Impairment and Plasticity of Language-Related White Matter in Patients With Brain Arteriovenous Malformations

Author:

Deng Xiaofeng12ORCID,Yin Hu12,Zhang Yan12,Zhang Dong12ORCID,Wang Shuo12ORCID,Cao Yong12,Li Maogui12,Wang Bo345,Zong Fangrong45ORCID,Zhao Jizong12ORCID

Affiliation:

1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China (X.D., H.Y., Y.Z., D.Z., S.W., Y.C., M.L., J.Z.).

2. China National Clinical Research Center for Neurological Diseases, Beijing (X.D., H.Y., Y.Z., D.Z., S.W., Y.C., M.L., J.Z.).

3. Hefei Comprehensive National Science Center, Institute of Artificial Intelligence, China (B.W.).

4. Institute of Biophysics, Chinese Academy of Sciences, Beijing (B.W., F.Z.).

5. University of Chinese Academy of Sciences, Beijing (B.W., F.Z.).

Abstract

Background and Purpose: Language dysfunction is rarely seen in patients with unruptured brain arteriovenous malformation (AVM) albeit the AVM nidus involving language areas, which provides a unique disease model to study language reorganization. The objective of this study was to investigate the impairment and reorganization patterns and characteristics of language-related white matter in AVMs located at different brain areas. Methods: Thirty-three patients with AVMs involving language areas were prospectively enrolled. Patients were categorized into 3 groups according to the lesion locations: the frontal (14 patients), temporal (15 patients), and parietal groups (4 patients). Thirty age- and sex-matched healthy controls were enrolled as comparison. All participants underwent diffusion tensor imaging scans, and automated fiber quantification method was applied to quantitatively study the difference of segmented language-related white matter connectivity between 3 AVM groups and control group. Results: Language functions were normal in all subjects according to Western Aphasia Battery test. In the frontal group, fractional anisotropy (FA) value decreased in the left arcuate fascicle and increased in left superior longitudinal fasciculus and uncinate fascicle; in the temporal group, FA values decreased in left inferior fronto-occipital fascicle and inferior longitudinal fascicle and increased in right anterior thalamic radiation and uncinate fascicle; in the parietal group, FA values decreased in left arcuate fascicle and inferior longitudinal fascicle and increased in bilateral anterior thalamic radiations and uncinate fascicles and right inferior fronto-occipital fascicle. In fascicles with decreased FA values, the increase of radial diffusivity was common, and fascicles with increased FA values usually presented along with increased axial diffusivity values. Conclusions: Remodeling of language-related white matter occurs when traditional language areas are involved by AVM nidus, and its reorganization patterns vary with locations of AVM nidus. Fascicle impairment is mainly caused by the myelin deficits, and its plasticity may be dominated by the axon remodeling procedure.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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