Structural changes in eloquent cortex secondary to glioma in sensorimotor area

Abstract

This study aims to investigate the structural reorganization in the sensorimotor area of the brain in patients with gliomas, distinguishing between those with impaired and unimpaired strength. Using voxel-based morphometry (VBM) and region of interest (ROI) analysis, gray matter volumes (GMV) were compared in the contralesional primary motor gyrus, primary sensory gyrus, premotor area, bilateral supplementary motor area, and medial Brodmann area 8 (BA8). The results revealed that in patients with right hemisphere gliomas, the right medial BA8 volume was significantly larger in the impaired group than in the unimpaired group, with both groups exceeding the volume in 16 healthy controls (HCs). In patients with left hemisphere gliomas, the right supplementary motor area (SMA) was more pronounced in the impaired group compared to the unimpaired group, and both groups were greater than HCs. Additionally, the volumes of the right medial BA8 in both the impaired group were greater than HCs. Contralateral expansions in the gray matter of hand- and trunk-related cortices of the premotor area, precentral gyrus, and postcentral gyrus were observed compared to HCs. Furthermore, a negative correlation was found between hand Medical Research Council (MRC) score and volumes of the contralateral SMA and bilateral medial BA8. Notably, our findings reveal consistent results across both analytical approaches in identifying significant structural reorganizations within the sensorimotor cortex. These consistent findings underscore the adaptive neuroplastic responses to glioma presence, highlighting potential areas of interest for further neurosurgical planning and rehabilitation strategies.

Keywords: ROI analysis; VBM; glioma; neuroplasticity; sensorimotor area.

FIGURE 1

The tumor overlapping map of all enrolled patients. The color of each voxel indicates the number of overlap (1–20).

FIGURE 2

Brain regions showing significant changes in GMV. Comparisons of GM volume in different brain areas between HCs, glioma patients with impaired hand muscle strength and glioma patients with unimpaired hand muscle strength with the corresponding mask after controlling effects for age, tumor volume, and total intracranial volume. The two‐sample t test map (volume mapping to surface) of (a) Right SMA between the impaired group and the unimpaired group with left‐side gliomas. (b) Right SMA between the impaired group with left‐side gliomas and HCs. (c) Left SMA between the unimpaired group with left‐side gliomas and HCs. (d) Right SMA between the unimpaired group with left‐side gliomas and HCs. (e) Right SMA between the unimpaired group with right‐side gliomas and HCs. (f) Left SMA between the unimpaired group with right‐side gliomas and HCs. (g) Right medial BA8 between the impaired group with left‐side gliomas and HCs. (h) Right medial BA8 between the unimpaired group with left‐side gliomas and HCs. (i) Left medial BA8 between the impaired group and the unimpaired group with right‐side gliomas. (j) Right medial BA8 between the impaired group and the unimpaired group with right‐side gliomas. (k) Right medial BA8 between the unimpaired group with right‐side gliomas and HCs.

FIGURE 3

Comparison of GMV among different groups. (a) Localization of the regions of interest in the brain. Comparison of GMV in the supplementary motor area (b), medial Brodmann area 8 (c), superior frontal gyrus (d), middle frontal gyrus (e), postcentral gyrus (f), postcentral gyrus (g), and superior occipital gyrus (h). *p < .05; **p < .01; ***p < .001; ns, no significance.

FIGURE 4

Volume changes of in sensorimotor area patients with different degrees of hand muscle strength impairment. Correlation of brain mask volumes and hand MRC score in sensorimotor area glioma patients: (a) ipsilateral medial BA8; (c) contralateral medial BA8; (e) contralateral SMA. Volume differences in the sensorimotor area between glioma patients with normal hand muscle strength (Score 5) and those with impaired hand muscle strength (Score 0–4): (b) ipsilateral medial BA8; (d) contralateral medial BA8; (f) contralateral SMA. **p < .01; ***p < .001.