Mechanism of Aphasia and Recovery of Language After the Injury of Geschwind's Territory: a Study Based on the Brain Network Analysis

At present, functional imaging studies have suggested that the Geschwind's territory (the inferior parietal lobe) is an important language area. It is the hub for semantics and phonetic language processing. However, the type and mechanism of aphasia after injury of Geschwind's territory and the subsequent recovery of language are still unclear. In our study based on brain injury model of brain arteriovenous malformation (BAVMs) resection, investigators found that the incidence of aphasia was higher after the injury of Geschwind's territory than after injury of the classical language area, and the type of aphasia was complicated, while the recovery rate of language disorder was high during follow-up. Investigators hypothesized that the type of aphasia may be associated with the type of brain connectivity damaged, and that reorganization of brain connections and brain network promote the recovery of language function. In this study, we aim to investigate the types of aphasia and their corresponding brain network changes after the resection of BAVMs located in the Geschwind's territory. Investigators will evaluate language function and collect multimodality images of the patients before resection of the lesions, as well as 7 days, 3 months and 6 months afterwards. In addition, the anatomical brain connectivity and brain network will also be analyzed. Our research will not only be a meaningful exploration for mechanisms of human language function damage and reorganization, but will also provide an important basis for the protection of brain function in neurosurgery.

Study Overview

• Status: Unknown
• Conditions: Language; AVM - Cerebral Arteriovenous Malformation
• Intervention / Treatment: Procedure: Surgical removal of the BAVMs

• Study Type: Observational
• Enrollment (Anticipated): 80

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100070
      • Recruiting
      • Beijing Tiantan Hospital, Capital Medical University
      • Contact: Yuming Jiao, MD; Phone Number: 8615010108242; Email: shengxiongyuming@163.com
      • Contact: Weilun Fu, MD; Phone Number: 8618611165669; Email: doctorfwl@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

In this study, we will recruit 40 patients with BAVMs located in Geschwind's area, and recruit 40 healthy subjects as healthy control.

Description

Inclusion Criteria:

1. Signed the informed consent form;
2. The dominant hand is the right hand (evaluated by the Edinburgh hand scale);
3. BAVM located in the left inferior parietal lobe
4. No history of rupture and bleeding and neurosurgical treatment

Exclusion Criteria:

1. There are implants in the body (cardiac pacemaker, artificial femoral head, etc.);
2. The dominant hand is unclear;
3. Illiterate or other patients who can not cooperate well with cognitive function tests;
4. The history of bleeding in BAVM patients within one month;
5. History of neurosurgical treatment.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Healthy controls
Geschwind's area BAVMs	Procedure: Surgical removal of the BAVMs; Resection the BAVM nidus by microsurgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Brain network of BAVMs in Geschwind's area	compare the brain network of the Geschwind's area BAVMs patients and normal controls	2 years
Brain network after injury of Geschwind's area	compare the preoperative and postoperative brain network of Geschwind's area BAVMs.	2 years
Brain network of the brain reorganization after surgery	After surgery, we compare the brain network before and after the reorganization.	3 years

Collaborators and Investigators

• Sponsor: Beijing Tiantan Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2020
• Primary Completion (ANTICIPATED): July 1, 2022
• Study Completion (ANTICIPATED): December 31, 2022

Study Registration Dates

• First Submitted: March 3, 2020
• First Submitted That Met QC Criteria: March 3, 2020
• First Posted (ACTUAL): March 5, 2020

Study Record Updates

• Last Update Posted (ACTUAL): March 10, 2020
• Last Update Submitted That Met QC Criteria: March 7, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Congenital Abnormalities; Cardiovascular Abnormalities; Nervous System Malformations; Vascular Malformations; Language Disorders; Communication Disorders; Intracranial Arterial Diseases; Speech Disorders; Central Nervous System Vascular Malformations; Arteriovenous Malformations; Aphasia; Intracranial Arteriovenous Malformations
• Other Study ID Numbers: 81901175

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No