Effect of Diffuse Glioma with Precentral Gyrus Invasion on Interhemispheric Brain Activation： A Task-based FMRI Study / 中山大学学报(医学科学版)

ObjectivesTo explore the effect of diffuse glioma with precentral-gyrus invasion on fMRI activation maps by grasping T-fMRI. MethodsA total of 56 diffuse glioma patients were divided into precentral-gyrus invasion （PGI： n=21） and precentral-gyrus non-invasion （PGNI： n=35） groups. Three statistical thresholds （P value： 10-4， P1； 10-6， P2； 10-8， P3） were set to obtain the activation maps accordingly （V1， V2 and V3）. The interhemispheric and bilateral precentral gyrus activation volumes ratios （IAVR and PAVR） were calculated， respectively. The activation volumes ［△V1=V1-V2； △V2=V2-V3； △Vn （ipsilateral）/△Vn’ （contralateral）， n=1， 2］ within two statistical thresholds and the corresponding interhemispheric ratio was further compared. In addition， the associations of tumor characteristics with IAVR and PAVR were analyzed. ResultsCompared with PGNI， PGI showed significantly decreased IAVR at p1， and the same trends of PAVR in PGI at P1 and P2 （P＜0.05）. However， neither IAVR nor PAVR showed significant differences at P3. PGI showed significantly lower ratios of △V1/△V1’ than PGNI （P=0.02）， except for △V2/△V2’. Additionally， within PGI， PAVR was negatively correlated with tumor volume （P=0.043）， and the distance from the tumor to the hand-knob was positively correlated with the IAVR and PAVR （P＜0.05）. ConclusionDiffuse glioma invading eloquent areas tended to affect interhemispheric asymmetry of activation at relatively lower statistical thresholds than diffuse glioma without invasion， rather than stricter statistical thresholds. Multiple ranges of statistical thresholds were recommended to analyze T-fMRI.

Metabolism Levels in Precentral Gyrus of Patients after Spinal Cord Injury / 中国康复理论与实践

Objective:To investigate the changes of metabolite concentration in the precentral gyrus (primary motor cortex, M1) in spinal cord injury (SCI) patients. Methods:From December, 2018 to October, 2019, 20 SCI patients and 15 healthy controls were scaned with magnetic resonance spectroscopy to measure the concentrations of N-acetylaspartate (NAA), choline (Cho), creatine (Cr) and myo-inositol (MI) in region of interest (ROI) of left M1. Results:Concentration of MI was more in the patients than in the controls (t = 3.745, P < 0.01). There was no significant difference in the concentrations of NAA, Cho and Cr, as well as the ratios of NAA/Cr, Cho/Cr, Cho/NAA between the patients and the controls (t < 1.431, P > 0.05). Conclusion:There may be hyperplasia of glial cells in M1 of SCI patients, indicating compensatory repair in cerebral motor cortex.

Supratentorial Intracerebral Schwannoma : Its Fate and Proper Management

Intracerebral schwannomas are rare and there have been none reported in Korea. We present the case of a 25-year-old man with newly developed right-side weakness and recent seizure aggravation. His seizures started approximately 9 years prior to admission. At that time, a 1 cm diameter intra-axial enhancing mass at the left precentral gyrus was found on magnetic resonance image (MRI). After 9 years of observation and treatment with antiepileptic medication, an MRI taken due to symptom aggravation revealed peri-tumoral cyst formation with tumor enlargement. The tumor was surgically removed. Subsequently, right-side weakness diminished and there was good seizure control. Pathologic diagnosis was schwannoma. Schwannoma is a very rare tumor and there are no pathognomonic findings on radiologic images; thus, it is challenging to make a correct diagnosis. However, considering the natural course and excellent prognosis after surgical treatment of this kind of intra-axial mass with benign features, early surgery for diagnosis and proper treatment is highly recommended.

Isolated Shoulder Weakness due to a Small Cortical Infarction

Small cortical infarctions can produce isolated motor paresis in the upper extremities. Several cases of isolated hand or finger paresis have been reported, but isolated shoulder weakness is extremely rare. We report here a patient who developed isolated shoulder weakness due to a small cortical infarction in the medial precentral gyrus.

Isolated Weakness of Middle, Ring, and Little Fingers due to a Small Cortical Infarction in the Medial Precentral Gyrus

Small cortical strokes can produce predominant isolated weakness in a particular group of fingers: radial or ulnar. The traditional views are of point-to-point representations of each finger to neurons located in the precentral gyrus of the motor cortex such that the neurons of the radial fingers are located laterally and those of the ulnar fingers are located medially. We present a case of isolated weakness of middle, ring, and little fingers due to a small cortical infarction in the medial precentral gyrus.

Characteristics of proton magnetic resonance spectroscopy on precentral gyrus in 92 healthy Chinese adults / 中国康复理论与实践

@#ObjectiveTo explore the characteristics of the metabolite concentrations of the precentral gyrus in healthy Chinese adults using proton magnetic resonance spectroscopy (1H-MRS).Methods 1H-MRS was carried out in 92 healthy Chinese adult volunteers. The metabolite ratios of NAA/Cr, Cho/Cr and NAA/Cho were compared and analysed.ResultsNo significant changes of NAA/Cr, Cho/Cr and NAA/Cho ratios were observed between the left and right precentral gyrus, nor between the male and female. However, the precentral gyrus NAA/Cr and NAA/Cho ratios were decreased gradually with aging and Cho/Cr ratios were increased gradually with aging.ConclusionThe characteristics of the precentral gyrus metabolite concentrations in healthy Chinese adults have been obtained.