Research Paper Volume 13, Issue 11 pp 15139—15150
Dexmedetomidine inhibits unstable motor network in patients with primary motor area gliomas
- 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- 2 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- 3 State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
- 4 University of Chinese Academy of Sciences, Beijing 100049, China
- 5 CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
- 6 Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- 7 Department of Neurosurgery, Peking University International Hospital, Peking University Health Science Center, Beijing 102206, China
- 8 Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Received: January 7, 2021 Accepted: March 13, 2021 Published: May 25, 2021
https://doi.org/10.18632/aging.203077How to Cite
Copyright: © 2021 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Sedative agents such as dexmedetomidine have been found to transiently exacerbate or unmask limb motor dysfunction in patients with eloquent area brain gliomas. The present study aims to investigate whether dexmedetomidine can inhibit motor plasticity in patients with glioma via fMRI.
Methods: 21 patients with brain glioma were prospectively recruited between September 2017 and December 2018. Patients were classified into pre-M1 (primary motor cortex) group (n=9), post-M1 group (n=6), and non-eloquent group (control group) (n=6) according to the tumor position related to M1. The hand movement task-fMRI and resting state fMRI (rs-fMRI) were performed before and after sedation using dexmedetomidine. The lateralization index (LI) of activation voxels and magnitude and the functional connectivity (FC) of motor network were compared before and after sedation and among different groups.
Results: Permanent postoperative motor deficit of the upper limb was found in 5 of 6 patients in the pre-M1 group, and none in other groups (P < .01). Task-fMRI showed the LI of activation volume and activation magnitude at M1 significantly increased only in the pre-M1 group after sedation (P < .05). Rs-fMRI showed 60.0% (27 of 45) FCs of motor network decreased in pre-M1 group after sedation (p[FDR] < .05); whereas there was no FC reduction in post-M1 and control groups (p[FDR] > .05).
Conclusions: In patients with eloquent area gliomas, dexmedetomidine can inhibit the unstable compensative motor plasticity on both task- and rs-fMRI. fMRI may be a promising method for elucidating the effect of sedative agents on motor plasticity.
Abbreviations
FC: functional connectivity; FDR: false discovery rate; TR: repetition time; LI: lateralization index; LI-M: magnitude lateralization index; LI-V: volumetric lateralization index; M1: primary motor cortex; MNI: Montreal Neurological Institute; PMA: premotor area; PMd: dorsal premotor area; Rs-fMRI: resting state fMRI; SMA: supplementary motor area.