气道体积百分比更高.这种效果对于言语情景记忆和流体智力是右偏右的，对于视觉空间取向和认知处理速度是双向的。我们的结果为FAT的功能专业化提供了新的证据，超出了语言和语音处理的已知范围。特别是它参与了几个高阶认知领域。根据这些发现,应鼓励进一步研究关注神经认知缺陷及其对FAT损伤后患者预后的影响，特别是在神经胶质瘤手术中。
