Altered Brain Structural Networks in Patients with Brain Arteriovenous Malformations Located in Broca’s Area

Abstract

Focal brain lesions, such as stroke and tumors, can lead to remote structural alterations across the whole-brain networks. Brain arteriovenous malformations (AVMs), usually presumed to be congenital, often result in tissue degeneration and functional displacement of the perifocal areas, but it remains unclear whether AVMs may produce long-range effects upon the whole-brain white matter organization. In this study, we used diffusion tensor imaging and graph theory methods to investigate the alterations of brain structural networks in 14 patients with AVMs in the presumed Broca’s area, compared to 27 normal controls. Weighted brain structural networks were constructed based on deterministic tractography. We compared the topological properties and network connectivity between patients and normal controls. Functional magnetic resonance imaging revealed contralateral reorganization of Broca’s area in five (35.7%) patients. Compared to normal controls, the patients exhibited preserved small-worldness of brain structural networks. However, AVM patients exhibited significantly decreased global efficiency ( p = 0.004 ) and clustering coefficient ( p = 0.014 ), along with decreased corresponding nodal properties in some remote brain regions ( p < 0.05 , family-wise error corrected). Furthermore, structural connectivity was reduced in the right perisylvian regions but enhanced in the perifocal areas ( p < 0.05 ). The vulnerability of the left supramarginal gyrus was significantly increased ( p = 0.039 , corrected), and the bilateral putamina were added as hubs in the AVM patients. These alterations provide evidence for the long-range effects of AVMs on brain white matter networks. Our preliminary findings contribute extra insights into the understanding of brain plasticity and pathological state in patients with AVMs.

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

“…We previously enrolled 14 patients with AVMs involving Broca area, and results showed enhancement of structural connectivity in perifocal areas. 18 It provided evidence that perilesional WM plasticity existed in AVM patients, but the detailed fascicles remain unclear.…”

“…This model is quite special, and brain AVM meets all these requirements, but the studies are limited. 8,[18][19][20] The investigation of language plasticity in brain AVM might contribute to the comprehensive understanding of language network mechanism.…”

Discernible interindividual patterns of global efficiency decline during theoretical brain surgery

“…It is also worth mentioning that other graph measures alone or in combination with GE may also be useful in quantifying postoperative deficits and improve the creation of personalized neurosurgical plans, but additional research is necessary to validate www.nature.com/scientificreports/ these approaches 62,63 . Future work may also attempt to correlate clinical outcomes with percolated structural networks in a prospective manner following localized brain surgery 64 . Linking ideas from the current study with such investigations provides a critical goal moving forward to continue to maximize the patient's oncofunctional balance.…”

A case series of gyrus rectus arteriovenous malformation: Clinical characteristics, angioarchitecture, microsurgical treatment, and outcome

“…They lead to arteriovenous shunting of blood and cause surrounding neural tissue to become nonfunctional or calcified, which may contribute to the development of seizures and another neurological phenomena. [ 1 , 3 , 4 , 11 , 16 ] They represent about 10–15% of all vascular malformations of the central nervous system. In the posterior fossa, the majority of AVMs are located in areas such as the cavernous, sigmoid, or transverse sinus, whereas supratentorially, they can be located in the gyrus rectus region with high predilection for intracerebral hemorrhage (ICH).…”