A pilot study of pre-operative motor dysfunction from gliomas in the region of corticospinal tract: Evaluation with diffusion tensor imaging

• Published in: PloS one Vol. 12; no. 8; p. e0182795
• Main Authors: Gao, Bo, Shen, Xudong, Shiroishi, Mark S, Pang, Mingfan, Li, Zhiqian, Yu, Benxia, Shen, Guiquan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22-08-2017; Public Library of Science (PLoS)
• Subjects: Anisotropy; Biology and Life Sciences; Brain; Brain cancer; Brain Neoplasms - physiopathology; Brain tumors; Complications and side effects; Correlation; Correlation analysis; Correlation coefficient; Correlation coefficients; Cortex (motor); Diffusion; Diffusion Tensor Imaging - methods; Displacement; Disruption; Glioma; Glioma - physiopathology; Gliomas; Health aspects; Hospitals; Human motion; Humans; Image acquisition; Infiltration; Injuries; Magnetic resonance imaging; Medicine and Health Sciences; Metastases; Motor task performance; Muscle strength; Muscular strength; Musculoskeletal system; Nervous system diseases; Neuroimaging; Patients; Pediatrics; Pilot Projects; Psychomotor Performance; Pyramidal tracts; Quality; Research and Analysis Methods; Risk factors; Spinal cord; Tumors; Variance analysis; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182795

Brain tumors in the corticospinal tract (CST) region are more likely to cause motor dysfunction. The aim of this study is to evaluate the effect of gliomas located in the CST region on motor function with diffusion tensor imaging (DTI) preoperatively.
Forty-five patients with histopathologically confirmed gliomas were included in this pilot study, in all cases (low-grade n = 13, high-grade n = 32) CST but not the motor cortex were involved by the tumor. DTI image were acquired and the posterior limb of the internal capsule fractional anisotropy (FA) and relative FA (rFA = affected FA/contralateral FA) were measured. Injury of the CST from tumor was divided into three grades (grade 1: displacement, grade 2: displacement and infiltration, grade 3: displacement and disruption). The fiber density index (FDi) and relative FDi (rFDi = affected FDi/contralateral FDi) of the injured and contralateral CST were measured. The correlations between muscle strength and the CST injury grade and the rFA, affected FDi, rFDi values were calculated using Spearman rank correlation analysis. rFA and rFDi values of muscle strength groups (MMT2-5) were compared with one-way analysis of variance (ANOVA). The difference of muscle strength between low- and high-grade glioma groups were analysed with the Mann-Whitney U-test.
Muscle strength was negatively correlated with the injury grade of the CST (r = -0.840, P<0.001). Muscle strength was positively correlated with rFA, FDi and rFDi (correlation coefficients (r) were 0.615, 0.643 and 0.567 for rFA, FDi and rFDi, respectively). The rFA values between grades (2&3, 2&4, 2&5, 3&5, 4&5) of muscle strength were significantly different (P<0.05), the rFDi values between grades (2&4, 2&5, 3&4, 3&5) of muscle strength were significantly different (P<0.05), while the rFA and rFDi values in the remaining groups of muscle strength grades showed no significant differences(P>0.05).
Preoperative DTI and diffusion tensor tractography may quantify the injury degrees of CST and the extent of motor dysfunction in patients with brain glioma.