Executive Function And Resting FMRI Study In Frontal Lobe Low-grade Glioma Patients

ObjectiveTo study whether executive function was impaired in frontal lobe low-grade glioma(LGG) patients and find related functional brain areas. To investigate the possible methods the executive function is impaired and reconstructed. When using the operation treatment of frontal LGG, the results of this study can improve the neurosurgeon to protect brain function, further improve the quality of life of patients and prognosis.MethodsAccording to the formulation of the inclusion criteria: 1. According to preoperative imaging data, the tumors were most likely to be LGG located in the frontal lobe, and excluded the possibility of other brain and mental illness, such as infarction, inflammation, dementia, depression etc. 2. Had normal ability of vision, language, expression, understanding, and more than 4 year education. 3. After operation treatment, to obtain pathological results. Exclusion criteria: The patients were more than 65 years old, or metastasis, or choosing non operation treatment. According to the frontal LGG patients collected(case group) matched normal subjects(control group), collected of basic data of 15 cases and 15 controls, and excluded of demographic differences. Stroop color-word test(CWT) was applied in patients and healthy controls to investigate the executive function by calculating the two groups response accuracy, average response time, the difference of average response time. Rest-state bloodoxygenation level dependent functional MRI(BOLD-f MRI) data were collected from the frontal lobe LGG patients and healthy controls. Regional homogeneity(Re Ho) approach was also applied for rest-state BOLD-f MRI data analysis and then calculated the different areas in two groups which showed in Canada Montreal Neurological Institute template.Results1. In CWT, the accuracy and the average response time were significantly differences between patients and healthy controls(P<0.05). The difference of average response time of patients was longer than controls, but had no significant difference(P>0.05). 2. Patients showed increased brain regions in Re Ho in the resting state compared with controls. The increased Re Ho was distributed over bilateral inferior temporal gyrus, bilateral middle temporal gyrus, right fusiform gyrus, right occipital gyrus. 3. Patients showed decreased brain regions in Re Ho in the resting state compared with controls. The decreased Re Ho was found in right caudate, bilateral cingulated gyrus, left medial frontal gyrus, right post central gyrus.Conclusion1. Executive function in frontal lobe low-grade glioma(LGG) patients was impaired and might be compensated. 2. In frontal lobe LGG patients, BOLD-f MRI showed decreased neuronal activities of right caudate, bilateral cingulated gyrus, left medial frontal gyrus, and right post central gyrus, and suggested that these parts of the brain were significantlycorrelated with executive function. 3. In frontal lobe LGG patients, BOLD-f MRI showed increased neuronal activities of bilateral inferior temporal gyrus, bilateral middle temporal gyrus, right fusiform gyrus, right occipital gyrus, and suggested that these parts of the brain might compensate for the impaired executive function.