Language Function Reorganization in Patients With Arteriovenous Malformations

Condition(s) studied

Investigational drug(s) / intervention(s)

MRI: All participants underwent MRI scans

Study summary

Brain arteriovenous malformation (AVM) is generally considered as a congenital lesion. Its unique clinical manifestation is that when the unruptured AVM involves and destroys the language function area of the left hemisphere, the patient has almost no language disorder. This phenomenon is distinct from those of acquired diseases such as cerebral infarction and gliomas. There is a hypothesis that it might be associated with that the occurrence of AVM is earlier than period of language learning. Therefore, patients with AVMs involving language areas can be regarded as population whose language areas are congenital "knocked out" but the language functions remain normal, which provide a special model and new insights for language reorganization research. Previous studies have found that the right hemisphere plays an important role in the remodeling of language function in patients with AVMs, but the specific mechanism remains unclear. The purpose of this study is to further elaborate the role of the right cerebral hemisphere in the reorganized language network and the interhemispheric interaction mechanisms in patients with AVMs involving the language areas, using multimodal magnetic resonanceimaging and from multiple dimensions such as functional remodeling, white matter pathway remodeling, structural remodeling, etc., so as to further understand the remodeling mechanism of the Chinese language network after damage of language areas, and also to provide a theoretical basis for the protection of language function in brain network surgery.

Eligibility

Primary outcome measure(s)

• Structural MRI (sMRI) Primary Metric — baseline and three months after surgery
  Cortical thickness of bilateral language-related brain regions (measured via FreeSurfer); intergroup differences between AVM patients and healthy controls
• Functional MRI Secondary Metrics — baseline and three months after surgery
  Resting-state regional brain activity: Amplitude of Low Frequency Fluctuation (ALFF) and Regional Homogeneity (ReHo) Dynamic effective connectivity (DCM): Excitatory/inhibitory effective connectivity between lesioned left hemisphere and remodeled right hemisphere regions
• Diffusion MRI (dMRI) Primary Metrics — baseline and three months after surgery
  White matter microstructural integrity: Fractional Anisotropy (FA, DTI) and Neurite Density Index (NDI, NODDI) of language-related white matter tracts Corpus callosum diffusion metrics (FA, NDI) reflecting interhemispheric communication

Trial sites (1)

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