2021 Fiscal Year Final Research Report

Characteristics of brain functional shift accompanied with brain tumor

Research Project

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Project/Area Number	20K21649
Research Category	Grant-in-Aid for Challenging Research (Exploratory)
Allocation Type	Multi-year Fund
Review Section	Medium-sized Section 56:Surgery related to the biological and sensory functions and related fields
Research Institution	Kanazawa University
Principal Investigator	Nakada Mitsutoshi 金沢大学, 医学系, 教授 (20334774)
Co-Investigator(Kenkyū-buntansha)	篠原治道金沢大学, 医学系, 客員教授 (20135007) 木下雅史金沢大学, 医学系, 講師 (50525045) 中嶋理帆金沢大学, 保健学系, 助教 (60614865)
Project Period (FY)	2020-07-30 – 2022-03-31
Keywords	脳腫瘍 / 覚醒下手術 / 機能シフト / 可塑性 / 運動 / 言語 / 高次脳機能
Outline of Final Research Achievements	This study aimed to clarify the limits of the functional shift by tumor invasion to functional brain regions. In this study, we identified the characteristics of functional shift and hub regions of brain function, including motor, language, and other neuropsychological functions. The functional area of movement shifted either within or across the precentral gyrus. The functional shift was developed by tumor infiltration in the primary motor area and repeated surgeries. For the language function, as the tumor extended to the classical language area, it shifted to the surrounding gyrus. Furthermore, we speculated that the neuropsychological functions, including emotion recognition, working memory, and visuospatial cognition, were shifted to the surrounding areas in the patients with brain tumors since the areas identified as functional localizations were more extensive than that of the areas shown previously.
Free Research Field	脳腫瘍学
Academic Significance and Societal Importance of the Research Achievements	従来、脳の解剖学的機能野や主要神経線維は損傷により重篤な障害を残すため「触れてはいけない領域」と認識されてきた。本研究では、ヒト脳機能を直接的に調べることができる覚醒下手術の知見に基づいて機能シフトの特徴と機能シフトの限界を明らかにした。本研究結果は、解剖学的には機能領域であったとしても、覚醒下手術などによる術中モニタリング下で積極的な外科的摘出の対象領域であることを示唆している。従来の脳神経外科手術の常識を覆すのみならず、脳科学への貢献度が高く学術的意義が大きい。また、病変摘出率は生命予後の延長に直結することから医学的・社会的意義は大きい。